FREDERICKSBURG, Va. - Members of a commission analyzing Virginia's mental health laws on Friday debated whether language dealing with civil commitments is too narrowly worded to force potentially dangerous people into treatment.
The laws have come under increased scrutiny since the April 16 shooting spree at Virginia Tech, where a mentally ill student killed 32 people and then himself. Seung-Hui Cho had been ordered into involuntary outpatient treatment by a judge in 2005, but there is no indication he ever received the treatment.
A study authorized by the Supreme Court of Virginia's Commission on Mental Health Law Reform and cited at the group's meeting Friday found that judges, psychiatrists, mentally ill people and their relatives are uniformly frustrated by almost every aspect of the state's civil commitment process.
More than 200 people interviewed in the study in 2006 and early 2007 complained that there are not enough beds in willing detention facilities, insufficient time for adequate evaluation, inconsistent interpretation of the law by judges and a lack of direction and oversight. The study also said that most of those who had been committed felt stigmatized and unfairly treated.
"In my opinion, the need for reform is irrefutable," said Richard Bonnie, chairman of the commission, which was created last year. "No one is satisfied with the current situation. The only question is how sweeping the reforms should be."
Bonnie also noted that Cho's case was unusual, and that the commission should be sure to avoid reinforcing "exaggerated associations between mental illness and violence."
The meeting's most spirited debate focused on the state's requirement that people involuntarily committed must pose an "imminent danger" to themselves or others or be "substantially unable to care for" themselves. Most states don't use the word "imminent" in conjunction with danger or harm, making it easier to force treatment.
Some suggested clarifying the meaning of "imminent danger" or eliminating the "imminent" standard altogether and replacing it with "in the near future."
Others argued that such revisions would only complicate matters and raise new questions - such as what "in the near future" means. They also said changing the standard could infringe on people's civil rights and lead to warehousing of the mentally ill.
Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services commissioner James Reinhard said during a break that changing the law's wording is pointless if adequate resources to care for patients aren't made available.
"I think the language is less important than the actual practice," he said. "If you have those resources, potentially some of the wordsmithing on the criteria is irrelevant."
In a separate study conducted after the Virginia Tech tragedy, the commission asked judges and special justices to fill out a questionnaire on every commitment hearing held in May. Data from that study is still being analyzed, but preliminary findings show that about 60 percent of about 1,400 hearings from that month were over in less than 15 minutes and virtually all were over in less than half an hour.
The commission plans to eventually funnel its recommendations into a mental health reform package for the 2008 General Assembly.
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