JESSE: Okay to start, how about you each do your own take on the intro, the “This is Committable” thing.
JIM: You go first Michelle, I want to see what you say cause I never know what to say to this.
MICHELLE: This is Committable. . Is this a trick question?
JESSE: Jim, you conveniently started drinking out of that water bottle as soon as it was your turn to speak.
JIM: I had bagel in my mouth. I had to wash it away.
MICHELLE: Uh huh.
JIM: I was pointing to Michelle. If you couldn’t tell for Michelle to go first.
MICHELLE: Uh huh.
JIM: Asking Michelle to go first to say…This is Committable.
MICHELLE: That was beautiful. Beautiful.
JESSE: And…cue the music.
(excerpt from song Reasonable by Christopher G. Brown)
JESSE: This is Committable, a podcast about involuntary commitments. I'm Jesse Mangan and I'm here with Committable producers, Michelle Stockman and Jim McQuaid.
MICHELLE: Hello, I'm Michelle Stockman.
JIM: Hi, I'm Jim McQuaid.
JESSE: For this season we're doing something a bit different. Instead of tracking the story of one person going through a system of detention and commitment, we’re broadening that view to look at the systems themselves. And to accomplish this we're going to go state by state to interview attorneys, advocates, people with lived experience, in each state, to learn more about mental health laws in that state; how they're intended to work, how they're actually implemented, what pitfalls there might be, and the things that need to change. But we've never done a format like this before, where the three producers are going over interviews together, so I thought it would be good to have us all introduce ourselves and talk a little bit about why we're doing this state by state exploration. So I'll start.
I'm Jesse Mangan, I've experienced being involuntarily detained, I've had that moment where you realize the clinician asking you about your day is really just doing a risk assessment. I've been through a voluntary commitment and an involuntary civil commitment, and those experiences were the most traumatic things I've ever experienced. And I think that trauma really could have been mitigated if I'd understood the systems I was being forced into. I don't think the risk of trauma that comes with involuntary detentions and civil commitments can ever be fully prevented, but actually being given an opportunity to understand what I was being forced into absolutely could have reduced the harm that was caused.
So for me, going state by state to look at these laws and putting that information out there is a way to make this information accessible, and let people know what rights they're supposed to have if they're ever forced into one of these systems.
So that's me, Michelle, you wanna introduce yourself and say a little bit about what the state by state series means to you?
MICHELLE: Yeah. I'm Michelle Stockman, I have never been committed but I am part of a family that has experienced the trauma of commitment. So I do know how an individual experience can ripple out to affect an entire community. And as someone who personally has had some lifelong struggles with mental health, that family experience made me actually very cautious in what I say and do to seek help. And I'm honestly grateful for that caution. It is really, really hard to ask for help when you are in crisis and so far, in my experience at least, the most valuable help has come from people with lived experience.
For me, that's the importance of this podcast in general, and now in going state by state, I think we're providing a platform for voices with lived experiences to help create a community of support. And part of that support is the knowledge of how to navigate some very complicated systems that may vary from state to state and despite what may be advertised otherwise, do not have the best interests of the individual in crisis in mind.
Between, for me, mental health and being a queer woman with interest in prison abolition, I'm looking to learn how does each state handle the people it wants to remove because they don't look or act the way they want.
JESSE: Awesome. Jim…I was gonna say, do you wanna go next? But there's really no one else left, so…
JIM: I wanna go but not next.
(laughter from Michelle and Jesse)
JIM: I'm Jim McQuaid and I have also never been committed, but I do have some personal and professional experiences that draw me to the subject. So personally, I have had struggles with mental health but thankfully I have had experiences seeking help that have range from, you know, neutral to good. So I've been really lucky there, but I understand how random chance or a change in circumstances, most significantly a change in privilege, could have led to very, very different outcomes.
And professionally, I'm an assistant professor of Sociology. And as a sociologist I spend a lot of time focusing on how large scale social systems operate, how they're supposed to operate, how shockingly often they fail in deeply destructive ways, and how easy it is for these institutions to make individuals feel completely powerless.
