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Michigan recently joined a legal movement that has been sweeping the country to force the mentally ill to take their medications and seek therapy. A total of 42 states have passed laws allowing judges to order treatment for people who are mentally ill and not following a doctor’s treatment regime. If they violate the court order, they could be institutionalized. According to attorneys specializing in mental health laws, more than a dozen states in the last five years—six of them in the last two years—have revamped their mental health laws to expand the courts’ powers over the mentally ill. Specifically, judges can now mandate treatment for people with mental illnesses who live in a community, where in the past they could only do so for those institutionalized. “This is important for a small but significant number of people with mental illness who because of their illness do not recognize that they are ill and that they need treatment,” said Mary Zdanowicz, an attorney and executive director of the Treatment Advocacy Center in Virginia, proponent of court-ordered treatment. Heavy-handed tactic? But civil rights attorneys-who have several times unsuccessfully challenged “outpatient commitment laws” on constitutional grounds-argue that the laws trample on the First Amendment rights of the mentally ill. “It seems like the state is resorting to using an unproven and heavy-handed tactic that tramples on the First Amendment rights of people with mental illness without any evidence that it will make people’s lives any better or make society safer,” argued Tammy Seltzer, a senior staff attorney at the Bazelon Center for Mental Health Law in Washington, advocates for the mentally ill who oppose court intervention. “Everyone knows that constitutionally you can’t force medication on someone. You can’t just stick a needle in someone’s arm. But they may as well be doing that here,” Seltzer said. Seltzer said further that “[i]t’s a very coercive situation. You’ve got a judge in robes. You’ve got a court order. And there’s the threat of going back to the hospital in a police car.” Lawyers say the movement to mandate psychiatric treatment for at-home patients has been fueled by two factors: the shutdown of 44 state psychiatric hospitals nationwide in the 1990s, which put many patients back into mainstream society, and the publicity surrounding several high-profile crimes that have involved people with psychiatric problems. There have been several challenges to the constitutionality of the laws, although none of them has succeeded. Most recently, New York’s high court, the Court of Appeals, in May upheld a judge’s right to mandate treatment for at-home mentally ill patients. In re K.L., 806 N.E.2d 480 (N.Y. 2004). A key incident that sparked a lot of attention in state legislatures was the 1998 fatal shooting of two security officers at the U.S. Capitol by a paranoid schizophrenic who had not been adequately treated. A similar incident prompted the New York Legislature in 1999 to pass an outpatient commitment law called Kendra’s Law, which was named after a woman who was pushed in front of a subway by a person suffering from a mental illness who had not received adequate treatment. The Michigan statute, known as Kevin’s Law, which was modeled after Kendra’s Law, was named after a college student who was killed at a bus station by a schizophrenic with a history of avoiding treatment. Under Michigan’s law, mentally ill patients who have been incarcerated or hospitalized at least twice in the previous three years will be subject to a court order. Persons who have acted violently toward themselves or others in the previous four years could also face a court order. A legal ‘tool’ Michigan state Senator Tom George, who introduced Kevin’s Law in 2001, believes the courts now have a tool they can use both to help the mentally ill, and keep society safe. “It makes it easier now to commit someone for care who has a severe mental illness and has been violent or dangerous in the past,” George said. “Most people don’t want to be in the hospital so this is a great lever to get them to comply . . . .The goal is that if their treatment is effective, they’re better off, they’re more functional and the streets are safer.” According to the Treatment Advocacy Center, there are eight states that currently do not have outpatient commitment laws. They are Connecticut, Maine, Maryland, Massachusetts, New Jersey, New Mexico, Tennessee and Nevada.

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