OPINION: State mistreatment of Alaskans with mental illness victimizes families

A parent of an adult child with mental illness recently called me after reading my ADN commentaries criticizing Alaska’s current failed system of involuntarily committing people with mental illness to lockdown psychiatric institutions and forcibly drugging them, rather than funding community-based, patient-centered treatment. The parent said they wanted to offer me another perspective. I listened. It was heartbreaking.

The parent’s relevant experience began as the child of a psychotic mother who was abusive. The scenarios described — unadorned, in an even voice — were chilling. Somehow, my caller went on to achieve stable work and income, experience a sustained marriage and raise several children. While acknowledging the distress of the adult child with mental illness, the parent described the rest of the family’s suffering.

Repeatedly, other family members were victims of verbal tirades, lies, property destruction, thefts and assaults. There were police calls, takings into custody, criminal charges and a revolving door of involuntary commitments and druggings.

The parent confessed that when their adult child was committed and drugged, they mostly felt relief. The rest of the family’s lives had become a living hell. They would’ve welcomed nearly any escape.

I tried to think of what to say. Then I stopped thinking and spoke from my own heart. I confessed that despite my sincere but intellectual forays into what I considered Alaska’s mistreatment of persons with mental illness, if I were in their shoes, I would feel the same.

I will always be grateful for that parent’s courage in sharing, caring and persevering. They opened my heart and mind to the families of Alaskans with mental illness.

But they didn’t change my view of our current system’s over-reliance on involuntarily committing and forcibly drugging persons with mental illness who would have much better treatment outcomes with less intrusive intervention. It just means that families are also tragic victims.

For decades, our Legislature has defunded and failed to fund community-based, patient-centered mental health programs. These are options that have demonstrably better treatment outcomes and are cheaper in the long run. Evidence of the better outcomes is contained in a white paper written by distinguished advocates with academic, legal, medical and lived experience credentials. It has been provided to every Alaska legislator and is available at https://psychrights.org/whitepaper.pdf.

Compounding this failure, our judiciary has failed to safeguard the constitutional rights of Alaskans with mental illness. In 2006, our state Supreme Court finally held the obvious: If the Legislature is going to allow forcibly drugging persons with mental illness who have been involuntarily committed in a “non-crisis situation,” the state must at least prove it is in the person’s best interest and there are no less intrusive alternatives available. In 2009, the same court held a less intrusive alternative was “available” if it was “feasible.” In a case not involving forced drugging, the same court ruled “feasible” meant what the dictionary said — ”capable of being accomplished or brought about; possible.”

Then in 2019, the court faced a case where a psychiatric expert said a less intrusive program that had been defunded would have been a better option than involuntary commitment to a locked institution. The court backpedaled. It decided “feasible” meant actually available, not capable of being brought about. That means the rights of Alaskans with mental illness are subject to the Legislature’s whims.

In contrast, our judicial system has no problem requiring the Legislature to adequately fund prisons to constitutionally mandated humane standards or else set the criminals free. But it allows the state to arguably “torture” persons with mental illness who have committed no crime. The United Nations has stated that forced detention and drugging of the disabled, “based on their supposed ‘best interests,’” can constitute “torture.” Our state Supreme Court has equated such drugging with a lobotomy, accompanied by significant risks of other devastating side effects.

Yet, because our Legislature has defunded and refuses to fund proven less intrusive programs, forced detention and drugging for Alaskans with mental illness have become the “go-to” option for the state and our judiciary. According to the parent who called me, the other “go-to” option is overwhelmed families. “Out of sight, out of mind,” is what the parent said.

In September of this year, I toured the Alaska Psychiatric Institute. It is one of the locked institutions where involuntary commitment and forcible drugging takes place. The staff invited questions. I asked them what was the No. 1 thing that would make their jobs easier and more effective. Two of the staff, one being the CEO, answered without hesitation — community treatment programs. They understood from the front line the toll that has been taken on persons with mental illness and their families from not having community-based, patient-centered treatment options.

If only the Alaska Legislature would listen — to distinguished experts, to the staff of lockdown psychiatric institutions, to persons with mental illness, and to their families. Alaskans with mental illness who have committed no crimes, and their families, should not have to choose between no treatment and forced detention and drugging.

There need to be community-based, patient-centered mental health treatment options. They have proven better treatment outcomes and are cheaper for the state in the long run. It’s the right, humane thing to do for all Alaskans, but especially for those with mental illness and their families.

Val Van Brocklin is a former state and federal prosecutor in Alaska who now trains and writes on criminal justice topics nationwide. She lives in Anchorage.

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