And I'm hoping that looking at different states’ mental health systems can maybe, possibly, provide some tiny glimmer of hope that there are ways to do things that can improve the systems and I am so optimistic about where we're gonna go that I am close to bursting.
JESSE: That was great, small note though, we don't do optimism on this podcast.
JIM: But it's optimism that is doomed to be crushed, is that okay?
JESSE: Oh yeah, that we do.
JIM: Okay.
MICHELLE: Perfect.
JESSE: So for this episode we are going to talk about mental health laws In New York, to be more specific, we're going to talk about New York's mental hygiene law.
JIM: Uh, are we gonna listen to something then talk about it? Like what's the format? Because I have some thoughts about hygiene.
JESSE: Yeah, go for it.
JIM: Okay. The word hygiene historically is really wrapped up with concepts of morality, which are deeply wrapped up with concepts of social norms and what society itself has deemed is appropriate, or inappropriate.
MICHELLE: I mean, before hygiene is brought to the table, you have a group of people already who know who they want to be, right. And they know who they want to be wrong. And so now it's just a matter of, okay, well great, how do we make sure that all the right people agree on the right? Well, let's start with making sure that the wrong people seem other, seem dirty, seem disgusting, seem immoral, seem, you know, it’s definitely deeply rooted in racism, misogyny, heteronormativity.
JIM: Thank you for saying what I've been trying to say in a way that makes sense. But so using words like hygiene accidentally say the quiet part out loud. In that they are reminders that a lot of what we think of as mental illness really comes down to violations of what is socially normal and not behaviors that are actually reflective of anything wrong with someone at some kind of objective level.
JESSE: So, I don't know the history of how this law was named but yeah, mental hygiene is a really problematic term. I cringe a little every time I hear it. But for now let's shift our focus to the content of the law, what it says, how it's implemented. And to learn more about this law and how people navigate it I spoke to Carolyn Reinach Wolf.
CAROLYN REINACH WOLF: Hi, my name is Carolyn Reinach Wolf, I'm the director of the Mental health Law Practice at Abrams Fensterman and I am also an executive partner in the firm. We're located in New York State and we consult not only in New York, but around the country on issues involving persons with serious mental illness, in support of helping families navigate through the mental health, legal system, clinical system, and so on. And thank you for having me.
JESSE: Thank you for being here. Uh, okay, before a civil commitment process ever begins, there's usually some form of detention for evaluation. In New York State how does the detention for evaluation process work?
CAROLYN REINACH WOLF: Well, a person can be brought into a psychiatric emergency room, a general hospital emergency room, or what's called a CPEP, which is a comprehensive part of an emergency room for an evaluation, if it's determined that they meet the legal criteria for commitment.
Then there's a whole process that goes on, a paper process, an evaluation process that goes on pursuant to Article 9 of our mental hygiene laws that have to be followed in order for a person to be either voluntary or involuntarily committed.
JESSE: In a typical scenario is someone brought into an emergency room, or a facility where that evaluation begins, are they brought in because of concerns by a physician? Are they brought in by family members? Do you have a sense of what a standard type of initiation into that process is?
CAROLYN REINACH WOLF: It varies depending on the facts and circumstances. It can be a referral from a treating psychiatrist, it can be a referral from an outpatient mental health program, it can be somebody in the family who brings them into the emergency room. It can be a variety of people who feel, for whatever reason, based on what an individual is saying and how they're behaving, that they get brought to the er. Police can bring them to the er. There's what's called a director of community services, they can do a remand through the police or the sheriff's department to the emergency room for an evaluation. But the ER is really the gateway into a hospital psychiatric setting.
JESSE: So in New York, as in many states, the ER becomes a sort of gateway to the process for psychiatric holds and civil commitments. And there are many ways that someone's path to the ER can be initiated, but once you reach the ER at some point you are going to be evaluated. Which leads to the next question of, is that evaluation being done by a psychiatrist?
