State Looks To Reform Handling Of Involuntary Commitments For Substance Abuse

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The Massachusetts response to the state's heroin and opioid addiction crisis centers around making more treatment available.

For some, that treatment is not voluntary. A process known as "Section 35" allows relatives or other concerned parties to put someone into confinement for court-ordered treatment.

Plymouth District Court Judge Rosemary Minehan, a member of Gov. Charlie Baker's opioid task force, says Section 35 requests across Massachusetts have gone from about 5,800 four years ago to 7,500 in the past year.

"The volume is extremely high," Minehan said. "Just this week we had seven on Monday and five on Tuesday. Those are high numbers. We never used to see that many numbers coming in in this court."

Those increasing requests come from people like Annemarie Whilton, of Cohasset. Whilton says she has run out of options in her two-year struggle to help her 19-year-old daughter overcome addiction.

"I just said enough is enough. And I also know she has been on this merry-go-round. I just knew she wasn’t clean. I don’t know any parent who hasn’t done it as sort of a last ditch measure," Whilton said. "We’re encouraged by the fact that a Section 35 usually provides 30 days of lockdown supportive treatment."

But, as Whilton explains, that's not always the case.

"We’ve done it three times, but the most she has ever received is 21 days," Whilton said. "And that’s because of a lack of [treatment] beds. The last time she did this she was actually sent to prison. She was sent to Framingham, and she was there for 14 days, I believe, before she was transferred to the women’s treatment center in New Bedford."

While at Framingham, Whilton says her daughter didn't get treatment, just detox.

"She was isolated from the criminal population, supposedly for her own safety, but she wasn’t receiving any services that would treat her addiction," Whilton said.

"She fought me," she added. "But I have to say each and every time after five or six days of treatment, she did say she understood. She even sent me a letter when she was in Framingham saying she understood, that she needed this done. I don’t think any of them want to be this way. It’s not a conscious choice."

In response to the concerns of parents like Whilton, state officials are trying to make big changes to how Section 35 commitments work — like getting patients out of state prisons. Health and Human Services Secretary Mary Lou Sudders says the state will spend $6 million to create 45 new beds for women at Taunton State Hospital, a facility that's under the supervision of the state Department of Mental Health.

"One of the reasons to move this to the Department of Mental Health is to provide a longer period of hospitalization at Taunton State Hospital," Sudders explained. "Obviously we’re starting with women, and then we’re expanding the number of clinical stabilization beds. So I’m hoping for a smoother transition from higher level of treatment, to then the next level of treatment, to help people on that long road to recovery."

But Judge Minehan says because criminal activity often follows addiction, the courts will always be involved. And she says that can be an incentive for people to get into — and stay in — treatment.

"While it is public health, I think the courts are a great treatment option. One of the things we decided in the governor's task force was that everything is in the toolbox," Minehan said. "So I think, going forward, the courts are a very valuable resource for this toolbox with the opiate addicted population, particularly those that are behaving either in a dangerous way to themselves or others, or are involved even more so in criminal behavior."

And Minehan says the Section 35 law needs to be more strictly enforced. For example, she says although the law requires follow up after someone is released, that typically doesn't happen. Minehan says many times patients are discharged for various reasons and go right back to using again. But the biggest problem, she says, is that the 198 treatment beds now available are not enough. She's seen how these issues affect so many families.

"I can remember an individual who came before the court a while ago and indicated that he had driven his daughter to get heroin during a snowstorm," Minehan recalled. "He indicated that the reason he did that was that he knew that she would do anything she could to get that heroin. So he reasoned that he would be better off driving her himself and waiting outside with the windows rolled down so that if something happened or she was in there too long, he could go in and save her."

As reforms to this involuntary commitment process go forward, families continue to look for immediate help. Whilton says she's dealing with a new problem with her daughter.

"[My daughter] went to a residential home in Boston, which is fabulous," Whilton said. "And unfortunately, it’s not a lockdown, so you can walk out and she chose to walk out. I don’t know where she is right now, and I'm worried."

Whilton says her daughter walked out of the facility three weeks ago. She says her daughter has texted her on and off, but that she won't tell her where she is, because she's worried her mother will possibly section her for a fourth time.

Correction: An earlier version of this story misspelled Annemarie Whilton's name and incorrectly identified the scope of Section 35 requests. We regret the error.

This article was originally published on August 06, 2015.

This segment aired on August 6, 2015.


Deborah Becker Host/Reporter
Deborah Becker is a senior correspondent and host at WBUR. Her reporting focuses on mental health, criminal justice and education.



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