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What do you tell clients who fear that someone they know and love might pose a threat to himself or others?
The news of the shooting of an Arizona congresswoman and 18 others, including a federal judge and a nine-year-old girl, who died, and the arrest of an apparently mentally disturbed unemployed 22-year-old for the acts, horrified all who heard it.
Media reports that a few months earlier his college had suspended the man and notified him and his parents that he would not be allowed to return without a letter from a mental health professional saying that he did not pose a threat to himself or others, suggests a question for lawyers: How should you advise clients who tell you that they're worried about their child, or someone they know, and fear that a similar tragedy might ensue?
"Honey, why did you bring a gun home?"
Professor Mark Heyrman of the University of Chicago, who drafted Illinois's current standard for involuntary commitment under the Mental Health and Developmental Disabilities Code (405 ILCS 5/1-100 et seq), addressed that difficult question for LawPulse. As in any matter, Heyrman suggests, get all the information you can before recommending a course of action.
"What's the basis for your clients' concern?" Heyrman asks. As threshold matters, find out whether your clients think that their child is seriously mentally ill, whether they think the child is getting worse, and whether they believe he or she might pose a threat to someone.
If the answers are yes, why have they arrived at those conclusions? One good question for your clients, Heyrman says, is whether they've noticed troubling behavior on their child's part. Has the child been making threats, or engaging in unusual or strange behavior? Put up posts on social networks suggesting the desire to hurt somebody? Brought a weapon home, despite never before showing any interest in marksmanship or hunting?
"It's not illegal to own a gun," Heyrman observes, and most mentally ill people are not violent. "But why is this person going out to get one? It's perfectly reasonable to say to someone who lives in your home 'Honey, why did you bring a gun - or a knife, or another weapon - home?'"
Though the child might just be planning on going deer hunting when the season opens, it could also be a signal that he is afraid, Heyrman says. And fear can lead persons to take steps to protect themselves that may or may not be reasonable.
If your inquiries suggest that your clients' concerns are well founded, Heyrman suggests trying to resolve those concerns informally before resorting to legal action. "See if you can get the person to go voluntarily, to a community health provider of some kind or even an emergency room. Often the person will agree to go."
Mental health professionals have training and skills that parents and lawyers do not, Heyrman observes. "They can engage the person without any type of coercion and make an assessment" of the person's mental condition.
If that doesn't work, Heyrman says, your clients may institute an involuntary commitment proceeding as long as they're 18 or older. 405 ILCS 5/3-701. If they convince the state's attorney of their county that their child meets the statutory standards, the state's attorney will handle the matter. 405 ILCS 5/3-101. The state's attorney's offices in some of Illinois's larger counties, including Cook, have dedicated telephone numbers and personnel who handle involuntary commitments, Heyrman says.
405 ILCS 5/1-119 and 1-119.1 define the conditions under which persons may be hospitalized or involuntarily admitted as outpatients without their consent for mental health treatment. Essentially, persons must be mentally ill and, because of their mental illnesses, are expected to put themselves or others at risk of physical harm or are unable to provide for their basic needs so as to put themselves or others at risk of serious harm unless treated on either an outpatient or an inpatient basis. Article VII of the statute sets forth the procedures that those seeking to involuntarily commit a person must follow.
Initiating involuntary commitment proceedings does not necessarily mean that the person will or should be committed, Heyrman says. But even if the petition ultimately fails, there may be a benefit to the person and the community. "It allows you to begin the process of evaluation," Heyrman says, which is the first step toward getting help for the person.
Heyrman says there are no longer any real legal roadblocks in Illinois to getting care and treatment for the mentally ill. The major current challenge to adequate treatment, he says, is budgetary.
"Almost every community mental health service provider I've heard of has laid off staff and reduced services." In Heyrman's view, "the most cost-effective thing we could do to fix our mental health system is to provide more of these services. If you don't have them, people are going to end up in more expensive places," including emergency rooms and prison.
For Heyrman, adequate funding is about the suffering of the mentally ill and their families even more than general safety. "Homelessness, loss of employment, divorces, harm, if only psychic harm, to children, highly expensive hospitalizations, and the occasional violent act" are all common and expensive ills that could be mitigated with adequate mental health funding, he believes.