CAROLYN REINACH WOLF: Yes. If there is a psychiatrist on duty, which generally there is. Sometimes it's a general hospital and it'll be done by the emergency room doctor who will then call in for a consultation by a psychiatrist. But it's the psychiatrist who will make the determination as to whether the person meets what's called a legal standard pursuant to our mental hygiene law, and whether clinically they're appropriate to be committed to a hospital setting. In New York specifically, and in many other states, a person has to be what's called on a legal status pursuant to the mental hygiene law in order for them to be able to be admitted to a psychiatric unit.
So psychiatry is actually the only area of medicine that is so closely linked between the medical or clinical system and the legal system.
JESSE: If there is a physician, an ER doctor, and then a psychiatrist coming in, are both physicians required to sign something to consent to it? Or is it just the psychiatrist?
CAROLYN REINACH WOLF: It can be both, we have different sections of our mental hygiene law. So one section, section 9.13 of our mental hygiene law, is the voluntary admission. Someone comes in and says, I know I have a psychiatric issue and I wanna be cared for and treated in a hospital setting. So I'm consenting to come in as a patient.
If that person isn't consenting, then they become an involuntarily committed person. And there's a process in New York where two physicians have to certify that the person has some mental illness, poses a risk of harm to themselves and or others, care and treatment in a hospital is necessary for their safety and the safety of others. And there's actually then a third doctor who has to affirm the other two physician's evaluations. So it's a pretty comprehensive system.
In addition, there has to be what's called an applicant who can be anyone from the director of the hospital, to a psychiatrist, to a family member, to a friend or neighbor. There's a whole list in the mental hygiene laws who say who can be this applicant on an involuntary commitment.
JESSE: Okay, so now we've gotten to the question of voluntary versus involuntary. A voluntary admission is theoretically where a person seeks help, goes to a hospital, and applies to be admitted to a psych facility as a patient. But the reality is often more complicated, and we've discussed this quite a bit in previous seasons because far too often the person being detained. signs a voluntary, but feels like they were coerced. I mean, there is heavy coercion sometimes. The person sometimes isn't even aware that they are technically on a voluntary status.
The other important thing to note about a voluntary commitment is that if you are admitted to a psych unit on a voluntary status, If you want to leave, you have to request discharge. Which triggers a process where your voluntary status can be converted to an involuntary status. Which brings us to an involuntary admission.
I looked up the language for this section of the law on the New York Office of Mental Health site and asked Committable contributor Brian Patrick Williams to read it for us.
BRIAN PATRICK WILLIAMS: Involuntary admission on medical certification, section 9-27 of the New York Mental Hygiene Law
Standard: person has a mental illness for which care & treatment in a mental hospital is essential to his/her welfare;
person's judgment is too impaired for him/her to understand the need for such care and treatment;
as a result of his/her mental illness, the person poses a substantial threat of harm to self or others.
Note: "Substantial threat of harm" may encompass;
(1) the person's refusal or inability to meet his or her essential need for food, shelter, clothing or health care, or
(2) the person's history of dangerous conduct associated with noncompliance with mental health treatment programs.
JIM: So, one of the things that jumped out to me is that one of the criteria that they can use to say, Hey, this person is a danger to themselves or others, is past behavior. One of the major problems with that though is that you are putting people in a situation where one act in the past labels them in a way that doesn't allow for, you know, moving forward. Doesn't account for changes in behavior, doesn't account for the fact that what can be counted as a violent act is very dependent on the context in which someone is, for instance, picked up.
So, for instance, the police come to pick someone up and are acting inappropriately, or if the police just decide that somebody is, you know, violent or whatever, that puts someone in a situation where they're gonna end up in this revolving door. They've been marked as violent once and therefore every time they end up in front of a judge, or in front of a doctor again in the future, oh, this person has been violent. Oh, this person has done this. Oh, this person's whatever, and then it just sticks with them. it's a mark that carries it forward.
