INSIGHTS ON PBS HAWAIʻI: Assisted Community Treatment | Program


NEW EDITIONS TO AN OLD LAW ARE
DESIGNED TO MAKE IT EASIER FOR STATE JUDGES TO ORDER
HOMELESS PEOPLE WITH MENTAL ILLNESS TO RECEIVE TREATMENT. SUPPORTERS OF THE AMENDED LAW
CALLED ASSISTED COMMUNITY TREATMENT SAY IT WILL HELP
VULNERABLE MEMBERS OF OUR COMMUNITY GET THE CARE THEY
NEED AND DESERVE. BUT,
HOW DOES THE LAW WORK AND ARE OUR CIVIL LIBERTIES FOR THOSE
INVOLVED PROTECTED? TONIGHT’S LIVE BROADCAST AND LIVESTREAM OF INSIGHTS ON PBS HAWAIʻI START NOW. [INTRO MUSIC] ALOHA AND WELCOME TO INSIGHTS
ON PBS HAWAIʻI…I’M LARA YAMADA. THE 2013 ASSISTED COMMUNITY
TREATMENT LAW, OR ACT, WAS INTENDED TO HELP INDIVIDUALS
WITH SERIOUS MENTAL ILLNESS GET MEDICATION THEY NEED
THROUGH A MANDATE FROM A STATE JUDGE. YET THE LAW TURNED OUT TO BE
DIFFICULT TO IMPLEMENT, AND SINCE THEN, FEWER THAN 10
COURT-MANDATED TREATMENT PLANS HAVE BEEN ISSUED. THE LAW WAS AMENDED EARLIER
THIS YEAR TO MAKE IT EASIER FOR ADVOCATE ORGANIZATIONS TO
PETITION THE COURT TO ORDER PSYCHIATRIC TREATMENT. AND
WHILE THERE WAS STRONG SUPPORT FOR THE LAW, THERE ARE
ALSO CONCERNS THAT CIVIL LIBERTIES ARE PROTECTED. OUR GUESTS TONIGHT INCLUDE
REPRESENTATIVES FROM A HOMELESS ADVOCACY GROUP THAT
IS ALREADY PETITIONING THE COURT FOR MANDATED TREATMENT
AND REPRESENTATIVES LOOKING TO PROTECT RIGHTS OF HOMELESS
INDIVIDUALS. WE LOOK FORWARD TO YOUR
PARTICIPATION IN TONIGHT’S SHOW. YOU CAN EMAIL, CALL OR
TWEET YOUR QUESTIONS. AND
YOU’LL FIND A LIVE STREAM OF THIS PROGRAM AT PBSHAWAII.ORG
AND THE PBS HAWAIʻI FACEBOOK PAGE. NOW, TO OUR GUESTS. CONNIE MITCHELL IS THE
EXECUTIVE DIRECTOR OF THE INSTITUTE FOR HUMAN SERVICES. IHS IS A NONPROFIT THAT
FOCUSES EXCLUSIVELY ON ENDING AND PREVENTING HOMELESSNESS
IN HAWAIʻI. CHRIS THOMAS IS AN ATTORNEY
REPRESENTING IHS IN PETITIONING THE COURT FOR
ASSISTED COMMUNITY TREATMENT. JOSH WISCH IS THE EXECUTIVE
DIRECTOR OF THE AMERICAN CIVIL LIBERTIES UNION IN
HAWAIʻI, WHICH, AMONG OTHER THINGS, FIGHTS TO PROTECT THE
CONSTITUTIONAL RIGHTS OF ALL U.S. CITIZENS. JOSH WISCH IS THE EXECUTIVE
DIRECTOR OF THE AMERICAN CIVIL LIBERTIES UNION IN
HAWAII, WHICH, AMONG OTHER THINGS, FIGHTS TO PROTECT THE
CONSTITUTIONAL RIGHTS OF ALL U.S. CITIZENS. AND PHYLLIS HIRONAKA IS AN
ATTORNEY IN THE PUBLIC DEFENDER’S OFFICE WHICH IS
MANDATED TO PROVIDE LEGAL COUNSEL TO ANY INDIGENT
PERSON CHARGED WITH A CRIMINAL OFFENSE OR
THREATENED WITH A LOSS OF LIBERTY. MAHALO TO YOU FOR JOINING US
TONIGHT – 442 VETERANS CLUB CHAPTER. THANK YOU FOR JOINING YOU. IMPORTANT CONVERSATION. LET’S KIND OF GET RIGHT INTO
IT. FIRST CONNIE. TALK P THIS ASSISTED
COMMUNITY TREATMENT LAW. KIND OF, HOW DOES IT WORK?>>WELL, IT’S REALLY ABOUT
IDENTIFYING PEOPLE WHO BECAUSE OF THEIR MENTAL
ILLNESS, SEVERE MENTAL ILLNESS ARE NOT ABLE TO CARE
FOR THEMSELVES IN A WAY THAT REALLY BECOMES VERY
DETRIMENTAL TO THEIR HEALTH. A THE A LOT OF THEM EXPERIENCE
A LOT OF WOUNDS, BECOME VICTIMIZED. REALLY DON’T HAVE THE
CAPACITY TO MAKE DECISIONS THAT WOULD REALLY AFFORD THEM
THE KIND OF TREATMENT THAT IS REALLY HELPFUL TO THEM. THEY OBJECT AND DON’T RECEIVE
THE TREATMENT. AND THEY TINE TO DETERIORATE. MANY TIME THESE ARE HOMELESS. YEAH, WE REALLY WANT TO BE
ABLE TO GO TO THE COURT TO HELP MAKE THE DECISION SINCE THAT
PERSON CAN’T MAKE THAT DECISION ANY MORE. AS A NURSE, PAINS ME TO SEE
THERE ARE SO MANY PEOPLE WHO NEED TREATMENT THAT JUST
AREN’T ABLE TO ACCESS THAT.>>Lara: WHAT DO YOU SAY? LAW HAS BEEN MORPHING CHANGE. THINGS HAPPENED RECENTLY. SOME OF THEM, CHIME IN ON
THAT. LET’S TALK ABOUT THE KINDS OF
MENTAL ILLNESS THAT WILL OFTENTIMES, NOT ALWAYS,
OFTENTIMES PEOPLE END UP HOMELESS OR HOUSELESS HAVE. WHAT ARE YOU SEEING? EXPLAIN TO PEOPLE DIFFERENT
TYPES OF MENTAL ILLNESS YOU’RE SEEING THAT SEVERE AND
GOING TO START TO FALL INTO THIS CATEGORY.>>I THINK MOST PEOPLE
UNDERSTAND SCHIZOPHRENIA. VERY DISORGANIZE IN YOUR
THINKING. REALLY CAN’T PLAN OR THINK
CLEARLY ENOUGH TO GET WHAT YOU NEED. SO THAT’S ONE OF THE THINGS. BIPOLAR ILLNESS, SEVERE,
SERIOUS MENTAL ILLNESSES. THEY ARE TREATABLE AND ALSO
DEPRESSION, REALLY, REALLY BAD DEPRESSION THAT REALLY
IMMOBILIZES PEOPLE AS WELL. WE ALSO SEE A LOT OF TRAUMATIC
BRAIN INJURY. THAT ROBS PEOPLE OF THEIR
ABILITY TO MAKE DECISIONS AS WELL. OR DISINHIBITS THEM
SUFFICIENTLY THAT THEY CAN’T REALLY MAKE GOOD CHOICES. SO OFTEN WILL END UP BEING
ARRESTED FOR THEIR BEHAVIOR AS WELL. IF DON’T GET ARRESTED,
DETERIORATE CAN’T CARE FOR THEMSELVES. SITTING IN THEIR OWN
EXCREMENT AND URINE FOR A LONG PERIOD OF TIME. ONE PERSON OUTREACHED FOR
MONTHS, HAD GO TO THE HOSPITAL BECAUSE SHE KIND OF FELL OVER
ONE DAY. SITTING THERE FOREVER. AND SHE HAD ULCER DOWN TO HER
BONE. AND THAT WAS SOMETHING THAT
SHOULD NOT HAVE HAPPENED AS FAR AS I’M CONCERNED. WAS MENTALLY ILL.>>Lara: HOW OFTEN ARE
INDIVIDUALS IN THIS TYPE OF SITUATION, WHETHER THEY’RE
HOMELESS, HOUSELESS, OR NOT, ARE YOU COMING ACROSS? ARE YOU HAVING TO DEAL WITH IN
YOUR AREA OF EXPERTISE?>>WELL, AT THE ACLU OF
HAWAIʻI, TRYING TO DO A LOT TO GET OUT INTO THE COMMUNITY AND
NOT IVY TOWER LAWYERS. A LOT OF PEOPLE IN, INCLUDING
MYSELF, GONE OUT INTO THE PARKS AND TO THE BEACH PARKS
AND STREET AND TALK WITH PEOPLE WHO ARE HOUSELESS. AND TO FIND OUT WHAT THEY NEED
FROM A LEGAL PERSPECTIVE TO SEE IF THEY KNOW WHAT THEIR
RIGHTS ARE. CIVIL RIGHTIES. OTHER THINGS CITY IS DOING
ALONG THE LINES OF SWEEPS. GENERALLY SEEN, JUST PEOPLE
LIVING THE COMMUNITY. THINK THAT’S SOMETHING THAT
IS WORTH KIND OF UNDERSCORING. THESE ARE PEOPLE LIVING IN OUR
COMMUNITIES. FAR TOO OFTEN DEHUMANIZED. FRIENDS AND NEIGHBORS. FAMILY LIVING IN NEARBY
TOWNS. WHEN WE LOOK AT IT FROM IS THAT
PERSPECTIVE, LOOK AT THIS LAW, GOT A FEW CONCERNS TAKE
A SECOND AND KIND OF JUST GO QUICKLY.>>Lara: BEFORE YOU DO. KIND SET IT UP FIRST. ALL OF YOU CAN TALK ABOUT
