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Del. James W. Hubbard: Setting the record straight

In its Aug. 14, 2014, commentary, the National Alliance on Mental Illness of Maryland (NAMI Maryland) claims that it is “flatly untrue” that the Department of Health and Mental Hygiene is violating the “Outpatient Services Stakeholder Workgroup” legislation passed during the 2014 session. As chair of the Public Health and Long Term Care Subcommittee and lead sponsor of House Bill 1267, I write to correct the record. My intent, as reflected in the law’s clear wording, is for the Stakeholder Workgroup to consider voluntary alternatives to outpatient civil commitment and recommend the program that best serves at-risk individuals. By pre-determining that the outcome will be outpatient civil commitment, the Department has violated the intent and express terms of the law.

Ironically, NAMI Maryland offers the 2013 Continuity of Care Advisory Panel as proof that the department is transparent. During last year’s legislative session, I reviewed evidence that the panel had publicly issued a recommendation for further study of whether outpatient civil commitment is appropriate for Maryland.

Without explanation to those who had participated in good faith, this was changed in the final report to a recommendation to move forward with designing an outpatient civil commitment program. I do not believe that engaging stakeholders in months of public dialogue only to change the outcome at the eleventh hour is a shining example of the department’s integrity. I purposely crafted the process outlined in House Bill 1267 to prevent such shenanigans. Much to my disgust, the department simply chose instead to openly ignore the law.

NAMI Maryland dismisses concerns raised by others about implementation of outpatient civil commitment. I strongly disagree with their characterization that the three years New York failed to provide intensive voluntary services to half of those seeking them is a temporary and minor inconvenience. People who desperately want and need voluntary services should not be told to wait it out a few years while the state “ramps up” its program. It is also strange that NAMI Maryland would be “stunned” that anyone would raise concerns that African-Americans are five times more likely than Whites to be civilly committed to outpatient treatment and that roughly two-thirds of all court orders in New York are issued against African-Americans and Latinos. Regardless of whether the racism reflected in these statistics is intentional, there is an inherent problem Maryland cannot ignore.

Outpatient civil commitment supporters frequently argue that our only choice is between forced treatment and letting people suffer without services. I disagree and introduced House Bill 1267 to provide an alternative to this false choice between coercion and neglect. The legislation would have created a program to reach people disengaged from mental health treatment, for whatever reason, by using evidence-based and promising practices consistently proven to have better outcomes than outpatient commitment. I amended my bill to allow stakeholders to have robust discussion and review of this proposed program and other alternatives, not for the Secretary to push through an outpatient civil commitment program on his way out the door.

Del. James W. Hubbard represents District 23A in Prince George’s County.