DA proposes civil commitment court during mental health symposium

SALT LAKE CITY — Several years ago, a member of the Salt Lake County District Attorney's Office came up with the phrase, "civil commitment is a status, not a place."

That phrase has since been used so often that today it's almost become cliché, said District Attorney Sim Gill.

But on Friday, Gill asked a full room of mental health advocates and law enforcers to think about what a civil commitment place might look like.

"My proposal, what my hypothesis is, is to create, for the first time ... a meaningful civil commitment court," Gill said.

Gill made his comments during his third Criminal Justice and Mental Health Symposium. The event is hosted by the Salt Lake County District Attorney's Office with sponsorship from the Utah Shattering Silence Coalition and the Utah Coalition for Severe Mental Illness. The goal is to have open and continued dialogue regarding alternatives to incarcerating people suffering from a severe mental illness while still maintaining protection for the public.

"We have to ask, how did a serious medical illness become a criminal justice matter?" Debra Widmer, head of the Utah Shattering Silence Coalition, said in her opening remarks.

She said it's not about choosing compassion over public safety, while adding that a person doesn't choose psychosis and that treatment and recovery are possible.

"These illnesses are medical conditions, and they must be treated accordingly," said Sherri Wittwer, director of the Utah Coalition for Severe Mental Illness. "We need to develop true alternatives to incarceration and develop civil processes to implement what already exists in statute."

Leaving people on the street and depending on local jails to be the "healthcare provider of choice….is neither effective nor cost-effective," she said.

Gill concurred that "our criminal justice system by default has become our mental health provider." But it's only a small percentage of people who have mental illness and have committed a heinous crime that should actually be in the criminal justice system, he said.

What is "pervasively present in the criminal justice system" are people who are not legally competent to stand trial nor functionally capable, "and that is absolutely wrong," Gill said.

If a person has a heart attack, they are taken to a hospital, he said. But if a person has a psychotic break, that person goes to jail. Gill pointed out that the state has successful mental health and drug courts. Why not also have a civil commitment court, the district attorney asked.

Although Gill admits his proposal is not perfect, he says having a civil commitment court would provide accountability, supervised oversight and allow the justice system to engage with a subject, especially those who have declined to voluntarily commit to a hospital or mental health program. Those people could be involuntarily committed to the Utah State Hospital or the Huntsman Mental Health Institute at the University of Utah. But most involuntary commitments only last 72 hours, he said.

Furthermore, Gill said that studies suggest the ideal ratio for addressing civil commitment in a region is 40 to 60 hospital beds per 100,000 people. In Utah, Gill says there are 8.4 beds per 100,000 people.

Yet, when a mental illness is not addressed, a person's condition gets worse over time, the district attorney stressed.

"And that means the intervention that you could have made upstream may not be as effective downstream because of the systemic neglect. And in a way, that's a self-inflicted wound. But we don't have enough space, so we don't give them the services that they need," Gill said.

What's missing are the "bridges" between community resources and the criminal justice system, he said. Gill used the analogy of deconstructing the current response system and using those "bricks" to reconstruct a better community-based response to those suffering from severe mental illnesses.

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