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Does the System Work for Those with Serious Mental Illness (SMI)?

According to the Treatment Advocacy Center:

  • At the federal level, 50 years of treating mentally ill adults separately and unequally have left countless individuals with serious mental illness without access to treatment or hope for recovery.
  • At the state level, outdated laws too often restrict access to treatment until people become dangerous to themselves or others, while state hospital beds have been eliminated almost to the point of extinction.
  • At the county level, half the counties in the United States do not have a single mental health professional within them, much less one of the community mental health centers meant to replace the state psychiatric hospitals of the 1950s.

The human and economic cost of this neglect has been catastrophic. People with the most severe psychiatric diseases make up barely 3% of the total population, of the total population, but are vastly more likely to be arrested, incarcerated, homeless or unemployed.

In Washington, according to the Treatment Advocacy Center, 1% of the population has schizophrenia. Of that 1%, about 40% are untreated. About 2% of Washington’s population has severe bipolar. Of that 2%, a shocking 51% are untreated.

If your loved one is among the roughly half of people with severe bipolar disorder or schizophrenia who do not recognize their own need for treatment (a condition known as anosognosia), you may find it necessary to seek involuntary intervention to stop a downward psychiatric spiral or reduce danger to the individual or others.

These resources from the Treatment Advocacy Center may help.

What Are the Consequences of Not Getting Treatment?

The consequences of non-treatment can be devastating, to the individual and family members. These can include suicide, homelessness, and incarceration.

According to the Treatment Advocacy Center there are 169,000 homeless adults with serious mental illness. There are 383,000 inmates with mental illness in jails and prisons. About 50% of individuals with schizophrenia or bipolar attempt suicide during their lifetimes. See more facts here.

This “criminalization” of mental illness has wide ranging and devastating consequences. Today, in 44 states, a jail or prison holds more mentally ill individuals than the largest remaining state psychiatric hospital. Individuals with psychiatric diseases like schizophrenia and bipolar disorder are 10 times more likely to be in a jail or prison than a hospital bed.

While many states attempt to divert people from jail if their crimes are the product of illness, diversion alone cannot address policies making the care of those with mental illness a law enforcement matter rather than a medical one.

What do I do now: What is Assisted Outpatient Treatment?

The Treatment Advocacy Center is dedicated to enacting compassionate, effective mental health treatment laws and equally determined to help state and local mental health systems implement these laws to take full advantage of their life-saving potential. Assisted outpatient treatment (AOT) is court-ordered treatment (including medication) for individuals with severe mental illness who meet strict legal criteria, e.g., they have a history of medication noncompliance. Typically, violation of the court-ordered conditions can result in the individual being hospitalized for further treatment.

Is AOT Available in Washington?

Technically, yes. It is called the Involuntary Treatment Act, or ITA. It permits investigators (called Designated Mental Health Professionals, or DMHPs) to detain individuals who, as a result of a mental illness, are gravely disabled or may be a danger to themselves or others. Those who meet the legal criteria (RCW 71.05) for an ITA commitment can be detained for up to 72 hours at an inpatient psychiatric facility.

If a DMHPs does not find that an individual meets these requirements, an immediate family member may file a Petition for Initial Involuntary Detention of a Family Member; known as Joel’s Law. This is legally allowed under RCW 71.05.201.

Joel’s Law have several steps required to file. You can read about them here. If you are sure the situation does legally follow Joel’s Law, you can download the court documents from Washington State Courts’s website.

If you need help filing this petition, support, or an advocate, don’t hesitate to call us at (360) 695-2823.

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