Civil commitment leaves Hennepin County offenders languishing

Mentally ill inmates wait months for evaluation, treatment

Civil commitment leaves Hennepin County offenders languishing

See also: Hennepin County court gap cycles out mentally ill offenders

Eugene Arthur Gates lost three months of his life to a pack of cigarettes.

On an October evening in 2010, Gates walked into a convenience store in Bloomington. He wanted the smokes, but he didn't have any money, and when the attendant explained why this was a problem, Gates lost his temper.

In the years prior to anti-psychotic medications, Minnesota's mental health system focused on long-term institutionalization
courtesy of the MN Dept. of Human Services
In the years prior to anti-psychotic medications, Minnesota's mental health system focused on long-term institutionalization
Judge Jay Quam believes that the civil commitment system needs to be reformed
Craig Lassig
Judge Jay Quam believes that the civil commitment system needs to be reformed

"Don't you know who I am?" he demanded. "I'm Bill Gates!"

Eugene, who has nothing in common with the Microsoft billionaire other than a last name, spat a mouthful of hot coffee at the attendant and ran out the door.

Police found him yelling at another employee outside the shop, holding the cigarettes and a stash of 5-Hour Energy drinks he had grabbed off the counter. The officers told Gates that he could face charges, but Gates had no intention of going quietly. After being handcuffed, he spat at an officer and a paramedic. He was eventually charged with fourth-degree assault and brought to the Hennepin County Public Safety Facility in downtown Minneapolis.

Gates suffers from a severe mental illness. The diagnosis is Schizoaffective Disorder, a condition that, without treatment, manifests in delusions, paranoia, and violence, according to his doctors. In addition to Bill Gates, he claims to be the owner of the Kansas City-based Gates Bar B.Q. franchise, and tells judges and guards of plans to open a restaurant in the Mall of America.

In short, there was no way that Gates was going to be found competent to stand trial for the minor assault charge.

If the civil commitment process had worked properly, someone might have noticed this right away, and scheduled a competency evaluation that would have eventually kicked his case to the mental health court, where he could get treatment.

But no one did notice—at least no one in a position to do anything about it—and because Gates couldn't make bail, he spent the meantime in a jail cell. By the time Gates was transferred to a hospital for treatment, more than 90 days had passed.

This is not how the civil commitment system is designed to work. In fact, after Gates sat in jail for months, his condition might have grown considerably worse by the time he finally received treatment, says Al Poncin, his defense attorney in mental health court.

"Psychiatric treatment delayed is very bad because you never quite get back to where you were," Poncin explains. "There is some kind of long-lasting mental health ramification."

But Gates's case is far from isolated. In Hennepin County, a combination of strapped resources, bureaucracy, and an increase in criminals referred to the mental health commitment court has made it the norm for offenders to sit in jail for months on end while they wait for the system to start working.

"It is a real issue," says Mike Freeman, Hennepin County attorney. "I think society—and primarily the state Legislature—has ignored the real need for mental health treatment and options for beds. We simply have to have these things. And the Legislature has known about it for a long time, but they just don't want to pay for it."

The problem touches everyone in the system. The longer mentally ill offenders languish in jail, the more guards are tasked with acting as de facto nurses, which can lead to attacks and more criminal charges.

"The more mentally ill people that find their way into the system that aren't treated promptly, the more difficult it's going to be for the jail," says Judge Jay Quam, who presides over the mental health commitment court. "The more difficult it's going to be for everyone—especially the people who are mentally ill."

As recently as 50 years ago, Minnesota's mental health system resembled something like an Authoritarian regime. In the age predating antipsychotic medications, the focus was on institutionalization, and patients were afforded little or no civil liberties. Experts in the system today still tell horror stories of men committing their troubled wives or children just to get rid of them.

Once committed, the patients would be filed into the Anoka State Hospital like cattle.

"Back in the '60s, they had, I think, 1,600 patients up there," says Donald Betzold, a former state senator who helped reform Minnesota's civil commitment laws. "Basically, you got committed, they sent you up there, and you stayed forever. People weren't getting out."

Over the next two decades, philosophies toward the mentally ill evolved. The country moved away from long-term institutionalization, and focused on treatment plans that moved patients back into their communities.

In 1982, Hennepin County lost a precedent-setting Supreme Court case to a patient named M.D. Vickerman, who alleged his due process rights were violated by the court. After this decision came the Hennepin County Civil Commitment Defense Project, a team of experienced defense attorneys paid by the county and selected by the bar association to represent mentally ill people who can't afford counsel.

Throughout the 1980s, Minnesota's civil commitment system continued to see landmark reform. The Legislature passed the Minnesota Commitment Act, which established a platform of civil rights for the mentally ill.

Next Page »