THIS. LET’S GET PEOPLE UP TO SPEED
AS TO WHAT HAS BEEN HAPPENING, EXPLAIN THE LAW MORE. WHAT IS IT ABOUT AND WHAT
HAPPENED RECENTLY THAT’S CHANGED?>>I THINK THE CONCERN
INITIALLY WAS THAT THE LAW WAS BEING UNDERLYSESSED TO SUCH A
DEGREE, WASN’T WORTH SEEKING PETITION. CHAPTER 334 OF OUR STATUTE. DEALS WITH MENTAL HEALTH. USED HANDFUL OF TIMES IN THE
LAST FIVE TO TEN YEARS. BASED UPON THAT, CONNIE AND
HER FOLKS ADVOCATED FOR INCREMENTAL CHANGES TO THE
LAW AND RECENTLY, 2019, KIND OF OVERHAUL TO THE STATUTE,
REDUCED AND STREAMLINED TO SOME DEGREE. EASIER IN OUR OPINION TO
IMPLEMENT.>>Lara: AT ITS CORE, HOW DO
YOU EXPLAIN WHAT THIS LAW DOES?>>IT ALLOWS UNIQUE
OPPORTUNITY OF CARE PROVIDERS TO NOT TREAT INDIVIDUALS IN A
HOSPITALIZED SETTING AND NOT TREAT THEM IN JAIL OR AS
INCARCERATED PERSONS, TO ALLOW THEM THE FREEDOM TO LIVE
IN THEIR COMMUNITY BUT ADHERE COURSE OF TREATMENT UNDER THE
CARE OF PHYSICIAN. I APPRECIATE THE CONCERNS OF
ACLU AND ANYONE CONCERNED ABOUT THE CIVIL RIGHTS ASPECT
OF TREATMENT PLANS. AFFORDS FOLKS GREATER FREEDOM
OF BEING ABLE TO LIVE IN THEIR OWN ENVIRONMENT. EVEN IF IS ON STREET. BUT TO BE MANAGED PROPERLY SO
THAT THEY CAN ONLY PROTECT THEMSELVES. ALSO PROTECT SOCIETY. ACT LAW ALLOWING DOCTORS AND
CARE PROVIDERS TO ACTUALLY TREAT INDIVIDUALS IN THE
COMMUNITY, ON THE STREETS, PARKS, WHEREVER THERE LIVING.>>Lara: YOU’RE TALKING ABOUT
THE UP TO THE AMENDED VERSION THAT JUST PASSED THIS YEAR. LET ME SHOW FEW GRAPHICS TO
BREAK IT DOWN. BACK AND FORTH, SEE THESE
GRAPHICS MIGHT APPEAR A LITTLE BIT BROAD. FIRST ONE HERE TALKING ABOUT
CRITERIA. BULLET POINTED. LONGER THAN THAT. PERSON IS ONE MENTALLY ILL ORG
SUFFERING FROM SUBSTANCE ABUSE. UNLIKELY, TO LIVE SAFELY
WITHOUT AVAILABLE SUPERVISION. COUPLE MORE BULLET POINTS AND
SOME GRAPHICS HERE. PERSON ALSO HAS REFUSE NEEDED
AND APPROPRIATE MENTAL HEALTH SERVICE. HISTORY OF REFUSAL. BECOMES DANGEROUS TO SELF OR
OTHERS. I THINK WE HAVE ONE MORE
GRAPHIC THAT WE CAN SHOW. QUOTED. PORTION OF THE LANGUAGE IN THE
LAW. TREATMENT CONSIDERED
MEDICALLY APPROPRIATE AND IS IN THE PERSON’S MEDICAL
INTEREST. SO GIVE US YOUR PERSPECTIVE
WHEN YOU LOOK AT THAT INFORMATION, SHARING WITH
PEOPLE, AND WHAT YOU WANT PEOPLE TO ALSO UNDERSTAND.>>SO FEW THINGS FROM OUR
SIDE.>>Lara: WHAT DO YOU WANT THEM
TO UNDERSTAND?>>ONE OF THE CONCERNS WE HAVE
ABOUT THE WAY THE LAW IS WRITTEN, QUITE BROAD. PEOPLE SHOULD UNDERSTAND. FOR INSTANCE YOU STARTED OFF
BY TALKING ABOUT HOW IT’S FOR PEOPLE WHO HAVE MENTAL HEALTH
ISSUES OR SUBSTANCE ABUSE. PRETTY IMPORTANT FOR
STARTERS.>>SAY HERE’S A SCENARIO THAT
COULD HAPPEN UNDER THE LAW AS IT’S WRITTEN. COULD HAVE SOMEONE WHO IS
PERHAPS SUFFERING FROM ALCOHOLISM. THE LAW SAYS THAT IT’S GOING
TO BE APPLIED TO SOMEONE THAT PREDICTABLY RESULT IN THE
PERSON BECOMING IMMINENTLY DANGEROUS. THERE’S A PRETTY LONG WALK
BETWEEN THOSE THINGS.>>Lara: SAY THAT AGAIN.>>LAW ACTUALLY SAYS TALKS
ABOUT SOMEONE IN A SITUATION WHERE THAT WOULD PREDICTABLY
RESULT IN THE PERSON BECOMING IMMINENTLY DANGEROUS TO
THEMSELVES OR OTHERS. DOESN’T JUST SAY IMMINENTLY
DANGEROUS. PREDICTICALLY RUTS IN
BECOMING IMMINENTLY DANGEROUS. PERSON SUFFERING FROM
ALCOHOLISM HAS CIRRHOSIS. WHICH IS HORRIBLE DISEASE. THAT PERSON HAS RESISTING
TREATMENT. SUBSTANCE ABUSE, STATUTE
NEVER DEFINES SUBSTANCE ABUSE. ARGUABLY HAS SUBSTANCE ABUSE. GOING TO PREDICTABLY BECOME
IMMINENTLY DANGEROUS TO THEMSELVES AS A RESULT OF THIS
CIRRHOSIS ESPECIALLY IF THEY KEEP DRINKING. REFUSING TREATMENT OR
RESISTING TREATMENT IN THE PAST, THEN AS WRITTEN, THIS
LAW COULD APPLY TO THEM. THAT SEEMS LIKE A PRETTY
SLIPPERY SLOPE WHEN YOU START LOOKING AT WHOLE BUNCH OF
RANGE OF CONDITIONS THAT PEOPLE MIGHT HAVE. ONE OF THE CONCERNS PEOPLE
WATCHING TONIGHT, PROBABLY LOOK AT THIS AND THINK, THIS
ISN’T GOING TO BE MY CONCERN. THIS ISN’T MY PROBLEM. WHEN
YOU TAKE A LOOK THE AT THE DETAILS OF THE LAW, PEOPLE WHO
ARE WATCHING TONIGHT COULD FIND THEMSELVES ULTIMATELY
SUBJECTED TO THIS.>>Lara: I JUST WANT TO
CLARIFY. FIRST OF ALL, I TOLD CONNIE
THIS PERSONALLY. BEFORE. I COMPLETELY ADMIRE WHAT IHS
IS DOING. COMPLETELY ADMIRE THE STEPS
THAT YOU FOLKS HAVE TAKEN, THAT YOU’VE GOTTEN HOUSES
BUILT, YOU HAVE OUTREACH TEAMS GOING OUT TO PEOPLE TO
TRY TO GET THEM INTO TREATMENT, THAT YOUR STAFF IS
VERY UNDERSTANDING AND THEY ARE
RELENTLESS. FOLKS ARE WALKING AWAY FROM
THEM, DON’T WANT TREATMENT. YOU GUYS ARE THERE ALMOST AS
SAFETY NET. OFFICE PUBLIC DEFENDER
PERSPECTIVE, WE ARE NOT OPPOSED TO HAVING PEOPLE GET
MENTAL HEALTH TREATMENT. OR TO GET HOUSING IF THEY’RE
UNSHELTERED, ET CETERA. WE JUST WANT TO MAKE SURE IF
THEY DO IT, YOU KNOW, THAT BY IMPOSING THIS LAW, IT’S DONE
WHILE GUARDING THEIR CONSTITUTIONAL RIGHTS. AND MAKING SURE THAT IT’S NOT
EITHER FORCED DOWN THEIR THROATS OR DONE
INAPPROPRIATELY. SO EVEN THOUGH THE WAY THE LAW
IS WRITTEN, IT’S BROAD BASED TO GIVE A LOT OF THE, I GUESS
YOU WOULD SAY, GIVE THE COURTS A LOT OF DISCRETION IN HOW TO
ORDER IT, ET CETERA. I HAVE SOME REALLY GRAVE
CONCERNS ABOUT THE CONSTITUTIONALITY OF THE
STATUTE. AND I THINK MY PREDICTION IS
THAT WITH FEW CASES WE’VE BEEN WORKING ON, CHRIS THOMAS AND
MYSELF, THAT EVENTUALLY, WE’LL BE WINDING UP BEFORE THE
SUPREME COURT ON APPEAL. GIVE ME EXAMPLES OF YOUR GRAVE
CONCERNS. GRAVE CONCERNS THE FIRST
CRITERIA SAYS THE PERSON IS MILLENIAL OR SUFFERING FROM
SUBSTANCE ABUSE. IT DOESN’T SAY SERIOUS
MENTALLY ILL. CONNIE WAS TALKING ABOUT
SCHIZOPHRENIA. BIPOLAR DISORDER, PERSON IS
SEVERELY HAMSTRUNG IN LIVING HIS OR OTHER LIFE. BY SAYING THAT IT’S ONLY
SOMEBODY WHO IS MENTALLY ILL, I MEAN, THAT COULD BE SOMEBODY
WITH SLIGHT DEPRESSION OR WHO KIND OF DOWN ABOUT SOMETHING,
ET CETERA. AND IF CONCERNED FAMILY
MEMBER OR SAY LIKE A PSYCHOLOGIST, PSYCHIATRIST,
SAYS HEY, I THINK YOU SHOULD BE ON MEDICATION AND THE
