At the Rick Van Story Center peer resource recovery and support center in Wilmington today, Governor Jack Markell signed legislation significantly reforming the way emergency mental health screenings are conducted, modernizing Delaware's involuntary commitment laws and providing people with a wider array of appropriate treatment options.
Until today, Delaware law allowed anyone to sign a complaint to start the involuntary mental health detainment process, which involved a police officer handcuffing a person and transporting them to a hospital emergency department, where any licensed physician could sign an order to detain that person for up to 24 hours for an evaluation. Critics noted that under that process, any licensed physician could mean that a podiatrist or ophthalmologist -- physicians who may have very little training in mental health -- could have a person held involuntarily.
The state Department of Health and Social Services noted there are about 3,000 involuntary detainments for mental health evaluations each year, or more than eight per day.
The legislation, which passed the General Assembly unanimously last month, would update the involuntary commitment laws by allowing a psychiatrist or credentialed mental health screener to evaluate a person anywhere and then transport that person to the most appropriate location for evaluation or treatment in the most appropriate and least restrictive manner. The credentialed mental health screeners will be available to go to the person in crisis at home, work or hospital emergency department, evaluate them and, if necessary, hold them involuntarily for a mental health evaluation that will involve a psychiatrist.
"This marks an important change for Delaware's mental health system and for the people who are served by that system ," said Governor Jack Markell. "This pushes us forward in helping people receive care in the most appropriate, respectful and least restrictive setting possible."
Rep. Michael A. Barbieri, who sponsored House Substitute 1 for House Bill 311, said that the new law is a huge step forward in bringing Delaware's mental health treatment into current, best practices, connecting people in crisis immediately to a trained mental health professional who can direct the person to the most appropriate care, in the most appropriate and least restrictive setting.
"This is the first step in our effort to modernize and humanize our mental health system," said Rep. Barbieri, D-Newark. "This effort will help us to develop a more robust community service system and to make sure that the services meet the needs of the individual work to keep people in the community and maintain their dignity. No longer can we do what is convenient, but rather we must do what is appropriate."
In addition to providing people with a wider array of appropriate treatment options, the law will free law enforcement from unnecessary transportation duties and long waits in hospital waiting rooms. It also expands the number and kind of professional staff who are credentialed to involuntarily detain someone for a mental health evaluation. Additionally, DHSS will now pay for voluntary mental health assessments instead of only covering involuntary admissions. This removes the financial incentive to institutionalize people.
"This will improve the quality of care for people being evaluated for mental health issues by giving professionals more flexibility in both examining people and by granting them a wider range of treatment options," said Senate Majority Whip Margaret Rose Henry, D-Wilmington East, who was the measure's chief Senate sponsor. "This is another important step in our efforts to treat mental health issues in the same manner as other health issues."
"This legislation is a start," said Rita Landgraf, Secretary of the Department of Health and Social Services. "It is not perfect legislation, but I have a really hard time seeing that people have to be handcuffed and put in a police car to get access to treatment. As we move forward, a stakeholder group in which consumers will play a significant role will look at the overall mental civil mental health laws, as well as the immunity provision. Consumers have to be engaged at every level of this reform movement."
Governor Markell also signed House Joint Resolution 17, a companion piece of legislation that establishes a study group to assess Delaware's civil mental health laws. Rep. Earl G. Jaques said he introduced the measure when several legal concerns were voiced about the involuntary commitment bill -- especially when it came to giving immunity to a group of workers yet to be identified.
"This study group will review and assess not only legal issues contained in the involuntary commitment bill, but it will address numerous legal issues across the spectrum of medical health in our state," said Rep. Jaques, D-Glasgow. "I believe that HJR 17 was the glue that held everything together. Without the study group, I don't believe we would be here today for this signing."