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As a young prosecutor, I was once handed a bunch of files and told to cover “Baker Act” hearings in the main courthouse. Normally, we lowly assistant state attorneys never ventured across the street to this courthouse; only the high powered lawyers practiced there. I was terrified. First of all, I didn’t know where to go; secondly, I had never even heard of a “Baker Act” and more to the point, had no idea what to do.
Feeling overwhelmed by the task, I immediately took my seat, when I finally arrived at the chambers of the presiding judge. I tried to be unobtrusive and certainly didn’t want to be in the line of fire should the judge require a presentation. My worries were unfounded, because it quickly became apparent that my role was non-existent. The statute mandated the presence of a state attorney and a court appointed attorney, but the judge required neither. He wanted to move his docket as quickly as possible, which meant interruptions were not tolerated.
I was not about to say anything; same with the other attorney. I guess this attorney had a good working relationship with the judge and was not about to jeopardize it by throwing up roadblocks, i.e. protecting the rights of the patient. As for me, I didn’t know enough to participate.
I vividly remember one case. A woman of about 40 had been diagnosed with “hebephrenia”. I didn’t know what it was. In a whisper, I asked the court clerk about the term. When I heard the definition, it explained the behavior. The woman alternated between uncontrolled crying and high pitched laughter. The notes in her case file disturbed me. Apparently, this young woman had had a “nervous condition” while in college and her parents, based upon advice from a doctor, had placed her in a mental health facility. There she remained for the next twenty years The judge was to determine if inpatient treatment was still required. No family member appeared on her behalf; her parents had since died. I am not sure if there was any other alternative for her, but the judge ordered her back to the facility.
Ten years later, I was the “Baker Act” judge. Coincidentally, I became a judge by defeating the above mentioned judge. By the time of my election and assignment to that division, lawsuits had forced the closing of that same mental hospital. Legally and philosophically, I understood the impetus behind the suits. But I always remembered the “hebephrenic” woman. Basically she had become institutionalized. How would someone like her be able to be released back to society without outpatient treatment or support available? The short answer is: she wouldn’t.
Advocates for the mentally ill take issue with involuntary confinement in locked facilities. Possibly, because in the past, cases such as the one above might have been routine. Many of the lawsuits closing these hospitals were the result of mistreatment of patients, and violation of patients’ civil rights. As a practical matter, without such hospitals, our jails have become de facto mental health facilities. In addition, the incidence of mental disease among the homeless is staggering. According to some estimates, approximately 1/3 of the homeless population has untreated mental illness.
Certainly, the lack of community mental health resources contributes to the problem. The fact remains that even with such availability, without 24/7 supervision, many patients would fail to follow directions, take medications, etc. Although it might be anathema to some activists in this area, those of us in the justice system, see that outpatient treatment may not the best option for all.
Perhaps it is time to resurrect the idea of long term, involuntary hospitalization for those with certain mental health problems. As has been observed, our society would never permit people with advanced Alzheimer’s to remain at liberty. Why should less consideration be given to our mentally ill population?