PERSON IS NOT REALLY, I THINK I’M GOING TO PETITION FOR YOU
TO BE UNDER THIS ACT SO WE CAN MAKE SURE YOU GET THE HELP
THAT I THINK YOU NEED.>>PROBABLY WOULDN’T GET IT
THOUGH BECAUSE EVEN THOUGH THAT — LANGUAGE IN THE LAW.>>YEAH. IT’S NOT JUST ONE CRITERIA. YOU HAVE TO MEET ALL. THE OTHERS, TALK ABOUT
SOMEONE BEING UNLIKELY TO LIVE SAFELY ON THEIR OWN
INDEPENDENTLY AND ALSO, HAS DEMONSTRATED BEING A DANGER
TO THEMSELVES OR OTHERS IN THE PAST. AND I THINK FOR HOW WE’RE
LOOKING AT IT, WHEN YOU SEE YEARS OF BEHAVIOR, PLAYING
OUT OVER AND OVER, IT REALLY IS PRETTY PREDICTABLE. EVERY TIME THE PERSON STARTS
DRINKING, LIKE JOSHUA IS SAYING, GET ANGRY, START
VICTIMIZING OTHER PEOPLE. DOES BECOME PREDICTABLE WITH
SOME PEOPLE. I UNDERSTAND YOUR CONCERN. JUST LIKE WHAT YOU WERE
SAYING. I DOUBT THAT’S COURT WOULD
ACTUALLY GRANT THAT FOR SOMEBODY WHO ACTUALLY —
>>YOU HAVE TO REMEMBER, THIS ISN’T A FACT PATTERN OR
DEBATE. THESE ARE FOLKS UNDER THE CARE
OF HISTORICAL CARE WORKERS LIFE AND SOCIAL WORKERS, WHO
ARE THEN EVALUATED BY A DOCTOR PSYCHIATRIST. IHS, LICENSE PSYCHIATRIST
OUTLINES TREATMENT PLAN. THIS ISN’T LAWYERS
DETERMINING WHO IS MENTALLY ILL OR SUFFERING FROM
SUBSTANCE ABUSE. THESE ARE DOCTORS, HEALTH
CARE PROFESSIONALS MAKING THIS DIAGNOSIS.>>Lara: CONCERN IS THE
LANGUAGE IN THE LAW WRITTEN IN A WAY THAT IT ASSURES THAT’S
GOING TO BE APPLIED ONLY TO THOSE PEOPLE?>>NO, IT’S NOT.>>Lara: OR STRONG ENOUGH?>>SOUND IT’S LIKE BECAUSE OF
THE DIFFERENT LEVELS OF CRITERIA, IT HAS TO — WOULD
ULTIMATELY LEAD TO THOSE INDIVIDUALS AS FAR AS —
>>I THINK THAT IT’S PROBABLY A SUBJECT OF OPINION. I RELY ON THE JUDGE. PRESENTATION OF THE FACTS OF
THE CASE. FOR THE JUDGE TO DECIDE. WHETHER THIS PERSON WOULD
NEED THE TREATMENT. BUT NOT ONLY THAT, MOST OF THE
TIME, THEY’RE ACTUALLY APPOINTING GUARDIAN AD LITEM
TO ACT ON THE PERSON’S BEHALF AS WELL.>>ONE OF THE CONCERNS, YOU
WERE TALKING ABOUT SUBJECTIVITY, ONE OF THE
CONCERNS THAT WE’VE GOT IS SOME OF THE MORE OBJECTIVE
CRITERIA THAT USED TO EXIST IN THE LAW. ONCE AGAIN, ACLU HAD REAL
CONCERNS ABOUT THE LAW PREVIOUSLY, BUT IT HAD SOME
MORE OBJECTIVE THINGS SUCH AS A HISTORY OF PREVIOUS
HOSPITALIZATION. WHICH I BELIEVE HAS NOW BEEN
STRIPPED FROM THE LAW. IN THE AMENDMENT. BECAUSE THESE AMENDMENTS WERE
WRITTEN TO MAKE IT EASIER TO SUBJECT PEOPLE TO THIS LAW. SO YOU’VE TAKEN OUT SOME OF
THAT OBJECTIVITY. THAT WAS IN THE LAW. TO KIND OF GRACE THE SKIDS ON
THIS A LITTLE BIT. THAT’S ONE OF THE CONCERNS
WE’VE GOT AS WELL. I THINK THE REASON WHY IT WAS
TAKEN OUT IS BECAUSE SOME PEOPLE HAVE GONE FOR YEARS
WITHOUT ANY HOSPITALIZATION OR ANY TREATMENT AT ALL.
AND WE’RE TALKING ABOUT PEOPLE SOMETIMES HAVE BEEN ON
THE STREET FOR OVER 20 YEARS. AND SO IT’S REALLY PRETTY SAD,
NEVER GOTTEN TREATMENT BEFORE. SO WITH THAT CAVEAT, IF THEY
NEVER WERE HOSPITALIZED BEFORE, WE WOULDN’T EVEN BE
ABLE TO BRING THEM. IF THAT WAS PART OF THE LAW.>>Lara: COUPLE QUESTIONS IN
HERE. FROM NICO. WILL ACTS BE LIMITED TO THOSE
WITH SEVERE WEATHER MENTAL HEALTH CONDITIONS DIAGNOSED
AND TREATED BY MEDICAL PROFESSIONALS, OR WOULD ALSO
OPEN THE DOOR TO COERCED NONMEDICALLY SUPERVISED,
QUOTED, TREATMENT, AND ATTENTION FOR THOSE WHO USE
SUBSTANCES? IS THAT AN AREA THAT YOU
FEEL — WHAT’S YOUR RESPONSE TO THAT? FOCUS RIGHT NOW ON PEOPLE WHO
HAVE SEVERE MENTAL ILLNESSES. BECAUSE OF THE STATUTE
DOESN’T LIMIT APPLICATION TO THAT, IT CERTAINLY COULD BE
USED ON PEOPLE WITH SUBSTANCE ABUSE. I CANNOT THINK OF CASES THAT
HAVE BEEN BROUGHT BECAUSE KIND OF TOO NEW INTO THE
SITUATION NOW. WHERE THE PERSON IS SOLELY
SUBSTANCE ABUSER AND THE DOESN’T HAVE MENTAL HEALTH
ISSUES. I CAN’T SPEAK TO THAT LANGUAGE
IN THE STATUTE ABOUT APPLICATION TO SOMEBODY WHO
IS I WANT TO SAY PURELY SUBSTANCE ABUSER IS NOT CLEAR
ENOUGH. IT’S VERY VAGUE. SO I THINK WHAT THE CALLER OR
VIEWER WAS TALKING ABOUT IS A POSSIBILITY. THAT’S WHYER ACLU IS
CONCERNED. MY OFFICE IS CONCERNED ABOUT
THE BROAD BASED POTENTIAL APPLICATION.>>Lara: WHAT IS MORE, WHAT DO
YOU SEE HAPPENING? IF YOU, IF THEY’RE NOT
COMMITTED TO PSYCHIATRIC FACILITY. DO YOU TEND TO SEE MORE
INCARCERATION? WHAT DO YOU SEE HAPPEN?>>MORE INCARCERATION. MORE ARRESTS RESULT IN THEM
COMING BACK TO THE COMMUNITY. A LOT WASTED RESOURCES. WHENEVER THEY GO IN, COSTING
ANOTHER, I DON’T KNOW HOW MUCH IT COSTS FOR ONE EMERGENCY
ROOM VISIT. BUT THAT WHOLE CYCLE OF GOING
TO THE EMERGENCY ROOM, BEING RELEASED, COMMITTING A CRIME
YOU END IN JAIL AGAIN. NOT ACCEPTABLE IF IT’S A
TREATABLE CONDITION.>>ONE AREA I’M GUESSING WE DO
AGREE, ACLU LIKE MOST REFENDERS WANTS PEOPLE TO GET
TREATMENT AND WANT PEOPLE TO GET THE RESOURCES THEY NEED,
HOUSING NEED, CRITICAL PART OF MAINTAINING THEIR LIVES. WHERE OUR CONCERN IS WHENEVER
THAT BECOMES COERCIVE. ONE OF THE CONCERNS WE HAVE IS
THAT THERE SEEMS TO BE SO MUCH EFFORT BEING PUT INTO
COERCING TREATMENT. THAT THAT ENDS UP DIVERTING
RESOURCES AWAY FROM GETTING PEOPLE WHO ARE ACTUALLY
SEEKING TREATMENT THE ASSISTANCE THAT THEY NEED. THERE HAVE BEEN STUDIES DONE
ON THIS. TECHNICALLY, WOULD HAVE BEEN
CONSIDERED THREE GOLD STANDARD OF CLINICAL RESEARCH
STUDIES WITH RANDOMIZED CONTROLLED TRIALS. WHAT THOSE HAVE SHOWN WAS THAT
COERCIVE TREATMENT DIDN’T MAKE A DIFFERENCE. WHEN THERE HAVE BEEN PATIENTS
INTERVIEWS WHO HAVE BEEN COERCIVELY TREATMENTED WERE
SO TRAUMATIZED, HAD A HARD TIME VOLUNTARILY SEEKING
TREATMENT IN THE FUTURE. WHEN YOU TIE THAT INTO THE
CONCERNS FOR INSTANCE THAT WE HAVE ABOUT BODILY AUTONOMY,
BECAUSE THERE IS NOT CIVIL RIGHTS THAT’S MUCH MORE
FUNDAMENTAL THAN HAVING CONTROL OVER YOUR OWN BODY. WHETHER YOU TAKE A LOOK AT
SOME OF THE GAPS AND THE VAGARIES THAT IN THE STATUTE
THAT WE’VE ALREADY DISCUSSED, WE THINK IT’S ENTIRELY LIKELY
THAT YOU COULD HAVE THOSE VIOLATIONS OF BODILY
AUTONOMY. BREAKING OF TRUST TO
