Massachusetts Weighs Letting Judges Order Mental Health Care

BOSTON, MASS. (AP) - When Ashoke Rampuria and Vinita Rampuria's son, Ashoke, returned home from college after a year away to finish his course work, he did not seem himself.

He was unable complete tasks. Ashoke Rampuria of Acton in Massachusetts said that he was lying on the couch. He took some jobs but couldn't hold them.

Rampuria's son was diagnosed in 2011 with a mental illness that Rampuria called severe. In 2011, Rampuria's son was diagnosed with what he described as a severe mental illness. The couple claimed that their son was able hold a full-time job for three month after using a new drug. However, he did not continue to take the medication.

Rampuria and his wife have always said that they lacked an important tool: the ability to order their son, now 36, who is currently in a psychiatric facility in Lynn, Massachusetts, to receive mandatory outpatient treatment.

Massachusetts, Connecticut, and Maryland are the only three states to not give this authority to courts.

This is a revolving-door. Rampuria stated that they would send him into a hospital, release him, and then send him back if he didn't take the medicine. If our son can stay on treatment for an entire year, he'll be able to do what he's aiming to, which is to have a job and to live independently.

Massachusetts legislators are considering a bill that would allow family members or mental health professionals to ask the courts to order adult outpatient mental care if they have a persistent mental disorder and a history of serious bodily harm.

According to Cindy Friedman, a Democratic State Senator, the court could order a customized treatment plan that included a monthly evaluation by a mental healthcare professional to determine if the individual should continue in community treatment. The bill has just begun its journey through the Legislature.

Friedman explained that the law relies on the "black robe" effect, which is the notion that patients are more likely to follow a treatment plan given by a court. She also rejected criticism that mental healthcare should be available only to those who ask for it.

She said, 'You can't solve this problem of not enough treatment by refusing treatment to people who need it.' This is a subset of people that don't realize how sick they are.

Friedman warned that the state can have tragic consequences if it allows the mentally ill to fall through the cracks. She cited the stabbing death in 2018 of a medical school student in Winchester by a man diagnosed with schizophrenia during high school. He was hospitalized several times for his mental illness.

In 2021, he was found not to be guilty due to insanity.

Some other states have grappled with this issue as well, largely due to concerns over homeless people who suffer from mental illness.

Gavin Newsom (a Democrat) signed legislation last year to create new Care Courts aimed at forcing people with mental health issues out of the streets and into treatment. Some lawmakers in Oregon have been pushing to increase the power to force people to seek mental health treatment.

In November, Democratic Mayor Eric Adams of New York City announced that he wanted the police and city medics more aggressively to get seriously mentally ill people off the streets, subways and into treatment.

John Piscopo, a Republican state representative from Connecticut, proposed a bill in this year which would have allowed probate courts to order individuals with substance abuse disorders or psychiatric disabilities into a medical evaluation without their consent and outpatient assisted treatment. The bill did not receive enough support.

Piscopo said, "I don't get the opposition of those who are in favor."

According to Lisa Dailey of the Treatment Advocacy Center (a non-profit organization aimed at removing barriers to mental health treatment), some people with mental illnesses lack the cognitive abilities to complete treatment. Others don't even realize that they are disabled.

She said, "You want someone stable for a sufficient amount of time so that they can realize how much better they are doing with the treatment and continue it on their own." Research shows that stabilizing on medication takes six months, and that no one stays in hospital for that amount of time.

Critics say that forcing people to seek mental health treatment can be counterproductive. They claim that the mentally ill are already exposed to a wide range of risks.

Sera Davidow is the director of Wildflower Alliance, an organization that opposes mandatory outpatient care. She says that there are many other voluntary strategies, such as peer-to-peer counselling or creating spaces for people to talk about their struggles.

She said, 'People are forced to accept resources that they don't want and those who do want them but can't have them.' Both of these are harmful.

Eliot Olson is a Connecticut resident and also opposes mandatory care. He said that as a student in high school, he suffered from depression.

"I didn't wish to be there." "I didn't want be there. Olson, 30, works for PeerPride which is a non-profit that focuses on homelessness among the transgender population.

Olson stated that he had been in the program about six months before the school recommended institutionalization. He said his mother refused.

He said, 'I didn't want to take part in something that I had no choice in.'

A voluntary treatment program in Boston aims to assist individuals who are suffering from a serious mental illness and have an pending criminal case, or are on probation. The Boston Outpatient Assisted Treatment Initiative, which began in 2020, has helped 165 people with a major mental illness. 33 of them have successfully completed the program.

Massachusetts Gov. Maura Shealey, a Democrat from Massachusetts, welcomed the ongoing debate on mental health care.

Healey stated that it was important to ensure that everyone has access to mental health services and that individual rights are balanced.