ANCHORAGE (KTUU) - When Alaska's troubled state psychiatric institute stopped taking new patients in October, it caused gaps in care that left some individuals in a type of treatment limbo. Ordered by a court to be held for care, either because they are gravely disabled or a danger to themselves or others, those individuals found themselves stacked up in emergency rooms or jail cells awaiting bed space at the Alaska Psychiatric Institute.
The Public Defender Agency and The Disability Law Center filed separate lawsuits against the state seeking relief for their clients and the population they serve. Those cases are now merged, and this week Judge William Morse took final arguments into consideration about what he should do.
There are two types of court-ordered commitments affected by API's restructuring and move toward privatization. Civil, where someone goes to court seeking protective care for a family member, patient or another individual. And law enforcement related, where a police officer is called to assist with an individual who is perceived to be a harm to themselves or others.
The plaintiffs believe forcing someone to stay in custody for an undetermined amount of time while they wait for bed space or evaluation is unconstitutional.
State law allows for a correctional facility to be used if someone is being transported to care, a practice the plaintiffs say was never intended to be used for long stays. A few hours in a rural jail while waiting for a flight to a hospital is understandable, they said. But days segregated in a punitive setting under the guise of keeping them safe is going too far, they argued.
The state admits the system could improve, but absent time to solve systematic issues, an obligation exists to keep people safe -- even if that means the only alternative for waiting out such evaluations and care is in a mental-health or segregated wing of a corrections facility.
"The state has, at a minimum, failed its statutory duties. There's no question in my mind about that," Judge William Morse said as he posed questions to the parties at a final hearing Tuesday. "But I'm trying to figure out, other than to order the state to do more, and to do more immediately, both in terms of getting staffing and figuring out what to do with this population who is awaiting admission, do I release people into the streets?"
The Disability Law Center and the Public Defender Agency say, if it comes to that, "yes."
"We are not asking for immediate release from jail. We are asking for immediate release if something else can't be done. What we're asking for is for people to be in appropriate facilities. If the state can't come up with a plan where that is possible, then yes, we think people should be released," Joanna Cahoon, a staff attorney with Disability Law Center, told Morse during the hearing.
"It is unconstitutional to hold mentally ill individuals who are civilly detained in corrections," similarly argued Linda Beecher, a deputy public defender. "Putting them in jail is not an answer. It's inhumane. And it's making them worse."
"Plaintiffs’ proposed preliminary injunction of having evaluations for possible commitment take place in jails or local hospitals would not effectively address the problem, as we believe those evaluations would be below the standard of care. The other relief plaintiffs request is immediate discharge to the street, regardless of a patient’s mental health; we believe that is not in the public interest," Cori Mills, Assistant Attorney General for the state of Alaska told KTUU late Wednesday afternoon.
Morse has yet to rule.