Judges ponder increase in mental commitments

BOISE – The courts have seen an exploding number of involuntary commitment cases in recent years, according to an annual report from the Idaho Supreme Court, and that has some judges wondering if budget cuts to the Idaho Department of Health and Welfare and the poor economy are partly to blame.

Last year more than 4,500 mental commitment cases were filed in state courts – an 82 percent increase compared to five years ago, according to the report. Idaho Supreme Court administrator Patti Tobias said there wasn’t any research examining the cause of the increase, but an informal poll of magistrate judges throughout the state had some speculating that cuts to IDHW staff and offices across the state, a lack of affordable mental health care, drug abuse, limited health care access and the faltering economy could all be contributing factors.

“It’s a tough question with a complex set of factors,” said Ada County Deputy Prosecutor Michael Anderson, who handles many mental commitment cases.

Usually, involuntary commitment proceedings begin when an emergency room physician, police officer or official of another facility initiates a “mental hold” on someone out of concern that the patient is a threat to themselves or others, Anderson said. A judge has to be notified of such holds within 24 hours, triggering the case filing.

Sixth District Judge Paul Laggis said he suspects that cuts to IDHW are a big factor in the increase in case filings. Laggis said he frequently discusses the “plight of adult mental health care” with the mental health professionals who work with his court.

“They tell me the state used to have clinicians who would actually make contact with people at their homes to see how they were doing, if they are taking their meds,” Laggis said. “They’d check their pulse, so to speak, to see if they’re deteriorating to the point where they might need intervention.”

But many of those services have been cut in recent years.

The Idaho Department of Health and Welfare, like all state agencies, faced significant budget cuts with the recession. In 2009 and 2010, 35 workers, including 28 clinicians, were laid off from the department’s Adult Mental Health Program. Several of the department’s regional offices were also closed in rural communities through the state.

In 2011, IDHW officials advised lawmakers that mental health services had taken a 19 percent budget cut since 2008, forcing the agency to prioritize by first funding intervention services for people in imminent danger to themselves and others, pushing to the bottom of the heap services for those who don’t have insurance.