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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: January 9, 2017 03:04 PM
From: Representative Thomas P. Murt
To: All House members
Subject: A Better Standard for Outpatient Commitment for Persons with Serious Mental Illness (Prior HB 2423)
Most of you know or have been contacted by distraught constituents seeking help for someone with a serious mental illness who is too sick to seek treatment voluntarily. Under existing law we must wait until individuals become dangerous to themselves or others before we can help.

Our “clear and present danger” standard is among the most restrictive in the country, and unreasonably applies the same standard to both inpatient and outpatient commitments. Keeping this standard means losing the ability to use a less restrictive outpatient treatment setting, and the chance to intervene sooner. Someone who is clearly and presently dangerous belongs in the hospital, not in outpatient treatment. A different standard for court ordered outpatient treatment has been established by 46 states, allowing timely intervention before someone becomes dangerous and tragedy strikes. I will soon be reintroducing a bill to address these barriers to treatment in Pennsylvania.

The status quo is not working for the seriously mentally ill or their families. All too often, the consequence of this broken system is hospitalization, incarceration, homelessness, substance abuse, violence, or suicide. We have a mental health “Catch 22”… on the one hand a law that prohibits intervening with seriously mentally ill individuals early enough to help prevent them from becoming a danger; and on the other hand, when they are a danger we lack sufficient access to inpatient treatment services, and they often wind up in jail with little or no treatment at all.

By requiring sick people to become dangerous before we can support them, we also are criminalizing mental illness. In Pennsylvania, a person with a serious mental illness is twice as likely to end up in jail as to receive treatment. Approximately 5000 seriously mentally ill people are arrested each month in the Commonwealth, and at least 20 percent of our prison population suffers from mental illness.

My legislation would establish a new standard for court ordered assisted outpatient treatment in the community, while leaving in place the clear and present danger standard for involuntary hospitalization. The new standard would be based on a medical determination of whether a seriously mentally ill individual needs and can benefit from assisted outpatient treatment to survive safely in the community. The standard would also take into consideration an individual’s history of involuntary inpatient commitments and acts of violence to self or others. Assisted outpatient treatment can help individuals avoid inpatient commitment as well as provide critical step-down services in the community for those who are being discharged from inpatient facilities.

My bill would keep in place all the existing due process protections under current law. Plus from a civil liberties standpoint, there will be an increased ability for those with severe mental illness to remain in the community for treatment and avoid involuntary hospitalization, or even worse, incarceration. Pennsylvania can join the 46 other states whose laws make outpatient treatment a real possibility, while simultaneously reducing both human suffering and the costs to the Commonwealth in emergency healthcare, corrections, law enforcement, homelessness, and other demands on public systems.


Introduced as HB1233