Alaska’s broken mental health system leaves judges with impossible choices and communities at risk.
Published: 31 minutes agoVal Van Brocklin writes regularly about the interaction of Alaska’s mental health and justice systems and the impact on Alaskans. As the judge who founded and presided over the first Mental Health and Competency Court in Alaska for 20 years, I read all of Van Brocklin’s opinions on these subjects with great interest.
explained how the rights of people alleged to be gravely mentally ill and in need of evaluation and psychiatric treatment have been routinely compromised. She pointed out how, in the face of an inadequately funded and failing mental health system, courts have been timid to enforce laws protecting those rights, resulting in extended hospital confinement of Alaskans who have committed no crime.It’s past time for our Supreme Court to stop judges from treating Alaskans with mental illness worse than criminalsThe failures Van Brocklin depicts are only parts of a larger and more complicated problem. The lack of funding of the only state psychiatric hospital, API, to perform its statutory mission affects not only Alaskans who are civilly committed for mental health evaluation and treatment. It affects even more Alaskans who are often charged with minor crimes but do not understand the nature of the charges against them and/or cannot assist counsel in defending them. These cases cannot proceed unless the defendant is competent — meaning they understand the proceedings and can meaningfully assist in their defense. When a defendant’s competence to stand trial is in doubt, courts must order an evaluation and, if necessary, commitment to API for treatment to restore competency. These defendants often languish for a year or more in jail, not the ER, like those subject to civil commitment. They await admission to API despite being presumed innocent and regardless of a court order directing API to admit and treat them. Many spend far more time in jail awaiting treatment than they would spend if found guilty and sentenced to the maximum penalty. During my career as a judge, I was forced to dismiss cases and release people who needed treatment because their constitutional rights had been violated by systemic failure. I did so with regret. It meant that individuals who needed treatment would return to the community without it because our legislative and executive branches had failed in their fundamental duties. A key problem Van Brocklin does not address is this: In both the civil and criminal mental commitment cases, evidence has been presented to the court that each of these Alaskans is either a danger to themselves or others, or they are unable to understand the nature of the proceedings against them and/or assist counsel in their defense. The court has issued an order for their evaluation and treatment to protect them and the public.Release from a court order that makes such findings does vindicate their liberty rights. But it does not fix the fact that these Alaskans are denied the statutory right to be timely evaluated and treated to restore their mental function. And it does nothing to protect the safety of the individuals or the community. Many of these unfortunate Alaskans are living on the street in conditions that distress them and their communities and present danger to both. The state’s mental health crisis response and treatment systems have entirely failed them for years. In my experience, almost none of those committed mentally comprehend the constitutional violation of being held against their will in ERs or jails for unconscionable periods. But nearly every one of these individuals comprehends that they are suffering from grave symptoms of mental illness. Many know — as do the judges who issued those commitment orders — that they have a right to treatment under the law, the very right those court orders are meant to ensure. Protecting liberty is necessary, but it is not the only right we need to protect, and alone it is not enough. Some people committed for restoration to mental competency and released because API has no room remain a danger to themselves or others — but not an imminent one. Once a criminal case is dismissed for delayed treatment, prosecutors must rely on the civil standard to obtain a court order for commitment. That standard requires that the individual be an imminent danger to self or others, not a historical one. Even if a civil petition is filed by a prosecutor, the person will likely not meet the civil commitment standard., but that presumption is overcome if they are not showing imminent suicidal or violent thinking.And, as Van Brocklin most recently points out, even if they meet civil commitment criteria when the criminal case is dismissed for delay, they would next sit waiting for a bed at API as a civil commit — and are then entitled to release underEspecially in criminal mental commitment cases, the person with cycling serious mental illness may remain a danger to themselves or others when released. Bully for the courts for having vindicated the right of Alaskans not to be held as criminals because there is no room at API, the treatment inn. Prosecutors and behavioral health clinicians know that API is full. They know that obtaining these orders often means unconstitutional detention without timely admission to API for treatment. This poses an ethical dilemma for them as well. If they seek an order, it is only a matter of time before a judge must abide by the law of unconstitutional detention thatWhen the predictable bad result occurs, the judge — where the buck stops — and not the Legislature, where the buck should begin, becomes theMy question for our community is this: Who will champion the individual Alaskan’s right to treatment without delay when they are found suicidal, dangerous toward others or incompetent for legal proceedings? Who will champion the community’s and victims’ rights to safety from those who suffer symptoms that make them dangerous without that treatment?Your governor and legislators decide whether the funding for API and the rest of the mental health system exists. Your governor’s proposed budget for API will be made public soon, if not already. Prosecutors and judges are left to deal with the systems that exist. Stop blaming them. Write your governor and legislators.The Anchorage Daily News welcomes a broad range of viewpoints. To submit a piece for consideration, email
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