NECESSARY MAINTAIN LONGTERM THERAPEUTIC RELATIONSHIP.>>Lara: I WANT TO GIVE PEOPLE
A CHANCE TO RESPONSE. WHAT WOULD THE ACLU DO ABOUT
THE SERIOUSLY ILL PEOPLE ON THE STREETS.>>IGNORE THEM? WHAT DOES SOCIETY HAVE AN
OBLIGATION TO HELP THESE PEOPLE? WHAT IS THE ALTERNATIVE HERE? SITUATION WHERE INDIVIDUAL
APPEARS TO BE AT A STAGE MENTALLY WHERE THEY MAY DO
HARM TO THEMSELVES OR TO OTHERS OR SEVERE HEALTH
SITUATION. WHAT IS THE ALTERNATIVE?>>FEW THINGS. ONE, IS THERE’S A MAN OUT OF
SAN FRANCISCO. FORMER CEO OF MENTAL HEALTH
ASSOCIATION OF SAN FRANCISCO. I THINK HE PUT IT PRETTY
SUCCINCTLY. FORCE ISN’T TREATMENT. WHAT HE HAD TALKED ABOUT WAS
IN HIS EXPERIENCE, WORKING WITH THE HOUSELESS
COMMUNITIES IN NEW YORK AND OTHERS, PATIENT AND
PERSISTENT OUTREACH AND DEVELOPING THESE
RELATIONSHIPS WITH FOLKS IS WHAT REALLY MADE THE
DIFFERENCE IN THE LONGTERM. THERE ARE ALSO OTHER THINGS
THAT GROUP LIKE OR SO WILLING TO TAKE A LOOK AT IF APPLIED
CORRECTLY. THINGS SUCH AS PSYCHIATRIC
ADVANCED DIRECTIVE. IF YOU HAVE SOMEONE WHO HAS
GONE THROUGH PSYCHIATRIC CRISIS, KNOW WHAT WORKED AND
WHAT DIDN’T WORK AND PERHAPS EVEN WHAT MEDICATION WORKED,
TO GET THEM OUT OF THAT, AT A TIME WHEN THEY WERE ACTING
TRULY VOLUNTARILY FASHION. IMPORTANT CRITERIA FOR US,
NOT MAY BE LOOKED VOLUNTARILY BUT WASN’T, SIGNED THAT. THAT WOULD BE SOMETHING THAT
WOULD BE APPLIED TO THEM LATER. WE WOULDN’T HAVE AN OBJECTION
TO THAT.>>MISNOMER THAT EVERY ACT OR
SOUGHT OR IMPLEMENTED IS SCENARIO WHERE MEDICATION OR
TREATMENT IS BEING GIVEN AGAINST SOMEONE’S WILL. THAT IS NOT ALWAYS THE CASE. THERE IS OPPORTUNITY WITHIN
THE LAW AND WITHIN THESE ORDERS FOR VOLUNTARY
TREATMENT. THESE FOLKS HAVE THE ABILITY
TO ACQUIESCE TO THE TREATMENT JUST AS HE’S RESIST IT. IN TERMS OF ACQUIESCENCE OR
ASSISTANCE, STATUTE REKAUAIS THEY’RE INCAPACITATED. MAY NOT HAVE ABILITY TO
DETERMINE WHAT THEY WANT. SOCIETY HAS TO BALANCE
INTEREST OF THE INDIVIDUAL VERSUS NEED TO PROTECT
SOCIETY. WHEN YOU PROTECT THE
INDIVIDUAL CIVIL RIGHTS BUT ALSO NEED TO PROTECT FOLKS
LIVING AMONGST US, PARKS, CHILDREN, ENCOUNTER PEOPLE
SUBSTANCE ABUSIVE. APPRECIATE THE CIVIL RIGHTS
CONCERNS BUT WE ALSO APPRECIATE THE NEED TO
PROTECT SOCIETY. I BELIEVE THIS ACT LAW GIVES
US THAT UNIQUE OPPORTUNITY TO BALANCE THOSE AND IMPLEMENT
AND DO BOTH. VIDEO WE WANT TO SHOW. CAN’T TELL WHO THE INDIVIDUAL
IS. BUT IF YOU WANT TO TAKE A LOOK
AT THE MONITOR BEHIND YOU. GET A SENSE FOR SOMETIMES
INDIVIDUALS YOU DO SEE OUT THERE, THINK TO YOURSELF, HOW
ARE WE SUPPOSED TO ADDRESS THIS INDIVIDUAL OR ADDRESS
THE ISSUE THAT IS BEFORE US HERE? WHAT ARE YOUR RESPONSES WHEN
YOU SEE A VIDEO LIKE THIS?>>OKAY. MY FIRST RESPONSE IS THAT I
SEE THE MAN IS ON THE STREET. AND HE IS IN ENDANGERING
HIMSELF. I THINK THAT’S A STREET. BEING SHOWN. I COULD BE WRONG. BUT IF THAT’S THE CASE, HE IS
IN ENDANGERING HIMSELF. APPROACHING THIS INDIVIDUAL. HERE.>>RIGHT. IN TRAFFIC. OKAY. PERHAPS HE’S — APPEARS IN
THE VIDEO TO HARASSING THAT INDIVIDUAL.>>RIGHT. OKAY. TO ME, THAT SORT OF A
SITUATION IS RIPE FOR POLICE INTERVENTION. HARASSING SOMEBODY OR
THREATENING SOMEBODY. POLICE HAVE ABSOLUTE RIGHT TO
STEP IN THERE. ARREST THE MAN FOR THAT TYPE
OF A CRIME. ALTHOUGH IT MAY BE MENTALLY
HEALTH RELATED BECAUSE HE IS OFF HIS MEDS. DEEP INTO HIS MENTAL HEALTH
ILLNESS. IN THOSE CASES, WHAT THEY DO
GENERALLY IS TO TAKE THEM TO QUEEN’S OR HOSPITAL, HAVE
THEM EVALUATED TO SEE WHETHER THEY NEED TO BE HELD. IF SOMEBODY IS IMMINENTLY
DANGEROUS LIKE THAT, CHASING AFTER THAT PERSON, AND IT
APPEARS THEY’RE IMMINENTLY DANGEROUS, THEY NEED TO BE
TAKEN OUT OF SOCIETY. AND TREATED LIKE IF
MEDICATION DO WORK, TO HELP THEM TO BECOME MORE FOCUSED
AND TO NOT PERSIST IN THOSE KIND OF BEHAVIOR. THEY CAN BE SAFELY RELEASED
BACK INTO THE COMMUNITY. WHAT I SEE PROBLEM WITH WITH
THE ACT, IF THAT, THERE’S KIND OF DISCONNECT. I WANT TO RESPOND TO WHAT
CHRIS WAS SAYING ABOUT VOLUNTARY. PERFECTLY FINE, PUBLIC
DEFENDER OFFICE HAS NO PROBLEM IF SOMEONE WANTS TO
VOLUNTARILY SUBMIT THEMSELVES TO ACT PROGRAM OR
TREATMENT. AND THAT IS KIND OF FINE. OUR OFFICE BECOMES INVOLVED,
WHERE JOSH OFFICE BECOMES INVOLVED, PEOPLE EITHER DON’T
KNOW WHAT’S GOING ON OR THEY ACTUALLY DON’T WANT TO
PARTICIPATE IN IT. SOME OF THE PEOPLE LIKE THE
LADY OR MAN YOU WERE TALKING ABOUT, MAY NOT HAVE HAD
TREATMENT FOR 20 YEARS, I’M SURE IT’S NOT FOR LACK OF
TRYING. GUY SAID, NO, NO, NO. NOT INTERESTED. SOMETHING MORE IMPORTANT TO
HIM IS GOING ON. SO TREATMENT IS KIND OF LESS
IMPORTANT TO HIM. AND SO HIS LIFE GOES ON.>>I WANT TO SAY, WHAT
COMMONLY WILL HAPPEN TO THAT GENTLEMAN, TAKEN TO THE
EMERGENCY ROOM, MH HIM, GOING TO THE EMERGENCY ROOM, AND
REFUSE TREATMENT.>>Lara: WHAT IS MH?>>POLICE MAY TAKE HIM IN, BUT
THEN THEY WON’T BE ABLE TO HOLD HIM BECAUSE HE WON’T BE
ANY MORE IMMEDIATELY DANGEROUS. SO IF HE REFUSES —
>>Lara: SO THE CYCLE CONTINUES.>>GETS RELEASED RIGHT BACK IN
THE COMMUNITY. FOR THAT GENTLEMAN THAT I KNOW
IT’S HAPPENED MANY TIMES BEFORE. WE’RE TRYING TO BREAK THAT
CYCLE SO THAT HE CAN GET SOME TREATMENT. SO HE WOULD BE ABLE TO
ACTUALLY HAVE A LIFE IN THE COMMUNITY.>>WHAT IS YOUR THOUGHT? HEARING COMMENTS SO FAR.>>WELL, THE ANSWER WHEN WE
SEE A VIDEO LIKE THAT, WE SHOULD ININCARCERATE HIM. DETAIN HIM. PUT HIM IN JAIL. THIS LAW GIVES US THE
OPPORTUNITY TO IT’S NOT ONLY TREAT THE INDIVIDUAL BUT DO IT
OUTSIDE THE CONFINES OF INCARCERATION. SO IF WE’RE GOING TO BREAK
THAT CYCLE, CONTINUALLY PUTTING THEM IN JAIL OR INTO
THE HOSPITAL AND THEY CONTINUALLY COME OUT WITHOUT
ANY BETTER SITUATION, WHY WOULDN’T WE ACTS UPON THE
OPPORTUNITY TO TREAT THEM IN THE COMMUNITY? IT’S MY UNDERSTANDING, I’M
NOT AN EXPERT IN THE MEDICINE, BUT THAT ALREADY MEDICINES
AVAILABLE TO FOLKS WITH SCHIZOPHRENIA AND OTHER
MALADIES THAT HAVE VERY EFFECTIVE MEANS OF MANAGING
