Involuntary commitments: a revolving door

Four days a week, court comes to a small conference room on the third floor of Huntsville Hospital. That’s where the Behavioral Health Unit is located and involuntary commitment hearings occur.

“Heartbreaking” is the word Gayle Williams uses to describe what she sees at the hearings. For the past ten years, Williams has served as a court-appointed guardian or guardian ad litem for patients who go through commitment hearings. Just last month she was representing a woman who had already been committed three times.

“Some of these people are just not prepared to be responsible, to take medication just by you giving them a prescription across the counter,” Williams said.

These people end up in involuntary commitment hearings because a family member or a county mental health officer files a petition with the probate court. For many families it’s a last resort and a heartbreaking decision.

“I see the concern they have, the frustration, the fear….They feel their loved one is going to be angry with them. They struggle with is this the best thing for the loved one, or is this just better for me at the time?” attorney Kimberly Brown said.

Brown is one of the attorneys designated by the Madison County Probate Court to file petitions. On hearing days she meets with Probate Judge Tommy Ragland, the patient and the patient’s appointed guardian. With the help of a representative from Wellstone Behavioral Health, they all decide to either commit the person or to find another solution like outpatient treatment.

If the person is committed, the order lasts for 150 days. But according to attorney Charlie Hooper, who also files the petitions, the Department of Mental Health usually doesn’t keep people for that long since so few beds are available.

“If they have the person over there for a week, two weeks or one day, it’s up to them. I mean they can discharge that person the day after the court commits them,” Hooper explained.

A case worker with Wellstone follows up with the individuals once they’re released. Some are homeless, so they’re difficult to locate. But even if the person has a strong support system, they often come back through the revolving door of commitment.

“A lot of times there’s family involved who say we can make sure they take medication or we can help them with this. Then they become overwhelmed. They realize I thought I could do this, but based on the conduct or the refusal, it just gets hard,” Brown said.

Advocates say there’s a desperate need for more funding to pay case workers and to build more group homes for patients whose families can no longer care for them.