So those labels matter.
MICHELLE: And it also matters because depending on who you are there's an inherent belief you might be violent. So there's that kind of bias that's going on. I mean, the black community is somehow just naturally perceived by white people as violent.
JESSE: Racial disparities and bias relating to which communities are more likely to be perceived as dangerous, and which people are more likely to be forced into these systems, are really important factors that need to be considered throughout this process.
MICHELLE: Yeah.
JESSE: Okay, so at this point in the process, if two physicians have certified that a person meets the criteria for involuntary detention at a psych unit, and a psychiatrist determines that, yes, this is a legally appropriate use of involuntary detention. Then at that point, what options does a person have once they are brought into that psychiatric unit?
CAROLYN REINACH WOLF: Patients in New York, as in most other states, have rights in terms of their admission, their continued retention, possible discharge, and so on. So when the patient comes to the unit they're given what's called a notice of Status and Rights. And it outlines what their rights are under our mental hygiene laws. It also outlines for them information about their right to counsel.
And in New York, we have an agency called the Mental Hygiene Legal Service. They're employed by the state. They're provided free of charge to any and all patients on an inpatient psychiatric unit, and they get appointments for other things too. But in terms of a hospital, they are assigned to each and every hospital and each and every psychiatric unit. And they're provided to the patients on that inpatient unit. So the patient's informed they have a right to counsel, they have a right to a hearing if they wanna ask for their release from the hospital. And requesting release and requesting a hearing triggers a whole court process, paperwork process, in order to bring them before the court and for the court to hold a hearing on whether they should continue to be retained and committed, or whether they should be released.
JESSE: At this point in the process if someone is involuntary and they ask for a hearing, they now get a chance to appear before a judge with an attorney, what happens then?
CAROLYN REINACH WOLF: Then, and in New York these are Supreme Court level judges. Now, Supreme Court in New York is the lowest level court, it's the trial court level. It's different than other states where a Supreme Court would be the highest level, here it's the opposite. But it is a full blown Supreme Court judge and Supreme Court hearing, and/or location. The patient is what's called “put on a calendar”. They're a list of the cases that are gonna go that day or the patients who are gonna have their hearings. The patient is represented by their lawyer, and the hospital is represented by their lawyer.
Generally, the expert witness who's called to testify is the treating doctor, sometimes it's another psychiatrist on the treatment. And the hospital has the legal burden to present evidence by clear and convincing evidence, which is a pretty high standard in the law, that the person suffers from a mental illness, care and treatment in a hospital is necessary, and they pose a risk of harm. Or a danger to themselves and or others.
JESSE: So at this point, if a person has been determined to be eligible for an involuntary commitment, they're being detained, but they have the right to request a hearing to contest that detention. If they do, then a lawyer from the mental hygiene legal service will be assigned to represent them at that hearing. My next question for Carolyn was, if at this hearing the judge finds that the person does need to be involuntarily committed for treatment, what happens next?
CAROLYN REINACH WOLF: The judge signs an order, there's actually a court order that says the patient is to be retained for whatever the period is that goes with their commitment. And every commitment has a certain number of days where the hospital can keep them. And it's an up to number of days. So for example, we talked about the two PC, that commitment is good for up to 60 days. Should a hospital wanna keep someone longer, they need to apply to the court under section 9 33 of the mental hygiene law. And that further commitment would be up to six months. And so on.
So the judge signs an order that says the person will be retained for either the balance of that 60 days or another week or two. Or in the alternative, the court will order them to be released.
JESSE: For the duration between the initial hearing and then the end period of the court order, does the patient have access to an attorney at all times? Someone to speak to?
CAROLYN REINACH WOLF: Yes, they always have access to their attorney. And in fact, under our mental hygiene law, if the person doesn't prevail at the first hearing, they actually have a right under another section of the mental hygiene law to an automatic, what's called “De Novo Hearing”, or jury trial.
