One year after troubled man killed in E Denny Way standoff, state laws are easing on involuntary treatments

Reuter

Reuter

Last July, Joel Reuter was shot and killed by two Seattle SWAT snipers. Reuter, suffering from a manic episode, fired a gun from inside his Bellevue and E Denny Way apartment after an 8-hour standoff.

Six months later, a 7-member jury found both officers had reason to believe Reuter, 28, posed an imminent threat to himself and others. Family and friends of Reuter that spoke with CHS agreed that police did everything within reason to deescalate the situation. What Reuter’s family decried was their inability to have their son involuntarily committed for treatment because of strict protections in Washington state law.

Following their sons’s death, Doug and Nancy Reuter worked to bring a bill before the Washington state legislature that would give families more influence in involuntary commitments of their loved ones. Currently a judge can issue a 72-hour involuntary hold on someone if a mental health professional recommends that the person meets the state’s criteria. Under HB 2725, family members would be given the chance to appeal a mental health professional’s recommendation that a loved one did not meet the criteria. The bill died in committee earlier this year.

During a hearing on the bill in February, Joel’s father said he and others had tried for months to have a designated mental health professional recommend to a judge that Joel should be involuntarily held at a hospital for treatment. During that time Reuter had a string of run-ins with police and crisis intervention specialists and threatened to kill himself and his parents.

“I was told if he had a loaded gun on his hand with his finger on the trigger, then we could get him help. That’s exactly what Joel had on the morning of July 5th, and the help they gave him was to kill him,” he said.

While the bill will have to be reintroduced next session, a separate law went into effect this month that eases restrictions on involuntary hospital commitments. The 2013 bill changed the criteria for involuntary commitments from “dangerous to self or others” to “gravely disabled,” a change lawmakers said would likely increase the number of involuntary commitments statewide.

On one of her visits to Olympia from her Texas home, Nancy Reuter told legislators that mental illness should be treated with the same sense of urgency as other diseases to avoid future tragedies like the one that ended her son’s life.

“Someone once told us that people have a right to be crazy. I can tell you that Joel did not want to be crazy,” she said. “When he got cancer, he was rushed into treatment ASAP. When his mental illness spiraled out of control, he was not able to get treatment. It’s discrimination of the worst kind.”

11 thoughts on “One year after troubled man killed in E Denny Way standoff, state laws are easing on involuntary treatments

  1. Changes in the involuntary commitment laws are WAY overdue. Under the new criterion of “gravely disabled,” more mentally ill people will be committed and get the help they need, and also society will be protected.

    The tragic death of Joel Reuter was entirely preventable. Since he had threatened to kill his parents and himself, why did this not meet the state requirement to be a “danger to self or others”? Are some of our “mental health professionals” incompetent? In my opinion, that one professional has way too much power in making the decision to commit.

    A huge thank-you to the Reuters for all the work they have done in changing our lax laws. I sure hope they get their bill passed at the next legislative session.

    • Well, if someone is brought into the hospital, it’s not just the MHP. First the ER MSW and MD evaluates. If the person is already involved with a mental health agency, then they are called as well and an after hours staff member comes to assess. If everyone agrees, the MHPs are called. It’s a ridiculously clunky process and it takes FOREVER. But yes, you are right, then it is up to the MHP to have the final word. And sometimes it is totally bizarre. While I wouldn’t say incompetent, I can tell you that I have been shocked and saddened by the people they have let go. Of course, no matter how well trained mental health staff are, the truth that most people can’t deal with is that some people are always going to fall through the cracks. A lot of people know the system very well and know just what they can and can’t say to get them detained or released. That’s why I really am all for changes like the ones mentioned above. As it is, they ITA system pays very little attention to past history or to family opinions.

      • @MSW, thanks for your “insider” information. Can I assume that a MHP is called in because the initial providers (MD, MSW, staff from mental health agency) agree that the person should probably be involuntarily committed? I think that the initial providers should have a say in the final decision, not just the MHP. It would be interesting to know the statistics on how often the MHP over-rules the assessment by the initial providers. Why is the MHP’s opinion assumed to be the definitive one?