MENTAL ILLNESS OVER A LONG PERIOD OF TIME. TIME RELEASED DRUGS CAN BE
GIVEN. MY UNDERSTANDING FROM TALKING
TO CONNIE AND HER FOLKS THEY HAVE HAD SUCCESS WITH THESE
MEDICATIONS IN MANAGING PEOPLE TO THE DEGREE THAT THEY
ARE ABLE TO HAVE THE WHEREWITHAL TO SEEK FOR THE
TREATMENT. AND BETTER THEMSELVES. LIVE MORE SAFELY AMONGST
THEM. TWO CONCERNS. ONE IS, REALLY I WANT TO HAVE
THIS. VIDEOS LIKE THAT, EASY FOR
PEOPLE TO LOOK AT THAT AND BE CONCERNED. AGAIN, I ECHO EVERYTHING THAT
YOU SAID ABOUT THE WORK. GOD BLESS YOU FOR BEING OUT
THERE AND DOING IT FOR AS LONG AS YOU HAVE. I THINK IT’S CRITICALLY
IMPORTANT THAT PEOPLE AT HOME WATCHING TONIGHT UNDERSTAND
THAT IT IS A VANISHING SMALL PERCENTAGE OF PEOPLE WITHEL
MENTAL HEALTH ISSUES WHO ARE EVER VIOLENT TOWARDS ANYONE
ELSE. I THINK IT IS OFTEN KIND OF
CONFLATED. IN IS PART OF UNFORTUNATELY
KIND OF THE DEHUMANIZING THAT HAPPENS ESPECIALLY WITH
PEOPLE WHO ARE HOUSELESS IN THE POPULATION, YOU’RE
HOUSELESS, WALKING AROUND, SHOULD BE SCARY. MOST PEOPLE WHO HAVE MENTAL
HEALTH ISSUES NEVER COMMIT ANY VIOLENT ACT. THAT’S SOMETHING I THINK WE
JUST REALLY CAN’T LOSE SIGHT OF.>>Lara: ALLOWS YOU TO
CONTINUE ON THIS. NEED TO ADDRESS THESE
QUESTIONS. ALONG THE THREAD OF WHAT
YOU’RE TALKING ABOUT. DEAL WITH THE PERCEPTIONS AND
HANDLE DIFFERENT THINGS WE SEE. I WOULD LIKE TO HEAR FROM THE
ACLU AND PUBLIC DEFENDER HAVE TO SAY ABOUT PROTECTING THE
CONSTITUTIONAL RIGHTS OF THE PUBLIC WHO VISIT PUBLIC PARKS
AND BEACHES WITHOUT BEING SUBJECTED TO AGGRESSIVE
HOMELESS PEOPLE OR HAVING TO LOOK AT PEOPLE DEFECATING IN
PUBLIC. INDIVIDUAL’S EXPERIENCE. WHAT ABOUT ME? IF I’M OUT THERE, WHAT ARE MY
RIGHTS IF I’M HAVING AN ISSUE WITH THIS? FEELING THREATENED, NOT
FEELING SAFE IN MY ENVIRONMENT?>>SO TWO THINGS. SOMEONE OUT THERE WHO IS
COMMITTING INDEPENDENTLY CRIMINAL ACT. THEN OUR ORGANIZATION ISN’T
GOING TO COME OUT AND DEFEND THEM FOR DOING THAT. SOMEONE WHO ASSAULTS SOMEONE
ELSE, THAT’S A CRIME. AND THAT IS SOMETHING FOR
WHICH THEY CAN BE PROSECUTED. I THINK THAT ALSO REALLY GETS
INTO THIS QUESTION OF PERCEPTION. THERE IS SOMETHING THAT
HAPPENED I THINK IT WAS ABOUT A YEAR AGO, I’VE TALKED ABOUT
THIS BEFORE, AT THAT THERE WAS AN ATTACK ON A COUPLE OF
JAPANESE TOURISTS IN A PARK IN KAKAAKO. SHORTLY AFTER THAT ATTACK
HAPPENED, THERE WAS A LOT OF SPECULATION THAT’S ATTACK WAS
DONE BY SOMEONE HOUSELESS IN THE PARK. TURNS OUT ATTACK WAS
COMMITTED BY SOMEONE WHO I BELIEVE LIVED IN LANIKAI AND
IT WAS STOPPED BY A COUPLE OF HOUSELESS PEOPLE. WHO WERE LIVING THE PARK. I BRING THAT UP JUST TO KIND
OF MAKE PEOPLE REALIZE SOMETIMES THOSE PERCEPTIONS
COME OUT OF MISPERCEPTION. WE REALLY DO NEED TO TRY TO
FOCUS ON THE FACT THESE ARE JUST MEMBERS OF OUR
COMMUNITY.>>Lara: YOUR RESPONSE.>>I WOULD AGREE. REALLY FEEL LIKE HOUSELESS
PEOPLE ARE STIGMATIZED, STEREOTYPED. BUT WE’RE TALKING ABOUT
PEOPLE WHO ARE DIAGNOSED, MENTALLY ILL, OR HAVE A
SERIOUS SUBSTANCE ABUSE PROBLEM WE HAVE ONE OF THE
WORST METHAMPHETAMINE EPIDEMICS ACROSS THE COUNTRY. WE LIVED WITH IT. FOR SCORES OF YEARS NOW. AT THIS POINT. WHEN I WAS AT THE STATE
HOSPITAL, SAW A LOT OF THE PATIENTS THERE COMING IN ON
FORENSIC ORDERS, THEY HAD COMMITTED CRIMES BUT WERE
ALSO HIGH ON ICE, OR HAD LONGSTANDING ADDICTIONS TO
ICE. WHEN YOU HAVE THAT IMPAIRS
YOUR BRAIN AFTER A WHILE. AND IF YOU DON’T GET
TREATMENT, IT WILL CONTINUE TO DEBILITATE YOU. I THINK A LOT OF THESE
CONDITIONS THAT WE’RE TALKING ABOUT —
>>Lara: IF THEY WERE TO SOMEHOW MIRACULOUSLY STOP
TAKING DRUGS AT THAT POINT IN TIME, OFTENTIMES, HEY, YOU
SHOULD BE ABLE TO JUST HAVE THE WILL DO IT. STILL IN A STATE BASED ON THE
DAMAGE THAT’S HAPPENED?>>RIGHT.>>Lara: CAN’T BE REVERSED AT
THAT POINT IN TIME?>>RIGHT. THERE’S BRAIN DAMAGE. WHAT I’M TRYING TO SAY. AS A PERSON WHO IS MENTAL
HEALTH PROVIDER. WHEN THE BRAIN IS DAMAGED IN
THAT WAY, WE CALL IT HIGH IMPACT NEUROLOGICAL
CONDITIONS. THERE IS AN IMPAIRMENT OF
THAT, BRAIN, WHICH IS RESPONSIBLE FOR YOUR
THINKING. FEELING AND ABILITY TO ACT. IF YOU CAN’T DO THAT WITH THE
NORMAL FUNCTION THAT WE WOULD NORMALLY HAVE IF YOUR BRAIN
WAS INTACT. YOU’RE IMPAIRED, YOUR CHOICES
ARE NOT GOING TO BE GREAT.>>MY RESPONSE ANSWERS YOURS. DOESN’T TALK TO JIM’S
QUESTION. SIN IT’S ON THE TABLE. ONE OF THE CONCERNS THAT I
HAVE IS THAT IF THERE IS A PERSON WHO HAS BRAIN DAMAGE
BECAUSE OF METHAMPHETAMINE USE, FOR EXAMPLE AND WE DO,
ALSO HAS SCHIZOPHRENIA OR SOME OTHER SERIOUS MENTAL
ILLNESS, GET HIM TREATMENT, IF THAT PERSON CONTINUES
USING DRUGS, OR IF THAT PERSON HAS BEEN SO DAMAGED MENTALLY,
THAT THEY CAN’T FUNCTION IN SOCIETY TO CONTINUE TO TAKE
HIS MEDICATIONS, GET HIMSELF SHELTER, EAT PROPERLY, ET
CETERA, I’M NOT SURE THAT WE’VE SOLVED THE PROBLEM AS
FAR AS THAT PARTICULAR INDIVIDUAL GOES. HE MAY STILL BE HOUSELESS. HE MAY STILL BE UNABLE TO FEND
FOR THEMSELF OR SO CARE FOR THEMSELF. MEDICATION IS NOT, MAGIC
BULLET THAT IS GOING TO ANSWER THIS.>>DEFINITELY NOT BUT IT IS
THE BEGINNING. ONCE YOU CAN RESTORE SOME
COGNITIVE FUNCTION IN THAT PERSON, THEY CAN START TO MAKE
SOME DIFFERENT CHOICES. TREATMENT IS NOT JUST
MEDICATION. WE ALWAYS SAY THAT IT’S MUCH
MORE THAN JUST MEDICATION.>>Lara: COUPLE QUESTIONS
HERE. WE HAVE MORE COMING OUT. KIND OF PARTIALLY IN LINE WITH
TALKING ABOUT THE LAW ITSELF AND ENVIRONMENT WE’RE DEALING
WITH HERE. JANET. SAYING, ARE WE TALKING ABOUT
MANDATING OR ADDRESSING INDIVIDUALS WE’RE FOCUSING
ON, ARE WE TALKING ABOUT GIVING PILLS OR FORCING
INJECTION? WHAT HAPPENS IF THE
INDIVIDUAL DOES NOT FOLLOW UP ON THAT TREATMENT? KIND OF SORT OF LOOKING AT I
THINK PARTIALLY SORT OF LOOKING AT THE LAW SITUATION. MAY NOT TOTALLY
UNDERSTANDING. WE’RE TALKING ABOUT
INDIVIDUAL.>>IF I COULD RESPOND TO THAT. THAT’S ONE OF MY CONCERNS. THERE IS A CHAPTER IN HERE
SECTION 334, 129, THAT SAYS, FAILURE TO COMPLY WITH
