Involuntary commitment to drug treatment raises worrying questions: gunshots

Robin Wallace thought that her years working as a substance abuse counselor gave her a decent understanding of the system. She has worked in private and public programs in Massachusetts and involuntarily engaged in treatment.

In 2017, while her 33-year-old son Sean Wallace was still fighting heroin use – after years of dealing with mental health issues and addiction – she thought she was made the right choice by forcing him to follow a treatment.

"His behavior was erratic," says Robin. "I think he's had mental health issues that have been made worse by his use."

Now, she fears that her decision has contributed to Sean's suicide.

The so-called article 35 law

Robin has become one of the thousands of Massachusetts residents each year who are asking the courts to compel a loved one to be treated for addiction under a state law known as a section. 35.

The law allows a family member, a doctor or a police officer to ask the courts to invite someone to treatment for drug addiction. Dozens of states have laws of civil engagement, but Massachusetts is thought to use it more aggressively than most states.

In the last fiscal year, more than 6,500 Massachusetts residents were treated this way.

After a clinician in Hyannis, Massachusetts, reviewed Robin's application, a judge agreed that Sean's substance use was dangerous and ordered him to undergo institutional treatment of up to 90 days.

Sean had begged his mother in court that day not to follow that path. He had been sent to a program, he told him, where he would be locked up and forbidden to continue taking the drugs that helped him fight his addiction, methadone.

"I thought he had misunderstood," says Robin. "Because I could not conceive that there would be an opioid treatment program that would not provide drug-assisted treatment."

It turns out that Sean was right. Although many providers consider that drugs are the norm in addiction treatment, Sean was sent to a program in a state prison in Plymouth, Massachusetts that does not provide the drugs.

When we spoke to Sean in 2017 – shortly after committing about a month, he stated that the conditions were inhumane and that he was often placed in isolation or "the hole" – although he did not commit any crime.

"I've been punished for not eating," Sean told us. "That's how I ended up in the hole.If you refused your tray, they consider it a behavior problem.I did not know it.I was just sick."

He has committed suicide

In this interview, Sean also stated that he was struggling to adapt to life after his stay at Plymouth Prison.

"I just feel different," he said. "I have a lot more anxiety, I'm scared, I feel like I'm going to wake up and be back there."

Less than a year after this interview, Sean is killed. His mother says that after this period of civilian involvement, Sean could no longer hold a job. He was found in a psychiatric hospital and later incarcerated for attempting to break into a house. Robin thinks that being imprisoned for treatment against addiction has contributed to his suicide.

"I think her trauma was caused by her being in the cell" of the local prison, she says. "And he just felt like he could not stand it anymore."

The sheriff did not want to comment, but documents at the local jail confirm that Sean attempted to commit suicide there. he died later of these injuries.

Sean's long-time partner, Heather McDermott, says he's never been the same after his civil engagement.

"It looked like a big, sad, depressed tumor that I was trying to bring back to life," said McDermott. "We had a house, I can not even believe we got here, and then – he died."

Massachusetts is one of the few states to use prisons to involuntarily induce men to take drug treatment – and Massachusetts uses it more than most states.

In an e-mailed statement, the Massachusetts Department of Corrections said its mission was to promote public safety by providing a secure treatment environment. And in Massachusetts, the demand for involuntary treatment for addiction is such that 100 extra beds were opened in another prison last year.

Hampdale County Sheriff Nick Cocchi said many traditional treatment centers are unwilling to accommodate patients who do not want to be present and that, with the decline in the prison population, prisons have room for these. men.

"It's a very dangerous population, extremely sick and – I would say – less wise," Cocchi said.

Many states follow the same path as Massachusetts: they reinforce their civil engagement laws to hold people against their will for them to be cared for. And some researchers, such as Leo Beletsky of Northeastern University, say more and more families are choosing to lock up their loved ones because that's the only way to get immediate help.

"Limiting the civil rights of someone should be the last resort and reserved for really serious cases," he said.

Denise Bohan believes that the involuntary commitment saved the life of his 33 year old son. Families are desperate, she says, and can not reason a loved one who is addicted.

"This is Bohan says: as a last resort, it's not something you do, but on a whim. It's a desperate act to try and save your child's life. "

Several Massachusetts officials pointed out that the law could change so that correctional facilities are not used for men who are incarcerated in drug treatment, mainly because drug addiction is now widely regarded as an illness requiring medical treatment.

Already, a class action against the state has been filed, accusing gender-based discrimination – because Massachusetts has stopped sending women involuntarily incarcerated in prisons in 2016, in response to a different trial.

A longer version of this story appeared originally in CommonHealth of WBUR. Deborah Becker is Senior Correspondent and Hostess at WBUR. His reporting focuses on mental health, criminal justice, and education.