Pennsylvania bill aims to boost support for mentally ill

March 23, 2018 | By Dave Lemery

When residents of Pennsylvania begin to exhibit signs of mental health issues, officials say, there’s often nothing that anyone can do to intervene unless a person becomes an immediate danger to themselves or to others.

That’s poised to change as the state legislature is moving closer to implementing a program known as assisted outpatient treatment. A bill creating that standard passed in the House on a unanimous vote in 2017, and it was taken up by the Senate Health and Human Services Committee recently, where it also found a receptive audience.

The House sponsor of the bill, Rep. Thomas Murt, R-Hatboro, appeared before the Senate committee to explain what assisted outpatient treatment does.

“House Bill 1233 changes the Mental Health Procedure Act to establish a different standard for assisted outpatient treatment, or court-ordered outpatient treatment,” he said. “At the present time, the standard for outpatient commitment, as well as inpatient commitment, is the same as that clear and present danger standard. The new standard will allow families and mental health professionals to intervene earlier, before the person decompensates to the point of being dangerous, to get them into treatment.”

Murt described the current code as out of date, not having been significantly updated since the 1970s. He said that 46 other states have already adopted assisted outpatient treatment. He also noted that his bill created no financial obligations on Pennsylvania’s counties because any expenditures contained within the bill were voluntary.

The committee’s chairman, Sen. Lisa Baker, R-Dallas, lauded Murt for designing the bill in such a way that it didn’t place a fiscal burden on counties. The vice chairman, Sen. Judith Schwank, D-Reading, agreed, noting that it might even help reduce some government costs.

“I’ve spoken to my county about the possible cost associated with this, … but I’ve also thought, and you mentioned this, representative, the fact that in many cases county jails are filled with people with mental health issues that should not be there necessarily,” Schwank said. “This process, I think, will help to avert that and the cost associated with that.”

Murt noted that Pennsylvanians with mental health issues are twice as likely to wind up incarcerated as they are to receive treatment, an issue that particularly affects veterans.

“As a veteran myself of the war in Iraq, I know many veterans that struggle with mental health issues and are homeless in my hometown of Philadelphia,” he said.

Baker offered an amendment that further strengthened the bill’s language to emphasize the voluntary participation of county mental health agencies and to specify what sorts of mental health professionals would be required to perform court-ordered examinations.

“It’s my hope that this amendment makes it clear that this will not cost the counties anything,” she said. “In addition, the amendment redefines a mental health professional in a manner that is now consistent with other [state Department of Human Services] requirements [and] requires a treatment plan to be approved by a psychiatrist or a licensed clinical psychologist.”

The bill seeks to maintain the state’s posture emphasizing voluntary engagement in treatment, Murt said, and it makes sure to keep civil liberties intact.

“The bill is very careful about protecting civil liberties and making sure that … constituents that struggle with mental illness are afforded full due process and their civil liberties,” he said. “The new criteria … is very stringent. A person has to meet all of the criteria in order to be considered for this assisted outpatient treatment. … It is a non-punitive, civil process, it is not a criminal process.”

Sen. Sharif Street, D-Philadelphia, echoed an earlier comment from Murt that improved mental health treatment would also be beneficial to combatting issues such as the opioid epidemic in the state.

“I think we have to recognize that … addiction is a mental health challenge, and when people have mental health challenges, they can’t always make the best decisions for themselves,” he said. “I think it’s very appropriate that we have a mechanism other than incarceration to help people through those challenges.”

The committee approved Baker’s amendment and the bill unanimously, and it will move to the full Senate for further consideration. If the Senate approves it, the two chambers will have to reconcile any changes to the bill that have arisen in the Senate before it can move on the the governor for his consideration.