Last month, Civil Beat published a Community Voice that called for the governor to veto the passage of Senate Bill 1322, which facilitates helping persons who are incapacitated by their mental illness or substance use to receive the treatment for which they have a right to access.

The author rightly cited the unfair stigmatization of persons with mental illness as being violent and should therefore be locked up or locked away.

While I fully agree with that particular statement, I am perplexed by the author calling for less detention of those with mental illness. In fact, the current statute guiding the MH10 (assisted community treatment) is meant to do exactly that: to reduce the need for hospitalization and institutionalization of persons for treatment and promotes treatment in the community.

Current law supports a legal process that requires petitioners to present sufficient evidence to convince a judge that the subject of the petition is better served by the delivery of treatment, including medication rather than being left on the street. If left untreated, they pose a danger to others or themselves through sheer neglect or lack of capacity for sound decision-making.

‘Heartbreaking’ Crisis

My perspective has been shaped by 15 years of working with mentally ill persons, both inpatient and in the community, in urban and rural settings alike, in addition to 19 years of serving homeless persons, many with mental illness. The people that outreach providers have encountered on the streets of Honolulu move me to tears.

The degree of deteriorated health in the form of wounds, infections that often become life-threatening or result in amputation of limbs and the heart, kidney and liver failures that ultimately take the lives of an ever-growing number of people is heartbreaking.

SB 1322 continues to pave the way for improved access to behavioral healthcare that is direly needed. It is an effort to establish greater consistency in the statute’s language across chapters of law.

More importantly, it sets the stage for our healthcare system and first responders to be more assertive and responsive to the needs of so many persons afflicted with serious mental illness and substance use disorders.

The bill calls for more concerted evaluation of a person’s appropriateness for court-ordered treatment to mitigate the danger to self or others they pose when brought into emergency rooms. Finally, it streamlines existing paths for people to receive the treatment they deserve to have their dignity and humanity restored.

As a nurse who participated in treating mentally ill and substance addicted persons directed to the Hawaiʻi State Hospital by the judicial system for treatment after committing a crime, I witnessed firsthand the power of treatment to help restore a person’s ability to be returned to a productive life in the community.

As part of a settlement agreement with the U.S. Department of Justice, the hospital developed a treatment mall that focused on stabilization, rehabilitation and preparing a person to be able to live safely in the community.

Unfortunately, without consistent medication and supportive services in the community, many mentally ill persons fail to sustain the gains made while hospitalized and we see the fallout with so many persons who are obviously mentally ill or suffering substance use disorders relegated to the streets.

The writer of last month’s article fears violations of a person’s right to due process because the subject of Assisted Community Treatment does not guarantee representation by an attorney. Actually, a guardian ad litem is appointed by the judge in every case to represent the person’s best interest. And if the judge believes the subject would further benefit from appointed legal representation, he/she has the authority to appoint one.

I would invite anyone to come with us on outreach and see the efforts being made to help persons accept treatment and the condition of those we cannot convince to do so. Surprisingly, of the people offered medication for their mental illness, over 60% to 70% of them accept it willingly.

For those who refuse because they are too sick to know they could benefit, should we turn away and let them sit and rot in their urine and excrement or condemn them to having their wounds become a death sentence?

We are in a crisis of humanity. SB 1322 is not “dangerous” but an effort to help persons incapacitated by their mental illness to receive the treatment they have a right to. It’s also an effort to save as many lives as possible — as soon as possible.

We urge Governor Green to sign SB 1322 into law and ensure education and resources be provided to support our systems of care to implement this bill as intended.