By MERRILEE GASSER
THE CENTER SQUARE CONTRIBUTOR
(The Center Square) — A bill that authorizes the creation of facilities where people deemed to be in a behavioral health crisis can be involuntarily committed and administered psychotropic medication without their consent was signed into Alaska law this week.
House Bill 172 was the subject of much debate through multiple hearings before it was passed by both the Alaska State House and Senate. It was first introduced at the request of Gov. Mike Dunleavy.
According to the bill, law enforcement can detain someone against their will if they believe they are in a behavioral health crisis, committing them to a crisis stabilization center where they may be held for up to 23 hours and 59 minutes or seven days in a crisis residential center.
The bill, which the governor signed Monday, says a crisis stabilization center would have the authority to “administer psychotropic medication to an involuntarily held or detained respondent only in a manner that is consistent with AS 47.30.838,” referring to Alaska statutes related to mental health.
The statute states that an “evaluation facility or designated treatment facility may administer psychotropic medication to a patient without the patient’s informed consent, regardless of whether the patient is capable of giving informed consent.”
The bill was created as part of an agreement with the Disability Law Center and the Public Defender Agency after an October 2018 lawsuit alleged people in psychiatric crisis were being held indefinitely in jails or emergency departments due to a lack of available beds at the state psychiatric hospital, Clinton Bennett with the Alaska Department of Health told The Center Square.
“The main goal of the bill is to create a strong system of care for Alaskans experiencing a behavioral health need,” Mr. Bennett said. “It does this through immediate response mechanisms such as crisis response teams and by new facilities such as crisis stabilization centers, so that individuals in crisis are not unnecessarily held at emergency rooms, jails or psychiatric hospitals due to a lack of other less restrictive options.”
However, critics say the bill misses the mark and puts civil liberties at risk.
“Placing law enforcement and courts at the center of a person’s mental health journey embeds coercion and is counterproductive to healing,” said Olivia Ensign with Human Rights Watch, a group that investigates and reports on abuses throughout the world. “To align with human rights, treatment should be rooted in the will and preferences of the person themselves, not overridden by what authorities deem to be the best course. Rights-respecting entities should prioritize community-based, trauma-informed voluntary care rather than systems bolstering intimidation and feeding into involuntary commitment.”
Lawmakers said residents had reached out, telling them not to pass it.
“I’ve had quite a few constituents and people in my area urging me to vote against this bill,” said Senate Majority Leader Sen. Shelley Hughes, R-Palmer, who voted in favor of the bill.
She said some of her constituents were concerned about language in the bill referring to involuntary commitment and administration of psychotropic medication without consent.
However, Sen. Hughes said those statutes are already in place regardless of the bill, and health officers are already authorized to involuntarily commit people and administer psychotropic medication in a crisis. What the bill changes are the locations where that would occur.
Sen. Lora Reinbold, R-Eagle River, one of three senators who voted against the bill, raised numerous concerns and introduced several amendments that were voted down.
“The bottom line here is there is no crime, yet these guys are going to be detained against their will, involuntarily committed, they could be without informed consent given psychotropic medications,” Sen. Reinbold said. “Parental rights are missing in this bill. They just notify the parent. So I just find so many serious concerns in this bill.”
The bill states a minor can be taken to a crisis stabilization center without first informing the parents. According to the bill, “the facility shall inform the parent or guardian of the location of the minor as soon as possible” after their child has already been involuntarily medically detained. Alaska law already allows this.
The minor may also be transferred to a different facility without parental knowledge or consent as long as “the center or facility makes a good faith attempt to notify the parent or guardian,” the bill says.
When asked whether there were concerns the bill could have implications for civil liberties, Mr. Bennett told The Center Square, “The governor believes that this bill protects Alaskans’ civil liberties.”
He said numerous sections of H.B. 172 expand patients’ rights compared to the current civil involuntary commitment statutes.
“The greatest civil liberty that HB 172 protects is a person’s ability to access appropriate behavioral health treatment without waiting – or being held involuntarily – in jails or emergency departments while waiting for a bed to become available in Anchorage, Fairbanks, Mat-Su or Juneau,” Mr. Bennett said.
He said the facilities would also mean closer to home treatment, “especially in rural Alaska and allowing patients to get back to their communities sooner and safer.”
The bill does not address the financing to build or operate the facilities, according to Mr. Bennett. However, he said there are existing mechanisms for payment, including grants from the Alaska Mental Health Trust Authority and an appropriation of $8 million by the legislature for Providence Alaska Mental Health Center to create a crisis stabilization center and crisis residential center expected to open in 2023.