So a person gets retained, they're not happy and, you know, don't wanna continue to be in the hospital. They can ask for a second hearing in front of a different judge. There's a choice to either do it in front of the judge, or what's called a bench trial, or they can ask for a jury trial. And that's section 9.35 of the mental hygiene law.
JESSE: Okay, this part seemed exceptional to me. If at the hearing the judge decides that a person does need to be involuntarily committed then that person automatically becomes eligible for a De Novo Hearing. They do have to request it, I think they have 30 days to put in the paperwork for that hearing, so it's not automatic, but the person who has just been committed can request a new trial. One that possibly happens before a jury instead of a judge.
JIM: So if I ever request a jury trial, am I committed? The entire time I'm waiting?
JESSE: They're committed to a psych facility because at the initial hearing the judge signed that court order. So, yeah, until a court says otherwise, that person is going to be involuntarily detained.
JIM: Am I being forcibly treated?
JESSE: Possibly.
JIM: Okay.
JESSE: So this brings us to the end of the interview with Carolyn Reinach Wolf, where I asked if there was anything else that is important to know about mental health laws in New York state.
CAROLYN REINACH WOLF: You know, I'd like to make the point that really the hospitalization is necessary when somebody is in an acute phase of their illness. It also can be very helpful when we don't know what we're dealing with. So to get a full evaluation, a diagnosis, a recommended treatment plan. But really the most important part of the process is the discharge plan, cause patients are not gonna stay in the hospital for months really, or years, with certain exceptions, but these days it's unusual. And so the discharge plan, in order to get as many services in place, because the goal is to hopefully not have the person return to the hospital but to stay stable, gain insight into having an illness, follow the treatment plan, and so on.
New York also has a law called Kendra's Law, also known as AOT, or Assisted Outpatient Treatment, that's very often used as part of a discharge plan. And it's a court-ordered outpatient treatment program that the individual is court ordered to follow. Now that legal standard is based on prior hospitalizations and non-compliance. Prior hospitalizations or prior incidents of violence and non-compliance.
And that carries with it a whole host of parts of a plan. You know, see your psychiatrist, go to your program, take these medications, live in a certain place, but it also is required by statute to have case management. What's called an ACT team or an ICM involved in the case so that there is someone in the community following the individual and making sure that the plan is followed. Again with the eye towards keeping people out of the hospital if they can remain stable.
JESSE: With AOT the person can be brought back in for evaluation if they disengage from treatment, right?
CAROLYN REINACH WOLF: Right, The team, the AOT team, and each county has an AOT team. If the team determines that they're decompensating, or they're somehow posing a risk to themselves and or others, the team can get the police and can do what's called a pickup order and bring them back to the emergency room for a 72 hour hold and evaluation.
JESSE: Is there anything different about the way that process would work as opposed to a detention for evaluation process for someone who is not on a AOT?
CAROLYN REINACH WOLF: No, I mean, either way somebody is bringing the person, whether it's by police and ems, or it's by walking them in, or New York has a mental health warrant statutes, there can be a court remand to an emergency room for an evaluation. So there's a variety of ways how you can physically get someone into the ER. But then it becomes the emergency room's job to process that and to make a determination as to whether or not they should be voluntarily or involuntarily committed.
JESSE: Okay, this concept that it is the job of the ER to figure out whether or not the person being detained should be voluntary or involuntary. This was in season two, episode three, the idea of the hot potato. The idea of passing the liability from one institution to the next.
You have these forces, these legally authorized forces, whether it's the family, whether it's a physician, law enforcement, or a therapist, who could have a person involuntarily detained and forced into an ER. And to say it is the ER's job to figure out whether or not this detention is appropriate sort of passes the liability from one group to the next and really diminishes the harm that could be caused on the way there. It is not inconsequential for police to show up at your home and drag you out in handcuffs to involuntarily bring you somewhere where you may be detained for, I mean, ER visits are supposed to happen quickly but you can be there for days. That's not inconsequential.
