Las Cruces advocates: Measure would fill mental health care gap

March 20--LAS CRUCES -- It's down to the wire for a legal change mental health advocates say is needed to address a gap in care for severe mental illness in New Mexico.

The measure, Senate Bill 53, would allow state district court judges to mandate outpatient treatment -- versus full-fledged hospitalization -- for people who are on the verge of a serious psychiatric collapse. It cleared the House Judiciary Committee on Thursday and now heads to the House floor -- the final hurdle before the session ends at noon Saturday.

The legislation, if passed, would for the first time grant permission to family members of an adult with serious mental illness to petition for a judge to intervene by ordering outpatient mental health care, proponents said. For years, family members have complained of feeling powerless to help an adult loved whose psychiatric state is spiraling downward. Several other people, such as a hospital director, also could seek the intervention under the proposal.

Earlier intervention

New Mexico's laws lean heavily in the direction of a mentally ill resident's autonomy and civil rights -- even if they're taking actions clearly detrimental to their psychiatric well-being, said Ron Gurley, president of the Las Cruces chapter of the National Alliance for Mental Illness. And, while a family member or friend of someone with schizophrenia might readily see the signs a person is headed toward a psychiatric breakdown, there's little legally that can be done to intervene.

Typically, it's only after residents with mental illness threaten harm to themselves or to others -- sparking a response by law enforcement -- that intervention becomes possible, Gurley said.

Police can take someone into involuntary custody for the purpose of a psychiatric evaluation, a short-term hospitalization, and -- after involvement from the district attorney's office and a state judge -- a longer-term hospitalization at the state's mental health hospital, experts have said. Sometimes a person can display prolonged neglect for their personal care and wind up in the same process.

Other times, a person with mental illness gets routed into the criminal justice system.

But until authorities get involved, "it makes it very difficult under our current statutes to get somebody treatment," Gurley said.

The bill also would allow intervention at an earlier stage -- when a person is showing warning signs of an impending breakdown -- than what's currently authorized by state law, mental health experts said.

In conflict

Sen. Mary Kay Papen, D-Las Cruces, a mental health advocate in the Legislature and sponsor of the bill, says it's "like a modified version" of New York's Kendra's law.

That measure was named after Kendra Webdale, a 32-year-old woman who was pushed in front of an oncoming subway train in 1999 by a man battling untreated schizophrenia, according to the Associated Press.

Papen said there are improvements needed in state laws to help the mentally ill. And the issue of mental disorders are prominently on the radar after last year's police shooting of in Albuquerque of homeless man James Boyd, who had schizophrenia.

"We might be able to make sure some of the people don't become compressed to such a point that they do something really dangerous," she said.

Gurley said measures similar to SB 53 have been introduced in past years but have fallen short -- mainly because of opponents who don't want to curtail civil rights. He contended the problem, however, is that severe mental illness -- usually schizophrenia or bipolar disorder -- can leave the sufferer with a warped view of reality. A person can stop taking his or her medications and skip treatment, causing the individual's condition to worsen to a dangerous level.

It's prompted the satirical expression, Gurley said, that in New Mexico "you die with your rights on."

The Senate OK'd the bill 30-11 on Feb. 24. Among those opposing it was Sen. Bill Soules, D-Las Cruces. He said Thursday he felt pulled in two directions when voting on the bill because two important values -- civil rights and mental well-being -- were at odds.

"I fully understand the need to make sure people are getting their medications, but the other side of me is, I don't like forcing people to do things against their will."

The Senate stripped away a funding allocation that had been proposed to support bill.

Concern stated

Over the years, a number of parents have expressed frustration -- and sometimes despair -- to the Sun-News about their inability to get help for their grown children who suffer from severe mental illnesses. Sometimes, the cases have ended in tragedy, as when the son of a well-like New Mexico State Police officer, Susan Kuchma, allegedly shot and killed her in a Las Cruces neighborhood in 2007. Relatives of Kuchma at the time described her repeated -- but fruitless -- attempts to get help for help for her son in the months leading up to the tragedy, according to Sun-News archives.

Before the start of the legislative session, 3rd Judicial District Attorney Mark D'Antonio hosted a panel discussion in support of Papen's legislation. Among the speakers was Las Crucen Danielle Nixon, a former girlfriend of Myron May -- an ex-employee of D'Antonio's who carried out a shooting last year at a Florida State University library before being fatally shot himself.

Nixon said, as a physician, she's familiar with the medical system and thought that would assist her as she sought help for May before he moved from the area. He'd shown signs of mental illness. But Nixon said she encountered barriers at every turn.

"That's the problem -- getting them plugged in to the help they need," she said. "There is a huge gap, and we need something to bridge that gap. I couldn't get there, and I tried so many times to arrange things."

The process

If passed into law, it would grant certain people the right to go before a judge to seek involuntary outpatient care for a mentally ill resident, such as counseling, medication, drug testing, group therapy, supervised living arrangements and other services outlined in a plan developed by a mental health professional.

The people who could appear before a judge seeking the intervention are a parent; a spouse; a person older than 18 who lives with the person; an adult sibling; an adult child; the director of a hospital where the mentally ill resident is hospitalized; a mental health provider who treats the person; a "surrogate decision maker"; or the director of a "public or charitable organization or agency or home" that provides mental health care, if the person is receiving services from that facility.

The bill includes a way for a person with mental illness to challenge someone's attempt to get approval for forced outpatient mental health care.

Third Judicial District Court Judge Mary Rosner, who presides over weekly involuntary mental-health hospitalization proceedings in Las Cruces, said she sees some residents cycling through the system repeatedly.

"It's not uncommon for me to see someone two, three, four, five times," she said.

But Rosner said she's optimistic the measure could help reduce a person's likelihood of reaching that point. She said its effectiveness could hinge upon the bill's final details -- including the funding, or lack thereof.

"As a society, we're not doing anything to address the fundamental needs of the mentally ill," she said.

What's next

Papen said she's been told the bill will get a hearing on the House floor.

If the measure clears the House without any changes, it will head to Gov. Susana Martinez's desk.

Papen said she hasn't talked to Martinez about it, but "I'm hoping she'll see it as good legislation."

Martinez's spokesman Enrique Knell said there were "many concerns raised about that legislation throughout the process."

"It's been amended many times, and if it passes, our office will need to review it very carefully," he said in an email.

Soules said the measure, if passed into law, may work "beautifully," or it may need to be revised down the road. Time will tell, he said.

Gurley said some provisions proponents had wanted were weakened during the legislative process. Even so, the bill is a frame work to build on.

"It was a hard battle, but it came out good in the end," he said.

Diana Alba Soular may be reached at 574-541-5443.

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