Tuesday, March 28, 2017

Gov. ignores guardianship crisis with veto


John Snook, Treatment Advocacy Center 6:32 p.m. ET March 28, 2017 



Governor Matt Bevin announced his veto of Tim’s Law, a commonsense bill passed nearly unanimously by the legislature to provide needed care for the most severely mentally ill. Unfortunately, the veto evidences both a misunderstanding of both the nature of the bill and the public health crisis it would address.


The veto message mentions personal liberty, but the failing status quo poses far more of a threat. Without Tim’s Law, Kentuckians with severe mental illness regularly become caught in a revolving door of crises and jailings. Kentucky jailers report about a quarter of inmates at Louisville Metro Department of Corrections and Campbell County jail receive medication for psychiatric disorders. Few would argue that care in the community under Tim’s Law is a greater infringement than a jail cell.



Those who avoid jail frequently end up wards of the state. The Kentucky Department of Aging and Independent Living reports courts increasingly rely on state guardianships for individuals with mental illness who don’t stay in treatment. Active wards now number almost 4,000 – a 227 percent increase over eight years. These guardianships are far more restrictive than Tim’s Law treatment orders but ill-suited to the task of actually ensuring treatment for the most severely ill. As a result, the Commonwealth of Kentucky and the individual guardians have liability for wards with severe mental illness but no power to address their needs.


In contrast, programs like Tim’s Law have been proven, in both independent studies and in practice in states across the country, to be the key to getting this population the help they need to become stable in the community. Forty-four states already have laws like Tim’s Law on the books.


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Communities as diverse as Summit County, Ohio; Orange County, California; and New York City all report significant reductions in incarcerations, hospitalizations and costs from the use of programs mirroring Tim’s Law. Groups such as the National Sheriffs Association, the International Chiefs of Police, the American Psychiatric Association and the National Alliance on Mental illness all support the program.


An even more pertinent measure of the impact on liberty is what those in programs like Tim’s Law actually say. Researchers from Columbia University surveyed those in a similar program in New York State, 75 percent said it helped them gain control of their lives, while 81 percent said it helped them to get and stay well. Rather than a violation of their liberties, 88 percent of participants said that they and their case manager agreed on what is important for them to work on.


Under Tim’s Law, the individual would follow a court-ordered treatment plan only after a hearing and order by a judge, and only for the specified period of time. Both the county and the individual have the right to ask the court to review and modify the treatment order as needed. Tim’s Law is, by design, the least restrictive option needed for the individual to live safely within the community, and would apply only to the small number of Kentuckians who are so sick that they have been hospitalized, involuntarily, at least twice in one year.


Tim’s Law would stem the mounting public health crisis posed by untreated mental illness and address the skyrocketing costs for public mental health services. It is an option that Kentucky needs and which is already long overdue. To help the most severely ill, Kentucky must override the Governor’s veto.

John Snook is the executive director of the Treatment Advocacy Center.

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