April, 24, 2023 – Passage of California’s CARE Court law to reform California’s Mental Health Services Act, efforts inthe State of Washington, and possibly in New York City, promise help for the tragic number of unhoused among us. California’s law may be a decent start in funding, hiring therapists and providing beds in facilities for the many tens of thousands who need it. What I would like to see more of, though, is recognition of the tens of millions of people afflicted with substance use disorders as a significant part of the same mental health conversation.
Some say that involuntary commitment laws deprive one of agency and that civil liberties are at risk here. However, these laws and the well-established Marchman Act in Florida, provide due process safeguards. And, as Gavin Newsom recently questioned: does an individual who is defecating in the streets have much agency? The same can be said for most chronic substance abusers.
Right now, it’s a matter of educating people about the Marchman Act, which has been an effective form of intervention through Florida’s legal system since 1993. Waiting for an impaired individual to hit bottom on their own is not working—anywhere. Overdose deaths of 100,000 people per year, drug overdoses, and a like number of alcohol related issues, underscore that reality. The Marchman Act accelerates movement toward recovery, first with a court order for assessment, and then an order for treatment. Studies have shown that involuntary commitment to treatment is at least as effective as, if not moreso than, voluntary treatment.
The first step for families struggling with the effects of substance use disorder and co-occurring mental health issues is to connect with clinicians, interventionists, case managers, treatment centers, who all need to understand that, at least in Florida, this is something that you can get done with relative ease, whether or not the impaired individual is a Florida resident. Let me say that another way. Neither the family nor the impaired individual need to be residents of the state of Florida. Wehave helpedapproximately 400 families—from across the country—with Marchman Act cases over the last 10 years. Typically, it begins with an interventionist or a family member reaching out to my office for help because a loved one has a substance use disorder—as of late: high dose THC cannabis, alcohol, inhalants, opiates including fentanyl—causing significant consequences. And someone has told the family that legal system intervention is an option. We hear more and more from interventionists who have exhausted all other intervention modalities without success. This is when they want their clients (loved ones of the impaired individual) to learn how the court system can help them engage in legal intervention. When I partner with interventionists, we get results. I encourage the family to rely upon the interventionist, especially with regard to treatment consulting and guidance. I offer my expertise in the realm of using and navigating the legal system. I have worked with many interventionists to this end.
Here is just one example of how the Marchman Act works. A year ago, we were hired by the North Carolina parents of a young man with substance induced psychosis. Their son had absconded from treatment, returned to abusing substances on the street, and was at the Palm Beach International
Airport, preparing to flee the state of Florida to avoid treatment. We got a same day pick-up order from the court for involuntary assessment just moments before the courthouse closed. I rushed to the airport, with the order in-hand, and tracked down deputy sheriffs to help me locate him. They were reluctant. But I pushed, and said, “Let’s do it together.” We found the impaired individual at the terminal getting ready to board a flight on Southwest Airlines. The deputies took the young man into custody and brought him to a facility to be detoxed and then to treatment. His parents recently told me that he has been clean and sober now for almost a year, and he is grateful that his parents pursued a Marchman Act intervention. Not every case requires a sprint through an airport, but this is certainly a repeating story for us. My practice is now exclusively devoted to helping people affected by substance use disorders with involuntary commitment to treatment.