Twice in the past few years a Lawrence-area woman named Cait has had her freedom taken away from her.
Cait, who asked that her last name not be published, didn’t commit a crime, but she suffers from bipolar disorder and required being involuntarily committed to a psychiatric facility after police stopped her from attempting suicide by jumping from a bridge. Police took Cait into custody and she was eventually taken to Osawatomie State Hospital.
The involuntary mental health commitment process Cait experienced remains a misunderstood, but regular process in Kansas. In 2008, an average of three involuntary commitment petitions were filed with the Douglas County court weekly, and last year nearly 400 people were involuntarily committed to Osawatomie State Hospital.
Mental health workers and advocates say the process is an option of last resort for mentally ill individuals who pose a risk to themselves or others.
“It deprives someone of their civil liberties,” said Susan Crain Lewis, president and CEO of Mental Health America of the Heartland, a Kansas City, Kan.-based organization providing services to the mentally ill. Lewis said that’s why the process is reserved for cases where someone is an imminent threat to themselves or others.
She said that there remains a misperception that people acting bizarrely in the community should be hospitalized, despite the strict circumstances in which the involuntary commitment process occurs.
“It’s not a crime to be mentally ill,” Lewis said.
Kansas law mandates that in order for someone to be involuntarily committed for mental health reasons, they must pose a danger to themselves or others.
Ganice Heims, a mental health screener at Bert Nash, said this could include someone who is suicidal, poses a threat to someone else, or in cases when a mental illness severely affects people’s ability to take care of their basic needs.
In Lawrence, the process is usually initiated by mental health screeners at Bert Nash, who must first determine whether people meet the criteria for hospitalization.
If they meet the criteria, Heims said the first option is to convince them to go to a psychiatric facility voluntarily.
“Most of the time, they’re willing to go,” she said. But when not, mental health workers begin the process of an involuntary commitment by filing a petition with District Court. After the petition is filed, the person is taken into custody by law enforcement. The person is then cleared medically at a hospital and transported to a mental health facility, such as the state-run Osawatomie facility. Some may also go to a privately run psychiatric facility such as Cushing Memorial Hospital if they have medical insurance.
Once at a mental health facility, the goal is to stabilize the patient through medication adjustments and therapy, and the court continues to have authority to determine when someone should be released. Those committed are entitled to a hearing with a judge within 48 hours of their commitment to assess the need for continued in-patient treatment.
‘Not the solution’
While sometimes necessary, the involuntary commitment process is one that should be avoided, if possible, said Rick Cagan, executive director of the Kansas chapter of the National Alliance on Mental Illness.
“Going to the state hospital is not the solution,” Cagan said. “The goal is to treat them at the community level.”
Cagan said the expense, and trauma, of an involuntary commitment is too great, and efforts should be aimed at preventing hospitalization.
Those efforts should include educating family members, the public and police about how to deal with those experiencing significant mental health issues, Cagan said.
The involuntary commitment process can be a traumatic experience for those who go through it.
“One of the worst points of my life,” Cait said of the process. “(It’s) the ultimate feeling of hopelessness.”
Cait describes the humiliation of being handcuffed and transported to the courthouse with those going for criminal issues.
“It’s mortifying,” she said. “I didn’t commit a crime.”
Cait is now out of the hospital as her mental illness has stabilized, and she is assisting with efforts locally to organize crisis intervention training for police in how to handle encounters with the mentally ill.
And despite some of the problems Cait experienced, she said she is thankful she was committed and prevented from hurting herself.
“It was what was needed at the time,” she said.