  2. What happened to Joel Reuter is a tragedy, but this is a very bad move. Involuntary committal is imprisoning people for being mentally ill. Sometimes it’s justified, but it’s also ripe for horrific abuse. Loosening the standard means that many more people who should not be there and do not want to be there will be forced into hospitalization by their families who don’t know how to deal with them or don’t want to deal with them.

    They will have no recourse, and once you are labeled mentally ill and subject to this kind of coercion it becomes very difficult to convince anyone to listen to you. This new standard is going to make life a lot worse for a lot of people.

    • You raise a good point. This is exactly what happened to thousands of people until, maybe the 1960’s? But hospital oversight is MUCH better now than it was then, especially with the adoption of HIPPA, and I think it’s time the laws making up for the lack of oversight were updated to match the current standards. At this point, loosening the involuntary commitment restrictions is probably the best tool we have for preventing things like domestic violence and school shootings.

    • You’re right that this is a possibility at one end of the spectrum. However, we have reached the opposite end of that pendulum swing I think. The mental health hospitals were emptied due to a combination of cuts to social programs in the 80s, and new treatments that looked so hopeful in the beginning. But they didn’t transition from involuntary commitment to some sort of supported living, they just dumped them in the streets. Now they fill the homeless shelters and the jails and prisons. I have a friend who works for the jail in healthcare who says most of her patients are mentally ill.
      So if what we were discussing was committing people to hospitals involuntarily for being mentally ill vs. supportive homes that would continue to allow them to interact with the community, I would agree that involuntary commitment is the wrong way. But in reality we’re discussing involuntary commitment to hospitals vs. literal imprisonment behind bars, without proper mental health services, or on the streets, homeless… in that case, a mental hospital is a step up. Maybe after we accomplish that for some of the worst cases we can find something better for those who are in-between.

  3. I am also pleased the laws are changing. The law only allows for increased access to 72 hour holds. During this time professionals can help evaluate and if necessary start or alter treatment for someone.

    I suffer from Bipolar 2 disorder, if something goes wrong with my medication I could spiral into a serious crisis, under the old law I would have to be an imminent threat to myself or others to be held, under the new proposals a medical professional could determine that I am sliding into a dangerous situation and an intervention could occur BEFORE things get out of hand.

    This is not a bad thing, this is a good thing.

    • I think your comments and insight are very important. You emphasize the reality that mentally ill people do not WANT to spiral out of control, but in fact want to be mentally healthy. Sometimes they do not realize when they are getting into a crisis, and in these situations it is more humane to have a system in place which helps them get stabilized (and at the same time to protect society from the minority who might get violent). We do not have such a system now, and that’s why the laws must change.

  4. As a social worker in the mental health system, I really do think this is a good thing. If it weren’t so tragic, it would be almost funny how difficult it is to get someone involuntarily detained in this state. I mean, the stories I could tell you, if I could tell them to you. Families are left no with no real options to help their loved ones, so it will be nice to put some power back in their hands, although of course one wonders if it will be misused in certain circumstances (like with family members that are sick of dealing with mental health issues of relatives). There are so many times I have had to tell parents: “I am so sorry, he is asking to leave and we have to let him go, we can’t hold him. You will have to wait for it to get worse before you can detain him and it can get better.” That is just the worst!

    Of course, I would love to know where all of these extra involuntary beds are going to come from, because there ain’t none right now!

    I do think some of this recent change just codifies things that have already been going on for a long time. I have made referrals to have people detained for grave disability for years. The problem is that it’s all so subjective and a lot of it really depends on what Mental Health Professional you get. And some of them don’t seem to want to detain no matter what. Like they’re seriously like “Oh, well, he had a serious suicide attempt 2 days ago and he’s asking to leave? Well, he’s saying he’s not suicidal anymore and the attempt was two whole days ago already so discharge him.” THAT IS SO FRUSTRATING!

    • @MSW, I know you didn’t agree with my use of the word “incompetent,” but really doesn’t your comment illustrate the reality that some MHPs are exactly that?

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