Hospital administrators told lawmakers they often can’t get patients placed in psychiatric facilities within three days, forcing them to discharge patients untreated even though they’ve been deemed a threat to themselves or others. (Dana DiFilippo | New Jersey Monitor)
Gov. Phil Murphy signed a new law that will double the time hospitals can hold people in psychiatric crisis against their will, despite advocates’ concerns that the measure could worsen racial disparities and trample civil rights.
Critics last month urged Murphy to veto the bill. After signing the bill into law Wednesday, the governor issued a statement defending his action, calling the state’s shortage of psychiatric beds “an emergent crisis” that prevents health care providers from treating people with mental illness in the most suitable, least restrictive environment.
“These capacity issues are particularly troubling in cases where an individual’s condition is so severe that they are in need of involuntary commitment, yet the path to timely intervention is unclear,” Murphy wrote.
The new law, he added, “provides interim solutions to these problems and takes important steps to increase bed capacity, which is the appropriate and sustainable long-term solution.”
Hospitals previously had been allowed to hold involuntarily committed people for just 72 hours, as they worked to place them in psychiatric hospitals or other facilities for specialized care. But hospital administrators told lawmakers in June they often can’t secure those placements within three days, forcing them to discharge patients untreated even though they’ve been deemed a threat to themselves or others.
The new law allows hospitals to hold such patients up to an additional 72 hours longer, with court approval. It also permits hospitals to apply for temporary approval from the state Department of Health to add psychiatric beds for involuntarily committed patients. Such applications were previously reviewed just twice a year.
Murphy pointed out two provisions of the law he said should ensure patients’ civil rights:
- Hospitals will have to persuade a judge both that they were unable to secure a psychiatric bed within the initial 72 hours and that there’s a continued need to hold the patient in question.
- A public defender will be appointed to represent the patient in court, and that attorney can challenge the hospital’s request for a longer hold.
“The law is designed to balance individual liberties and due process rights with the state’s duty to ensure the safety of the patient and the general public,” Murphy wrote. “The expedited nature of judicial review helps facilitate prompt treatment so that patients may be returned to their full autonomy as soon as clinically appropriate.”
Still, Ami Kachalia of the American Civil Liberties Union of New Jersey said she and advocates from almost 50 other groups that sought a veto “remain concerned.”
“There’s no clear evidence that explains the scope of this issue, and therefore what the real need is in order to address any gaps that might exist,” Kachalia said. “For us, it’s always essential that policy is evidence-based, but I think that’s especially true when people’s personal freedom is at risk.”
The mental health system’s shortcomings must be fully analyzed “to make sure that we have a right-sized response to whatever the issue might be,” Kachalia added.
In his statement, Murphy acknowledged the new law isn’t meant to be a permanent solution. It sunsets after two years.
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