When Vanessa Schultz was released from the hospital at the end of June, it was time for her to make a decision.
The 17-year-old – who struggles with mental health and addiction – could go into intensive inpatient treatment. Or intensive outpatient treatment. Or neither.
Regardless of her choice, her adoptive parents, Kevin and Rochelle Schultz, wouldn’t have much input.
That’s because Washington state law allows anyone over the age of 13 to make their own medical decisions.
“The child has to be willing to engage and if the child is not willing to engage, you’re kind of stuck,” Kevin Schultz said in an April interview.
This spring, Vanessa Schultz went missing for two months after spending 62 days in treatment at Daybreak Youth Services. Like the majority of addicts who have been in and out of treatment, she had already relapsed several times before.
Then, on June 10, she was picked up by a police officer and sent to Providence Sacred Heart Medical Center’s child psychiatric unit.
The psychiatrist at the hospital – who believed Vanessa needed intensive inpatient treatment – suggested the Schultzes hire someone to forcibly remove her to another state where she could be involuntarily committed. Certain treatment centers specialize in this kind of drastic removal.
Kevin Schultz said he considered it, but the cost of those types of programs and the harm it would do to his relationship with Vanessa convinced him not to.
“What kind of resentment would Vanessa have if I had someone come and get her in the middle of the night?” he said.
Ultimately, Vanessa Schultz decided she didn’t want to go into inpatient treatment again. She didn’t see the point. Instead she started an intensive outpatient treatment plan. But on July 5, a week after her release from the hospital, she dropped off the grid again.
“The next thing we know, we’re getting a call from her on a strange phone and she’s in Seattle again,” he said.
So the Schultzes are left in a eerily familiar position.
They wait for Vanessa to return. She seems to be doing well, calling regularly. Based on those conversations, Rochelle Schultz doesn’t believe she’s using drugs. Still, they worry and hope.
“She has a lot of goodness in her, and she has a lot of intelligence in her,” Kevin Schultz said. “She just has to fight through these demons for a few more years.”
Washington has some of the nation’s strongest teen privacy laws. The laws allow teenagers to make their own decisions about birth control, abortions, mental health treatment and addiction treatment. Rochelle Schultz recalls having to get Vanessa’s signature in order to view her medical records and schedule appointments.
Vanessa was only 13 years old at the time, Rochelle Schultz said.
Still, there are good reasons for strict laws, said Rosey Thurman, an attorney for Team Child, a child and parent advocacy group with an office in Spokane. The laws give children the space and privacy to speak openly about what they need.
“Therapists are in a better position to say OK, what can you do about this,” she said.
Thurman has seen cases where parents want a drastic treatment for their child, even though the underlying issue is an interpersonal conflict.
“A lot of times with adoption, the youth for some reason don’t feel like they fit in the family,” she said.
Thurman recognizes that in some cases teenagers may not be best suited to make their own medical decisions. But overall, she thinks it’s an important protection for minors.
But others, like the Schultzes, see the laws as an impediment.
“I don’t think that a 13-year-old has the cognitive capabilities, nor do they have the judgment, to make decisions about their health care,” said Annette Klinefelter, the executive director of Daybreak.
“As an adult, it’s our job as adults to care for children because they can’t care for themselves,” she added.
Still, Klinefelter sees the value in the medical privacy laws. That’s why she cheered the passage of new legislation that would act as a workaround. Ricky’s Law, which was passed in 2016 by the state legislature, will allow for involuntary commitment for addiction treatment of minors and adults for up to 90 days.
Ricky’s Law will mirror an already established law that allows minors and adults to be committed for mental health evaluations. Under the framework, parents, family members or neighbors can refer a person for involuntary treatment. That person is then evaluated by professionals who decide whether or not they need treatment. A judge also reviews the case, prior to involuntarily committing the person. The new law will go into affect on April 1, 2018.
But there are concerns. Amy Sullivan is one of four public defenders in Spokane County who handles civil commitment cases. The way Ricky’s Law is written, she said, someone can only be committed if they are sent to a secure detox bed.
Currently the only provider statewide offering secure detox facilities is Daybreak. They have a total of nine beds – three in Spokane and six in southwest Washington.
“Where are we going to put someone who needs to go and be in one of these beds?” Sullivan said.
Alayna Becker, a spokeswoman for Daybreak, called the law a “step in the right direction” that starts addicts on a recovery path. She hopes other providers will follow Daybreak’s lead and build more secure detox beds.
“The benefit of Ricky’s Law is it gets you in the door,” she said.
Ricky’s Law aside, Sullivan has mixed views on the state’s involuntary commitment and medical privacy laws.
“I tend to think of this holistically,” Sullivan said. “The current commitment laws are sometimes helpful. But I do see clients of mine who get detained and after they go through the process they feel humiliated.”
That was Savannah Ingell’s experience. The 19-year-old also suffers from addiction and mental illness and has been in and out of treatment. She’s been involuntarily committed into psychiatric facilities before. That, she said, did more harm than good.
“I’m very easy to influence,” Ingell said. “And when you go into treatment there are other people who have either done worse things or are in there for the same reason.”
She said her needs and input were ignored, which exacerbated some of her problems. Ingell is now voluntarily in a treatment facility in Spokane.
“We’re the ones going through this,” she said. “We’re the ones that know what’s going on. We’re the ones that know what’s best for us.”
Marieka McPhee doesn’t agree.
“People are too young to make that kind of decision,” she said. “It will impact the rest of their lives.”
“At certain times, I was so symptomatic I didn’t even know what I was doing,” she added.
McPhee is diagnosed with schizoaffective disorder and started using drugs “to self-medicate.” She’s been clean for about five years.
“Now the pendulum has swung too far,” she said. “It literally takes the hand of God to involuntary commit someone.”
Kathy Ingell, Savannah’s adopted mother, agrees with McPhee.
Like the Schultz family, she’s spent years trying to help her daughter. There have been misdiagnoses, multiple commitments to treatment centers, jail and hundreds of early morning and late-night phone calls full of bad news.
A state law that keeps parents at an arm’s length is just one more obstacle in a system full of them.
“The system is so broken,” McPhee said. “And everybody says that but nobody bands together and says, ‘Let’s fix it.’ ”
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