So to pass the blame there, to put the responsibility on this other institution, on the ER to figure it out, it seems like it is disregarding the potential harm, the potential trauma, of forcing someone somewhere.
MICHELLE: We also need to confront the assumptions that everybody thinks. I mean, everyone it feels like is coming to the table these days with these assumptions when we talk about mental health of things like; risk assessment works and there's evidence to support it, depression or anxiety come from chemical imbalances, somebody having a mental health episode needs some kind of emergency intervention, someone who has a mental health issue, that's somebody who won't understand reality, can't make decisions, might be more violent, might be more likely to commit a crime.
Like, these are all of these assumptions and these are all false narratives.
JESSE: And this goes to the other thing that I wanted to talk about from that last clip, which is AOT. Assisted Outpatient Treatment.
JIM: Can I ask a quick clarifying question?
JESSE: Yeah, go ahead.
JIM: So if we remove the other resources, what constitutes AOT? What is that? What's happening to people like, so it's outpatient treatment, right?
JESSE: Right, so, AOT is a court-ordered outpatient commitment which requires that the person adhere to a specific treatment plan. That treatment plan can dictate what medications the person is required to take, what therapist or psychiatrist the person engages with. What meeting a person has to go to. It can require drug tests. And if that person does not adhere to that court-ordered treatment then they are almost certainly going to be brought into a facility where they'll be detained for evaluation.
So effectively what this means is that it is a court order saying adhere to this treatment plan, or we could have police apprehend you and force you into a facility where you'll be evaluated for an inpatient detention which could lead to a civil commitment.
MICHELLE: Oh wow.
JESSE: And one of the ongoing controversies about this AOT program is the racial disparities in regards to who's being forced onto these court orders. So in 2009 there was an independent evaluation of this AOT program that found that,
“Since 1999, about 34% of AOT recipients have been African Americans who make up only 17% of the state's population. Well, 34% of the people on AOT have been whites, who make up 61% of the population.”
So hugely disproportionate representation in who is put on an AOT court order.
And part of the finding of that evaluation was that,
“Whether this overrepresentation is discriminatory rests in part on whether AOT is generally seen as beneficial or detrimental to recipients. And whether AOT is viewed as a positive mechanism to reduce involuntary hospitalization and improve access to community treatment for an underserved population. Or as a program that merely subjects an already disadvantaged group to a further loss of civil liberties.”
JIM: That's not what discriminatory means.
MICHELLE: Yeah, that's like model minority logic. Like no, we're saying all Asians are good. So it's not discrimination, right? So it's not a big deal cause it’s nice.
JIM: If AOT is beneficial or detrimental to recipients is a completely separate question than whether or not AOT is being imposed on different groups at different rates because of that person's belonging to one of those groups, right?
JESSE: In this evaluation there was also an attempt to answer that question of whether or not African Americans are being targeted by the people issuing these court orders and,
“We find that the overrepresentation of African Americans in the AOT program is a function of African Americans' higher likelihood of being poor, uninsured. Higher likelihood of being treated by the public mental health system rather than by private mental health professionals. And higher likelihood of having a history of psychiatric hospitalization. The underlying reasons for these differences and the status of African Americans are beyond the scope of this report. We find no evidence that the AOT program is disproportionately selecting African Americans for court orders. Nor is there evidence of a disproportionate effect on other minority populations.”
JIM: if they are not taking those other factors into account then they as people who are making determinations about whether or not someone is supposed to be forced into an AOT program, then it's discriminatory. I mean, it's fundamentally racist. Like this is a textbook, textbook, example of structural racism.
MICHELLE: Yeah. I mean, that's where the history that we ignore becomes so prevalent because, hey, let's ignore Redlining. Let's ignore all of these historical factors that led to all of this that we caused. We forcibly caused those to occur with purpose. But like, if we ignore all that and we just start at this baseline right now well then all of a sudden, it's not discrimination anymore, right?
