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Friday, 15 December 2017

July 11 Hearing

STATE HOUSE, BOSTON, JULY 11, 2017.....People who were involuntarily committed to hospitals and who dropped medicine regimes that made them feel worse told lawmakers about their experiences in the mental health system Tuesday as they spoke against bills they said would allow courts to order outpatient treatment.

Opponents of the bills described them as restrictive and said policymakers should instead funnel more resources into voluntary, peer-based supports that allow people to choose paths to recovery that work for them.

"Taking away people's civil liberties in the name of treatment is simply wrong and doesn't work," Ruthie Poole of M-POWER, an advocacy group representing current and former psychiatric patients, told members of the Committee on Mental Health, Substance Use and Recovery.

SHNS Audio: Mental Health, Substance Use and Recovery Committee hearing

Poole said she was twice involuntarily committed to a psychiatric unit after first responders took her from her home tied down to a gurney. She said she lost touch with reality while committed and her mental health "fared much better" when she was in control of her choices.

Members of M-POWER and others who had been treated for mental health conditions asked the committee to oppose three bills: Rep. Kay Khan's bill dealing with emergency treatment plans (H 1069); Rep. Mathew Muratore's proposal to establish court-ordered outpatient mental health treatment (H 1073); and legislation filed by the late Sen. Ken Donnelly (S 1087) setting procedures for petitioning courts to issue a "critical community health service treatment plan."

Khan's bill, according to her office, establishes the role of "treatment monitor" to oversee a court's treatment plan and report on a patient's compliance, in hopes of limiting the cycling of patients in and out of psychiatric hospitals when they stop taking medications.

Social worker Lynn Nanos spoke in support of the Donnelly and Muratore bills, telling the committee she had worked with people who were mentally ill and experienced a symptom of psychosis that made them unaware of their own illnesses, including one man who jumped off the Tobin Bridge to his death within a month of his discharge from an inpatient unit.

"We shouldn't wait for the next tragedy due to a lack of assisted outpatient treatment," she said.

Massachusetts has procedures in place that allow courts to order mental health treatment. A person can be involuntarily committed to a psychiatric facility if they are mentally ill and facing a likelihood of serious harm without a commitment, and there is no appropriate, less restrictive setting. Under what is known as Rogers guardianship, a Probate and Family Court judge can appoint a guardian to authorize "extraordinary medical treatment," such as antipsychotic medication, for a person deemed unable to make informed decisions.

According to the Treatment Advocacy Center, Massachusetts is one of five states that do not authorize involuntary treatment in the community, also known as assisted outpatient treatment.

Susan Fendell, a senior attorney with the Mental Health Legal Advisors Committee, said methods of "coercive" outpatient treatment may have unintended consequences, like causing people to eschew treatment altogether or avoid the people who make up their support systems, out of fear loved ones will put them into treatment.

"I don't think that we need to get to the point of having court proceedings if we are offering people options that are palatable to them," Fendell said. "And I think a lot of the problem is that our mental health system has relied too heavily on limited options, or even the options that are there are not available. We hear all the time about people waiting for [Department of Mental Health] housing. We hear all the time about people waiting to see a therapist. The problem is that we're not funding services that people would accept voluntarily."

Several speakers touted peer support services as potential alternatives. Thomas Brown, who described himself as a "survivor of really extreme physical and sexual violence" who first attempted suicide at 11, said he was over-medicated for years until finding therapists and psychopharmacologists who worked with him instead of engaging in a "top-down" treatment approach.

"What really finally helped more than anything was finding peer support," said Brown, who is now trained as a peer specialist. "When I found peer support I stopped wanting to die."

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