ASSISTED COMMUNITY TREATMENT. IF SOMEBODY DOESN’T FOLLOW
THE TREATMENT PLAN, THE TREATING PSYCHIATRIST OR
APRN, ADVANCED PRACTICE REGISTERED NURSE WITH
PRESCRIPTIVE AUTHORITY. SOME OTHER CRITERIA, MAY
PRESCRIBE OR ADMINISTER TO THE SUBJECT REASONABLE OR
APPROPRIATE MEDICATION MEDICATIONS IF SPECIFICALLY
AUTHORIZED BY COURT ORDER. AS I READ ADMINISTER, TO ME,
THAT MEANS THAT YOU CAN ACTUALLY FORCE MEDICATE THE
PERSON AS LONG AS THERE IS A ORDER BY THE COURT SAYING THAT
IT’S OKAY TO FORCE MEDICATE THEM. THE ACT ALLOWS THE JUDGE TO
IMPOSE THIS TREATMENT PLAN FOR A YEAR. SO THAT MEANS REGARDLESS OF
WHETHER THE GUY IS DANGEROUS NOW, RIGHT AT THIS MOMENT,
JANUARY 1, HE CAN BE FORCED MEDICATED ALL THE WAY TILL
DECEMBER 31 OF THAT YEAR.>>ONE THING TO MENTION IS
THAT THE INITIAL GOAL OF THE ACT ORDER IS TO ATTEMPT TO GET
MEDICATION TAKEN OR ADMINISTERED VOLUNTARILY. THEY’RE VERY GOOD ABOUT DOING
THAT. IF THAT DOESN’T WORK,
SOMEWHAT SOFTER COURSE OF MEASURES TO TRY AND CONVINCE
THEM IT’S THE RIGHT THING TO DO. ONLY IN A VERY EXTREME
CIRCUMSTANCE. CAN AN INDIVIDUAL BE
TRANSPORTED TO EMERGENCY ROOM IN A CLINICAL SETTING TO BE
ADMINISTERED WITH MEDICATION IF THEY REFUSE IT. THIS ISN’T A SITUATION WHERE
THE DOCTOR ON THE STREET CAN WALK UP, DRAG SOMEBODY TO THE
GROUND AND SHOOT THEM WITH A NEEDLE. THEY HAVE TO BE NOTING
STATUTE, BROUGHT TO — FOLLOWING STATUTE,
BROUGHT THEM TO THE EMERGENCY ROOM, GIVEN TREATMENT IN A
CRITERIA. TO ANSWER YOUR QUESTION,
MEDICATION CAN BE GIVEN ADMINISTERED IN THAT
SITUATION. BUT IT IS NOT, IT’S NOT THE
INITIAL AIM OF THE ACT ORDER.>>Lara: QUESTION IN HERE. STARTING TO PILE UP. RACHEL FROM KAUAI. AS A CONSUMER, I FEEL HELPFUL
TO HAVE BEEN TAKEN TO A FACILITY FOR TREATMENT. CRITICAL TO MAKE IT EASIER TO
INTERVENE TO GET HELP. CAN’T JUST LEAVE PEOPLE OUT
THERE. IF YOU WANT TO, I DON’T KNOW
WHAT ELSE YOU WANT TO RESPOND TO. HEY, NEED TO GET THEM IN THAT
SORT OF SPACE WHERE WE CAN SORT OF CONTROL THE
SITUATION.>>THAT’S AN EXAMPLE OF
SOMEBODY WHO HAS HAD THEIR COGNITIVE ABILITIES
RESTORED. RECOGNIZES THAT. WHEN SHE’S SUFFERING FROM
MENTAL ILLNESS, CAN’T MAKE THOSE DECISIONS ON HER OWN. AFTER SOMEONE GETS
MEDICATION, THEY’RE ABLE TO MAKE BETTER DECISIONS. I’VE SEEN WHEN SOME PEOPLE
ACTUALLY HAVE BEEN BOTH MENTALLY ILL AND SUFFERING
FROM ADDICTION, AFTER GETTING MEDICATION, ACTUALLY USE LESS
AND THEY START TO CONSIDER GOING TO TREATMENT FOR THEIR
ADDICTIONS AS WELL. SO IT’S REALLY MANY
OPPORTUNITIES TO BENEFIT THEM.>>FLIP SIDE TO THAT. COUPLE OF EXAMPLES. ONE, COUPLE OF PSYCHIATRISTS,
DR. DINAH MILLER AND ANNETTE
HANSEN WROTE BOOK, COMMITTED BATTLE OVER INVOLUNTARY
PSYCHIATRIC CARE. INTERVIEWED PEOPLE IN FAVOR
AND PEOPLE OPPOSED TO IT. THEY INTERVIEWED NUMBER OF
PATIENTS WHO TALKED ABOUT HAVING BEEN FORCIBLY
MEDICATED AND TRAUMA THAT THAT CAUSED THEM. ONE OF THE PEOPLE THAT THEY
INTERVIEWED ACTUALLY SPECIFICALLY SAID, SHE WAS SO
TRAUMATIZED BY IT, SHE DIDN’T THINK SHE COULD EVER GO SEE A
MENTAL HEALTH PROFESSIONAL AGAIN. TALKED ABOUT HAVING RECENTLY
HAD TWINS, KNOWING SHE WAS SUSCEPTIBLE TO POSTPARTUM
DEPRESSION. STILL NOT WANTING TO GO TO
TREATMENT BECAUSE OF THAT. THAT IS NOT JUST THEORETICAL. SPOKEN WITH A SOCIAL WORKER
BEEN WORKING IN THE MENTAL HEALTH ARENA FOR OVER A
QUARTER OF A CENTURY RIGHT HERE IN HAWAIʻI. TWO THINGS THAT SHE HAD TOLD
ME. KNOWS A NUMBER OF PEOPLE WHO
HAVE VERY SIMILAR STORIES. FORCIBLY MEDICATED. AS A RESULT, REALLY HAVE
TROUBLE NOW GOING TO VOLUNTARILY SEEK TREATMENT. THIS MAY BE SHORT TERM
BAND-AID CAUSED LONGTERM DAMAGE.>>I’LL LET YOU REPOSTPONED. LET THEY GET THIS QUESTION IN
HERE. WHAT OPERATIONAL AND LEGAL
MECHANISMS ARE IN PLACE TO ENSURE THAT APPROPRIATE
MEDICAL STANDARDS OF CARE ARE FOLLOWED? WILL PATIENTS HAVE ACCESS
INDEPENDENT COUNSEL TO PURSUE PRIVATE RIGHTS OF ACTION IF
NECESSARY?>>I CAN SPEAK TO THAT STATUTE
DOES AFFORD PATIENTS THE PUBLIC DEFENDER’S OFFICE. HOWEVER, IT ALSO ALLOWS THEM
IF THEY DON’T SEEK COUNSEL FROM THE PUBLIC DEFENDER
OFFICE, TO HIRE THEIR OWN ATTORNEY. HAVE THE ABILITY TO REQUEST
THEIR OWN INDEPENDENT PSYCHOLOGICAL EVALUATION. NOT RELYING ONLY UPON THE
DOCTORS PROCURED BY CONNIE MITCHELL AND IHS. HAVE THE ABILITY GET THEIR OWN
INDEPENDENT EVALUATION. TO ANSWER THAT QUESTION,
COUNSEL FOR THEM. THEY CAN HIRE THEIR OWN.>>Lara: ONE OF THE PROBLEMS
THAT I SEE A LOT OF CLIENTS THAT WE HANDLE ALL CLIENTS WE
HANDLE ARE INDIGENT. COULDN’T AFFORD TO HIRE THEIR
OWN ATTORNEY. WHY THEY HAVE US. AS FAR AS GETTING SEPARATE
PSYCH EVAL FROM INDEPENDENT CONTRACTOR KIND OF A PERSON,
THAT ALSO WOULD BE –>>Lara: DO YOU GET A LOT OF
REQUEST FOR REPRESENTATION FOR PEOPLE WHO ARE MENTALLY
ILL?>>AUTOMATIC. IF THEY FILE A PETITION,
PUBLIC DEFENDER HAS TO BE NOTIFIED. AUTOMATICALLY APPOINTED TO
THESE CASES.>>WORTH NOTING, BESIDES THE
PUBLIC DEFENDER OFFICE, GUARDIAN AD LITEM CAN AND
OFTEN APPOINTED IN THESE CASE. ANOTHER LAYER OF DUE PROCESS
AND PROTECTION FOR THE INDIVIDUAL BUILT INTO THE
STATUTE WITH A GAL AND SO IN TERMS OF ASSERTING LEGAL
RIGHTS OR SEEKING COUNSEL, THEY HAVE A COURT APPOINTED
ATTORNEY.>>Lara: I WANTED TO DISAGREE
WITH THAT. IN A LITTLE WAY. I WANT TO CLARIFY THAT THE
PUBLIC DEFENDER’S JOB REALLY IS TO PROTECT THE LEGAL RIGHTS
OF THE CLIENTS. LEGAL INTERESTS OF THE
CLIENTS. GUARDIAN AD LITEM APPOINTED
FOR THAT HEARING. THEY LOOK AT THE BASICALLY THE
BEST INTERESTS OF THE CLIENT. THEY STAND IN THE SHOES OF THE
CLIENT. IF THE CLIENT WERE LUCID, THEY
MAKE DECISIONS BASED ON WHAT’S IN THE CLIENT’S BEST
INTEREST. THAT’S KIND OF BROAD AND
UNDEFINED. THAT’S DIFFERENT FROM MD,
LOOKING AT THE BEST MEDICAL INTEREST OR THE PSYCHOLOGICAL
INTEREST OF THE CLIENT. SO YOU KNOW, MY POSITION OR
WHAT I DO IS DIFFERENT FROM WHAT A GAL DOES. GUARDIAN AD LITEM. GUARDIAN OF THE PERSON FOR
THAT CASE.>>Lara: WHAT TREATMENT
