The Free Press, Mankato, MN

March 19, 2014

Bill hastens prescriptions for state's patients

By Dan Linehan

---- — ST. PAUL — In Minnesota, newly civilly committed patients can’t receive their mental health medications immediately unless they understand their illness and know the risks and benefits the drugs pose.

New patients aren't always mentally competent to consent to medication, and it can take as long as six weeks for a court order triggering the medication to start, said Dr. Steven Pratt, executive medical director of the Department of Human Service’s behavioral health division.

A bill from Rep. Clark Johnson, D-North Mankato, would change this law by allowing patients who aren’t medically competent to give their consent to be nonetheless given medication right away. It passed through committees in the state House and Senate on Wednesday.

The courts still have their role under the bill; the change gives the state 14 days to put the matter before a judge. The drugs can be prescribed during those two weeks, as well as an interim period before a hearing takes place.

That these court orders are even a requirement might be considered counterintuitive. If it’s fairly common for patients to be incompetent to give their consent, as Pratt said, why must the state wait weeks for a prescription?

After all, that delay can slow treatment and poses safety risks for employees who work with the patients. Tackling both of those problems is a priority at the Minnesota Security Hospital in St. Peter, which houses about 375 people deemed mentally ill and dangerous. Staff injuries have been rising in recent years, and the average patient stays for about eight years.

Pratt said the current practice stems from a court case in the 1980s involving a man who was prescribed medication against his will. The case’s wider implications, including for patients who are incompetent to give consent but not refusing medication, was an oversight, Pratt believes.

Another solution to this problem would be for a judge to consider approving medication at the time the civil commitment is made. That change was originally part of this bill, but it wasn’t ready for passage this year, Pratt said.

Johnson characterized the bill as one of several small steps the state is taking to improve treatment and staff safety in St. Peter and other mental health hospitals.

The bill passed through the House judiciary committee without controversy and may be bundled up with a list of similar laws.