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Letter Responding To AOT Program Concerns

Letter from judges Guy Herman and Dan Prashner.

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Houston Chronicle
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3K views2 pages

Letter Responding To AOT Program Concerns

Letter from judges Guy Herman and Dan Prashner.

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Houston Chronicle
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TRAVIS COUNTY PROBATE Court NO. 1 200 W. 8" Street, Second Floor P.O. Box 1748 Austin, Texas 78767 Phone: (512) 854-9258 Fax: (512) 854-4418 January 12, 2022 Good afternoon, everyone — Severe mental illness (SMI) is tragic for the person suffering from it, and for their friends and families. Judge Prashner and I know this from over 50 years collectively conducting commitment hearings and secing these tragedies unfolding first-hand. Because we refused to accept that nothing more could be done to help the people with SMI whom we see over and over, we — with our caring, dedicated partners at Austin-Travis County Integral Care (ATCIC) and U-T. Dell Medical School ~ sought, and were awarded, a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to fund an Assisted Outpatient Treatment (AOT) program — to try bending the arc of hospitalizations, homelessness, and jailings toward recovery. We have nothing but sympathy for a mother’s pain for her son suffering from SMI. All of us with family members or friends suffering from SMI know something of how she feels. But what she wants a court to do cannot be done under the law that governs outpatient mental health programs, because even people with SMI have rights that courts are required to respect. ‘At least since the U.S. Supreme Court decided O'Connor ». Donaldson in 1975, courts have been empowered to involuntarily put people in mental health facilities only if, as a result of a mental illness, they are likely to cause serious injury to themselves or others (grave disability is essentially a subset of “harm to self”). Civil courts do not have the coercive powers of criminal courts. They lack power to set bond conditions and revoke the bond (remanding the person to jail, or in our case, a mental health facility) if the person does not comply with the cour’s conditions. Nor can hospitals be required to readmit people who do not meet inpatient criteria. “The era of forcing people with SMI into hospitals solely because it may be in their best interest is long past. Austin State Hospital, for example, once home to thousands of patients, now has 200 beds to serve 38 counties for adults and 75 counties for minors. These beds are exclusively for people with SMI mecting inpatient dangerousness criteria (and criminal defendants needing competency restoration). It should be noted our Mental Health Code does not permit involuntary hospitalization of people suffering traumatic brain injury, autism, or dementia (which is specifically excluded by statute) unless SMI is also diagnosed and inpatient dangerousness criteria are met. All in this court sympathize with a mother’s anguish, and we as judges do our best to encourage and coax the people in our program to participate in the services we order ATCIC to provide them. One of the ways we try to encourage and coax them is to point out in our AOT otders and treatment plans that non-compliance might result in rehospitalization, Bur, as noted above, the court ca not order hospitalization unless inpatient dangerousness criteria are met. ATCIC’s case managers do a heroic job of finding and serving the people we are trying to help. SAMHSA must agree our progtam is not a sham — they have completed their first-year audit and renewed our grant. Thank you for taking time to ead this. Sincerely, Aly Rew ON Guy Herman Dan Prashner Presiding Judge Associate Judge

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