JESSE: And all of these incredibly problematic conclusions rest on the belief that AOT is reliably beneficial for the person who is forced onto one of these court orders. And often to demonstrate the effectiveness of AOT I've heard people citing statistics from the New York Office of Mental Health, so let's look at those stats.
These are from the New York Office of Mental Health website, they have a section for AOT reports, and these statistics are from August 10th, 2022.
Among AOT recipients there is a 66% reduction in psychiatric hospitalizations, a 73% reduction in incarceration, and a 63% reduction in homelessness. Which is amazing! But how did they reach these conclusions? Those stats were created by comparing a person's status, so whether they have experienced a psychiatric hospitalization, whether they have experience being incarcerated, or whether they have experience being categorized as homeless. They look at whether or not a person has experienced any of those things, at any point in their life prior to AOT as compared to their time on AOT.
MICHELLE: Interesting.
JESSE: So, to put that into perspective, the average length of a person's time on an AOT court order is about 18 months. The average age of a person in AOT is about 38. So they're comparing the approximately 36 years prior to AOT to the approximately one and a half years that a person is on AOT.
MICHELLE: What? I don't understand.
JIM: Well that's obviously bullshit. To say we're comparing someone's time on AOT to any other time in that person's life? Like, my brain immediately just rejects the possibility that anybody could have written that down in a report as if it is anything other than pure nonsense and idiocy.
JESSE: It seems to me that a more appropriate way to measure these types of things would be to look at someone's status at the time that they begin AOT and then compare that to someone's status at the time that they're released from AOT. And fortunately the Office of Mental Health site has some of that data.
Okay, so this is also from August 10th, 2022.
At the onset of AOT monitoring, so when the court ordered program starts, statewide, 6% of the people starting AOT were inpatient and 1% of the people starting AOT were incarcerated. At the time of the expiration of the AOT court order, statewide, 9% of people were inpatient and 3% were incarcerated.
So at the onset of the court order 6% inpatient, 1% incarcerated.
At the end of the AOT court order 9% inpatient, 3% incarcerated.
So by this data there's an increase, not a reduction.
JIM: I'm not surprised by that because you're putting people under surveillance, right? So you have a group of people who are already defined as can't survive or act independently, and you're monitoring them. So, you know, you're gonna be more likely to see things that are gonna trigger being forced to be inpatient. You're also more likely to see things that are going to lead a person to be incarcerated.
MICHELLE: And also you're actively saying we're gonna give you access to all sorts of free resources, as long as we can control all of your behavior. We're not gonna acknowledge that maybe access to these resources in the first place could have in any way, shape, or form prevented us from getting to this spot.
JESSE: So as we wrap up. Jim, Michelle, what are your final thoughts on how mental health laws in New York compared to mental health laws in other states? I mean, other than AOT which I find deeply problematic. But other than that, what do you think of New York's mental hygiene laws?
MICHELLE: Final thoughts on New York are…it's actually not that bad.
JIM: Despite everything this seems like the state that has the most protections, at least on paper.
JESSE: For me I think it comes down to whether you value more steps in the process, or whether you value a higher bar for entry into that process. So is it better to have multiple physicians involved in certifying the detention? Or is it better to have a more focused definition of what requirements have to be met in order to justify forcing someone into that detention?
And I think we're going to see a lot of variations in how those two elements interact with one another as we continue to look at mental health laws state by state, but for now, we did it. We got through the first episode.
MICHELLE: We did it!
JIM: Yay. Yay. Woo. Woo.
MICHELLE: Exactly Jim, “Yay. Yay. Woo. Woo.”
JESSE: Let's keep up this enthusiasm because next time, on Committable, we'll be looking at mental health laws in Pennsylvania.
JIM: Wooo…
(laughter from Jesse and Michelle)
JESSE: Committable is produced by Jim McQuaid, Michelle Stockman, and me, Jesse Mangan.
With additional production help this episode by Brian Patrick Williams.
All music is from the Song Reasonable by Christopher G. Brown.