Proposals to Force More Involuntary Treatment Stir Debate

Yaakob Hakohane of Arlington had been through decades of legal and mental health experiences. In the early 1990s, he helped create a group to advocate on behalf of the mentally ill. But even he said he was amazed by how easily he was involuntarily committed to a mental hospital last summer.

Hakohane, who suffered a brain injury as a teenager, said he fell and hit his head on a sidewalk one afternoon in July in Crystal City. He became disoriented and said police and paramedics who responded "were kicking and poking me," so he decided not to talk to them.

Hakohane was also suspicious of the people who treated him in the emergency room. He remained silent and was temporarily detained. When he went to a civil commitment hearing two days later, despite the testimony of two people who said he was perfectly rational, he was ordered into treatment for up to six months.

"It seems obvious from this experience [that] it's not hard to commit people," said his friend Diane Engster, who attended the hearing.

"It's easy," Hakohane said. "Anybody can commit anybody else." He said he cooperated with his doctors and was released in a week.

Consumers such as Engster, who founded the Northern Virginia Mental Health Consumers Association with Hakohane, are also troubled by attempts to open up patients' records. Special justices who decide whether to commit a person typically do not have access to psychiatric histories, and legislation is pending to allow that.

Alison Hymes, a Charlottesville consumer advocate who served on a state Supreme Court task force on mental health law reform, writes a blog about such issues. She wrote that if the state requires mental health providers to turn over patient records, "mental health practice in this state will never be the same. Patients/clients/consumers will not be able to trust their secret thoughts and feelings with their clinicians. Clinicians will not be able to abide by the ethical standards of their professions. People will not seek help and those who are already receiving therapy, such as myself, will quit."

Virginia is going through an unprecedented examination of its mental health system after the slayings at Virginia Tech. This is one in an occasional series of reports about problems in the system.