KNOXVILLE, Tenn. — When he saw the news in December 2007 that a 25-year-old man with a history of mental illness had shot two people at a West Knoxville restaurant before himself being killed by police, Knox County Mayor Tim Burchett — then a state senator — said he thought a law might have helped.
Burchett had already been pushing for Tennessee legislation supporting court-ordered assisted outpatient therapy (AOT) for people with severe mental illness. The measure would be patterned on New York's Kendra's Law but without the expense of creating the statewide infrastructure that is part of that law.
On Friday, he stood in front of Helen Ross McNabb Center with Sen. Becky Massey (R-Knoxville,) Sen. Doug Overbey (R-Maryville), Rep. Ryan Haynes (R-Knoxville), Tennessee Commissioner of Mental Health and Substance Abuse Services Doug Varney and McNabb CEO Andy Black to announce that the law he long wanted took effect July 1 — and McNabb Center would pilot a program that could later be expanded statewide.
Knoxville "can prove this works," Burchett said. "On the bare minimum, it saves dollars, but it saves lives also."
The state-funded pilot program, which hasn't yet begun, provides a way for a judge to order comprehensive outpatient services for people with "mental illness or severe emotional disturbance," to divert them from being committed to a psychiatric facility or jailed for minor offenses.
The hope is that such treatment will stabilize those people and prevent crisis situations.
"We don't need to be incarcerating the mentally ill; we don't need to be committing them to a facility," Massey said. "What we need is a way to get them treatment."
The pilot project is an amendment to Senate Bill No. 420, which was sponsored by Massey, Overbey, Haynes and Rep. Bob Ramsey (R-Maryville). The state will pay McNabb Center $125,000 per year for the two-year pilot, using some of the funds that formerly would have been budgeted to operate Lakeshore Regional Mental Health Institute, which closed last month.
The closure was part of Varney's plan to "deinstitutionalize" mentally ill people in Tennessee, diverting them whenever possible to community-based services, including several run by McNabb Center. Varney said that, despite the few "tragic" cases that make national news, most mentally ill people are more dangerous to themselves than to others. When services are ordered, he added, it's often to protect vulnerable people from being taken advantage of by others.
Some advocates for people with mental illness have protested AOT, because the court may order a patient who does not comply with it to be taken into custody. But the National Alliance on Mental Illness has supported the legislation. In order for AOT to be an option in Tennessee, the court must deem it the "least restrictive" but still appropriate treatment option.
"There is this belief that we're doing something cruel to the person, that we're somehow denying this individual's right to direct their own course of treatment," said Brian Stettin, policy director of the Treatment Advocacy Center in Arlington, Va., who has worked on AOT issues since 1999. "It is compassionate. It's about helping people (and) ... stopping the revolving door" of psychiatric hospitals and jails.
Varney said the pilot program "is not an easy project for a community provider." Black, of McNabb Center, said District Attorney General Randy Nichols and Sheriff J.J. Jones have formed a committee to look at appropriate uses for the new option.
"Nobody's suggesting ... that we're going to see lots of people under this AOT law," Stettin said. "It's going to be a pretty small handful of cases. But in those people's lives it's going to make a pretty profound difference, at negligible cost to the state."