PROTOCOLS AND GUIDELINES HAVE BEEN ESTABLISHED TO ENSURE
THAT THOSE IMPACTED BY THE NEW LAW ARE SUBJECT TO CONTINUAL
MEDICAL SUPERVISION AND NOT DETAINED IN ANY LONGER THAN
NECESSARY TO STABILIZE THEIR CONDITION? WHAT CAN YOU SPEAK TO? FOR THE NEW LAW?>>QUICKLY, STATUTE REQUIRES
THAT A CARE PLAN BE FILED WITH THE PETITION. WHICH IS LICENSED SOCIAL
WORKER TO HAVE A LONGTERM CARE PLAN. THEN THAT CARE PLAN HAS TO BE
ADOPTED BY THE PSYCHIATRIST TREATING. PSYCHIATRIST HAS THE
RESPONSIBILITY OF FOLLOWING UP IN TERMS OF THE TREATMENT. ORDERS ARE ONLY A YEAR OF
DURATION. CAN BE EXTENDER. OPERATION IS FOR A YEAR.>>Lara: STANDARDS OF CARE,
PSYCHIATRIST AND OTHER MENTAL HEALTH WORKS HAVE TO FOLLOW. IMPORTANT TO NOTE THAT WHEN HE
DO GO FOR ACT ORDER AND HAVE INTENTION OF IMPLEMENTING A
TREATMENT PLAN, THERE ARE DIFFERENT MONITORING SYSTEMS
PEOPLE LOOKING AT THE CASE, ARE YOU ACTUALLY DOING WHAT IS
GOOD FOR THE PERSON? I THINK WHEN FOR US, IT’S
ALWAYS ABOUT A PATIENT CENTERED TREATMENT PLAN. SO WE WANT TO GIVE THE PERSON
AS MANY CHOICES AS POSSIBLE. AND AS THEY RESUME UP THEIR
ABILITY TO MAKE CHOICES –>>Lara: LET YOU RESPOND. LET ME GET TO THIS QUESTION. AMANDA FROM HONOLULU SAYING,
WHO IS LIABLE IF THE PERSON BEING SUBJECTED TO TREATMENT
HAS SEVERE NEGATIVE REACTION. WHAT IS THE MINIMUM AMOUNT OF
INTERACTION WITH THE DOCTOR REQUIRED BEFORE INTERVENTION
CAN BE INITIATED? TWO QUESTIONS HERE. BOTH YOU HAVE JUMP IN.>>I MEAN, THERE IS NO MINIMUM
AMOUNT OF INTERACTION REQUIRED BY A DOCTOR. THE DOCTOR JUST HAS TO
EVALUATE THE PERSON. DETERMINE THAT HE OR SHE
SUFFERS MENTAL ILLNESS OR SUBSTANCE ABUSE, TREATMENT
WOULD BE IN THEIR BEST MEDICAL INTEREST. PREVIOUS POINT, ALTHOUGH THAT
IHS MAY BE FOLLOWING UP WITH THE PERSON IN THE FIELD, THE
COURT BASICALLY LOSES THE CASE. THEY CLOSE THE CASE. ALTHOUGH THE ACT MAY BE IN
PLACE FOR A YEAR, COURT DOESN’T GO BACK AND
SUPERVISE. THEY DON’T ASK FOR REPORTS. TO SEE HOW THE PERSON IS
DOING. SO WE KIND OF HAVE NO IDEA. WE JUST KNOW THAT THERE’S A
PAPER OUT THERE THAT SAYS THAT THE PERSON HAS TO BE UNDER
THE –>>Lara: REVISIT THAT AGAIN.>>I THINK ALSO GETS A LITTLE
BIT TOO THE INTERSECTION. CIVIL RIGHTS CONCERNS. PROVIDING SOMETHING THAT I
THINK EVERYBODY AT THIS TABLE WANTS. EFFECTIVE LONGTERM
TREATMENT. PEOPLE GENERALLY HAVE A
PRETTY GOOD SENSE WHEN THEIR RIGHTS BEING VIOLATED OR
IMPERILLED OR COERCED DO SOMETHING AND GENERALLY PUSH
BACK AGAINST THAT. THAT IS ONE OF THE CONCERNS
THAT WE HAVE. YOU HAVE THAT INTERSECTION
WHERE WHETHER YOU THINK IT’S GOOD IDEA OR NOT, REGARDLESS
WHETHER YOU THINK IT’S A GOOD IDEA TO COERCIBLY TREAT
SOMEONE, WE CAN ALL AGREE THERE IS A VIOLATION OF THEIR
BODILY AUTONOMY WHEN YOU DO THAT. ARGUE WHETHER IT’S
JUSTIFIABLE ONE, BUT IT’S A VIOLATION OF THEIR BODILY
AUTONOMY. IMPLICATES CIVIL RIGHTS. OTHER THING THAT THEN COME
INTO PLAY ARE SOME OF THE OTHER KIND OF DOWNSTREAM
EFFECTS OF THAT. SOMEONE ELSE SPOKEN WITH
RECENTLY, WORKS IN THE MENTAL HEALTH ARENA, RIGHT HERE IN
HAWAIʻI, POINTED OUT THAT ONE OF HER CONCERNS UPON LOOKING
AT THE LAW YOU COULD HAVE SOMEONE WHO IS COERCIVELY
TREATED IN A WAY THAT IS CULTURALLY INAPPROPRIATE FOR
THEM. AND ONCE THAT HAPPENS, DAMAGE
IS DONE. THAT COULD BE CULTURALLY
INAPPROPRIATE JUST BECAUSE OF THEIR HERITAGE, BACKGROUND,
MIGHT EVEN BE BECAUSE OF THEIR RELIGION. FOR INSTANCE, JUST ONE, WE
DON’T MAKE PEOPLE ACCEPT BLOOD TRANSFUSIONS IF THEY
DON’T WANT IT.>>Lara: HOW WOULD YOU KNOW
THAT IS THIS SOME MORE OBVIOUS. OTHER SITUATIONS MAY NOT BE
ABLE TO GET THAT INFORMATION. OR WOULD YOU? IF YOU’RE TALKING ABOUT
RELIGION OR TALKING ABOUT WHAT THEY MIGHT BE CULTURALLY
SENSITIVE TO. IF THEY CAN’T COMMUNICATE
THAT.>>YOU DON’T GET IT. THE FACT IS THAT MENTAL HEALTH
OR PSYCHIATRY HAS A SET OF STANDARDS AND A SET OF
CRITERIA FOR PROVIDING A DIAGNOSIS. THESE DIAGNOSES ARE
RECOGNIZED THROUGHOUT THE WORLD. NOT JUST THE UNITED STATES. I AGREE WITH JOSH. THERE ARE CULTURAL ISSUES
THAT COME INTO PLAY. PROVIDING GOOD MENTAL HEALTH
CARE, YOU TAKE INTO CONSIDERATION A PERSON’S
CULTURAL BACKGROUND IN YOUR ASSESSMENT OF THAT PERSON. CLEARLY, YOU HAVE TO BE
SENSITIVE TO THOSE THINGS. BUT THERE ARE OTHER OBJECTIVE
THINGS. WHEN SOMEBODY IS CLEARLY
RESPONDING TO VOICES IN THEIR HEAD, OR ACTUALLY ACTING UPON
IN A WAY OR NOT ACTING TO SEEK TREATMENT FOR VERY SERIOUS
CONDITION, THAT THERE ARE OOZING WOUNDS CARRYING AROUND
WITH THEM, THEY’RE JUST NOT MAKING GOOD DECISIONS. I DON’T THINK ANYBODY WOULD
DISAGREE WITH THAT.>>IT’S ALSO WORTH NOTING THAT
THERE ARE LOTS OF CHOICES PEOPLE MAKE. THAT MAY NOT BE GREAT CHOICES. BUT AS SOCIETY, WE HAVE
DECIDED THAT THEY CAN MAKE THOSE CHOICES. SO THAT COULD BE THE EARLY
EXAMPLE I MADE. IF YOU’RE AN ALCOHOLIC, STILL
DRINKING, GOT CIRRHOSIS, COULD BE RIDING A MOTORCYCLE
WITHOUT A HELMET. STAGE 4 CANCER, DECIDED THEY
DON’T WHAT TO HAVE ANY CHEMOTHERAPY EVEN IF THERE
WHAT DOCTOR CONSIDERS GOOD COURSE OF CARE AFFORD TO DO
THEM. WE HAVE DECIDED THEY’RE
ALLOWED TO MAKE THAT CHOICE EVEN IF IT’S NOT A CHOICE WE
WOULD MAKE.>>Lara: I WANT CHRIS TO
EXPOUND ON THAT. CONSIDER COMMENT YOU MADE
ABOUT HAVING INDIVIDUALS HAVING A SENSE THEY’RE BEING
COERCED. WHAT IS YOUR RESPONSE TO THAT? IF THAT SORT OF THE PART OF THE
ARGUMENT THAT JOSH IS MAKING. PEOPLE GENERALLY HAVE A SENSE
THEY’RE BEING COERCED?>>BACK TO ONE OF THE PRIOR
QUESTIONS. IS THERE A TRAUMA OR EFFECTED,
DETRIMENT TO HAVING SOMEONE TAKE MEDICATION AGAINST THEIR
WILL. QUESTION ABOUT THE
INDIVIDUALS CONCERNED ABOUT SOMEONE WHO IS MENTALLY ILL,
SUBSTANCE ABUSING IN THE PARK. CHILDREN SEEING PERSON EXPOSE
THEMSELVES. GOES BACK TO THE BALANCING
TEST. GOING TO BE LOOKING AT
INDIVIDUAL CIVIL RIGHTS. LOOK AT SOCIETY PROTECTED
AGAINST THESE INDIVIDUALS. IF THERE IS A SITUATION ACTING
IN CRIMINAL OR MENTALLY ILL MANNER. SO OF THAT SITUATION, I
