FREDERICKSBURG, Va. — Judges, psychiatrists and family members of the mentally ill are uniformly frustrated by almost every aspect of Virginia’s civil commitment process, according to a study authorized by a commission analyzing the state’s mental health laws.
The study’s findings, cited yesterday during a meeting of the Supreme Court of Virginia's Commission on Mental Health Law Reform, illustrated the widespread concern many have about the procedures Virginia uses to force people showing signs of mental instability into treatment.
The state’s commitment laws have come under increased scrutiny since the April 16 shooting spree at Virginia Tech, where a purportedly mentally ill student killed 32 persons and then himself. Gunman Seung-hui Cho was ordered into involuntary outpatient treatment in 2005 after a special justice found that he presented “an imminent danger to himself as a result of mental illness,” but there is no indication he ever received the treatment.
The statewide study, conducted between July 2006 and February 2007 and led by Dr. Elizabeth McGarvey of the University of Virginia School of Medicine, involved intensive interviews with 64 professionals involved in the commitment process — judges, police officers, psychiatrists — along with 60 family members of those with serious mental illness and 86 persons who had been committed.
Among the most common complaints were a shortage of 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.”
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 are still being analyzed, but preliminary findings show that about 60 percent of the approximately 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 study also found that representatives of the community service boards were present at the hearings in less than half the cases.
The survey also showed that just 6 percent of those committed were ordered into outpatient treatment, as Cho was, and that most of the seriously mentally ill were not considered a danger to others.
Virginia law allows involuntary commitment only if a person is found to pose an “imminent danger” to himself or others or is “substantially unable to care for himself.” Most states don’t use the word “imminent” in conjunction with danger or harm, making it easier to force treatment.
The commission plans to eventually funnel its recommendations into a mental health reform package for the 2008 General Assembly.
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