BELIEVE THAT STATUTE AND PRECEDENT ALLOWS US TO
MEDICATE THESE FOLKS.>>I WANT TO ADD ON TO CHRIS’
COMMENT. FOR THE GENTLEMAN FROM KAHALA
SAYING, WHAT P ABOUT MY RIGHTS AND KIDS SEEING SOMEBODY
DEFECATING IN THE PARK, ET CETERA. YOU’RE NOT SUPPOSED TO DO
THAT, PERIOD. SO HE HAS A RIGHT CALL THE
POLICE AND LET THEM INTERVENE WITH THE PERSON. THE BIG QUESTION I THINK IS
WHAT HAPPENS FROM THERE? I SEE A PROBLEM WITH HAWAIʻI’S
MENTAL HEALTH SYSTEM. IT’S JUST NOT HOT BUTTON
ISSUE. IT’S NOT A SEXY ISSUE THAT
LEGISLATORS WANT TO THROW MONEY AT. OR EVEN THE COMMUNITY WANTS TO
KNOW MONEY AT. WE HAVE SO MANY PEOPLE WHO
NEED MENTAL HEALTH TREATMENT. SO QUEEN’S, SHS, HAWAIʻI
STATE HOSPITAL, BURSTING AT THE SEAMS WITH PEOPLE NEED
TREATMENT MORE SUBSTANTIVE LONGTERM TREATMENT. DON’T HAVE ENOUGH BEDS. CONSTANTLY FINDING WAYS TO
DISCHARGE PEOPLE BEFORE THEY’RE REALLY READIED TO BE
DISCHARGED. THOSE ARE THE PEOPLE THAT I
BELIEVE WIND UP HOUSELESS. ON THE STREETS, KIND OF
BUMBLING AROUND, AND THE MAN IN KAHALA WILL SEE, ET CETERA. THERE ARE — CONTINUE TO
CYCLE THROUGH THE SYSTEM. SO I THINK, UNDERLYING THING
REALLY HAVE TO WORK ON IMPROVING THE MENTAL HEALTH
SYSTEM IN HAWAIʻI.>>I WOULD SAY THAT MENTAL
HEALTH LAWS ARE PREVENTING US FROM ACTUALLY BEING ABLE TO
TREAT SOME OF THOSE FOLKS IF THEIR SICKNESS OR ILLNESS
PRECLUDES THEM FROM MAKING A DECISION FROM RECEIVING
TREATMENT AND WE HAVE THE WHOLE CYCLE STARTING AGAIN. A LOT OF THE LAWS WERE MADE WAY
BACK WHEN, WE HAD MEDICATIONS THAT REALLY HAD BAD SIDE
EFFECTS. BUT THEY’VE COME SUCH A LONG
WAY, YOU DON’T SEE THE SAME KIND OF SIDE EFFECTS ANY MORE. USED TO HAVE THE SHUFFLE ALL
OF THESE INVOLUNTARY MOVEMENTS CAME OUT OF SOME OF
THE MEDICATIONS THAT WERE USED BEFORE. WE HAVE A DIFFERENT CLASS OF
MEDICATIONS NOW.>>EXCEPT THAT ONE OF THE
MEDICATIONS THAT WAS BEING SUGGESTED FOR CLIENT OF MINE
RECENTLY, IS THAT INVEGA SISTENA, I LOOKED AT
THE PATIENT INSERT THING. THERE ARE LOTS OF DIFFERENT
DOWNSIDES INCLUDING IRREVERSIBLE, DYSKINESIA,
IRREVERSIBLE PROBLEMS. IF THE PERSON WAS ON PAR, ABLE
TO MAKE A DECISION ABOUT WHETHER TO TAKE THAT. THEY MIGHT RATIONALLY SAY I
DON’T WANT TO TAKE THIS BECAUSE OF POSSIBILITIES.>>USUALLY WHEN THOSE START TO
HAPPEN, PERSON HAS COMPENSATED. THEY CAN MAKE A CHOICE TO
MAYBE NOT WANT TO TAKE IT. NOT EVEN GIVE THEN CHOICE.>>Lara: FEW MORE MINUTES
LEFT. WANT TO MAKE SURE WE GET A
COUPLE MORE QUESTIONS IN HERE. HOW MANY COURT ORDERS ARE IN
PLACE RIGHT NOW? WHERE ARE WE AT? COURT ORDERS IN PLACE WITH
THIS NEW LAW? OR THERE’S CASE THAT CAME UP
EARLIER THERE WEEK, IS THAT CORRECT?>>I MEAN, ARE YOU TALKING
ABOUT THE 2016 AMENDMENT? 2019 AMENDMENT?>>RIGHT.>>WENT INTO PLACE. JULY?>>SO THOSE CASES ARE STARTING
RIGHT NOW.>>NO CASES.>>THERE ARE CASES THAT WHERE
THE ACT HAS BEEN GRANTED UNDER THE OLDER LAW OR OLDER LAWS. SO SOME OF THEM LIKE BECAUSE
THEY’RE VOLUNTARY, WE DON’T REALLY HEAR ABOUT THEM. UNLESS OF COURSE THE
PETITIONER WANTS TO REPETITION AND HAVE IT
CONTINUE ON FOR LONGER THAN A YEAR OAR EXPIRATION OF THAT
PERIOD. SO YOU KNOW, THERE MIGHT
BE — THERE ARE CASES OUT THERE WHERE THE ACT HAS BEEN
USED. LET ME GET THIS ONE MORE TIME. ONE MORE QUESTION. LLOYD FROM WAIALAE. WHAT IS THE FEEDBACK FROM
INDIVIDUALS WHO HAVE BEEN COURT ORDERED TREATMENTS? TALKING MORE BEFORE THIS
RECENT AMENDMENT. WHAT KIND OF FEEDBACK HAVE YOU
GOTTEN WHEN YOU HAVE BEEN ABLE TO GET FEEDBACK PEOPLE WHO
HAVE GONE THROUGH COURT ORDERED TREATMENT? THANKFUL? RESENTFUL? WHAT KINDED FEEDBACK.>>HAVEN’T HAD THAT
DISCUSSION. HAVEN’T HAD ENOUGH OF THEM. EVEN BEFORE THE RECENT
AMENDMENT. EVEN BEFORE.>>GENTLEMAN THAT YOU HELPED
US GET ONE ON THE OLD ORDER, HE ACTUALLY HAD THE NEVER HAD
THAT QUESTION POSTED TO HIM. BUT I THINK THAT HE
APPRECIATES BEING HOUSED. APPRECIATE IS NOT LIVING AT
THE BUS STOP ANY MORE. APPRECIATES THE FACT THAT HE
WAS ABLE TO GO TO HIS FATHER’S FUNERAL WHEN HIS FATHER DIED
AND HAVE RENEWED RELATIONSHIP WITH SOME OF HIS FAMILY
MEMBERS. REALLY ABOUT TRYING TO FIND
WAYS TO HELP PEOPLE BE ABLE TO HAVE A NORMAL, AS NORMAL LIFE
AS THEY CAN IN THE COMMUNITY.>>Lara: FINAL THOUGHTS?>>GOOD TIME TO JUST, PEOPLE
REMEMBER THIS IS A COMPLEX ISSUE. DOESN’T HAVE A SIMPLE
SOLUTION. ONE THING THAT WE HAVE
GENERALLY SEEN OVER THE COURSE OF OUR COUNTRY
HISTORY, WHEN WE DO THINGS SIMULTANEOUSLY LOOKING, AT
THE CIVIL RIGHTS IMPLICATIONS, EVEN IF THAT
MAKES IT HARDER, WITH WE TRY TO MAKE SURE THAT WE ARE
PASSING PUBLIC POLICY ALSO KEEPS THAT IN MIND, GENERALLY
END UP WITH BETTER SOLUTIONS. AND WHERE WE NEED TO BE DOING
SOME OF THE HARD WORK, HARD WORK THAT IHS DOING, PUTTING
MORE RESOURCES INTO THOSE TIMES OF RESOURCES, MORE
MONEY INTO RESOURCES PEOPLE WITH VOLUNTARILY ACCEPT SO WE
CAN START REVERSING SOME OF THIS. IF WE JUST KEEP COERCING
PEOPLE INTO TREATMENT. PEOPLE GOT NEGATIVE
REACTIONS. PERPETUATING BAD CYCLE.>>Steve: HARD WORK CONTINUES
WITH ALL OF YOU. IMPORTANT ISSUE. ALL OF YOU CARE SO MUCH. WE APPRECIATE YOU BEING HERE. MAHALO TO YOU FOR JOINING US
TONIGHT – AND WE THANK OUR GUESTS –
CONNIE MITCHELL, EXECUTIVE DIRECTOR OF THE INSTITUTE FOR
HUMAN SERVICES JOSH WISCH, EXECUTIVE
DIRECTOR OF THE AMERICAN CIVIL LIBERTIES UNION. CHRIS THOMAS, ATTORNEY
REPRESENTING IHS IN COURT PETITIONS. AND PHYLLIS HIRONAKA,
ATTORNEY IN THE HAWAIʻI STATE OFFICE OF THE PUBLIC
DEFENDER. THIS IS OUR LAST INSIGHTS
EPISODE FOR THE CALENDAR YEAR 2019. WE RETURN ON JANUARY 9, 2020
TO PREVIEW THE UPCOMING LEGISLATIVE SESSION. UNTIL THEN, I’M LARA YAMADA
FOR INSIGHTS ON PBS HAWAIʻI – ALOHA!




Comments
  1. One side effect of Mental Illness is you lose the insight and awareness that you are mentally ill, thus you don't seek care because your sick even when you are.

Leave a Reply

Your email address will not be published. Required fields are marked *