Going to try to tweet some pearls from #harmred22 talk about #Section35 (involuntary substance use treatment) program in Massachusetts.
38 states in US have some kind of involuntary commitment program, but MA is the only one that uses correctional settings to hold people!!!!
38 states in US have some kind of involuntary commitment program, but MA is the only one that uses correctional settings to hold people!!!!
Family members, MD, police officers, parole officers can petition court for section 35 if perception of severe harm. Risk can be acute or chronic.
Individuals are handcuffed, arrested, and brought to jail as if they’ve committed a crime. They are assigned a public defender.
Individuals are handcuffed, arrested, and brought to jail as if they’ve committed a crime. They are assigned a public defender.
Each stage of this process can take hours. People often face withdrawal/distress while waiting to go through. Men can be sent to jails and prison for treatment (though they have not been charged with a crime).
“In correctional settings, security will always take priority of treatment”
Moreover, incarceration is a structural determinant of health - more time in carceral settings ==> ⬇️ life expectancy
Moreover, incarceration is a structural determinant of health - more time in carceral settings ==> ⬇️ life expectancy
Evidence is limited but what we have shows #section35 does not work:
2019 MA report found those subjected to civil commitment where 2x as likely to die of overdose upon release as those who sough treatment voluntary.
34% sectioned on 35 relapsed on same day of release (!!)
2019 MA report found those subjected to civil commitment where 2x as likely to die of overdose upon release as those who sough treatment voluntary.
34% sectioned on 35 relapsed on same day of release (!!)
Due to prior lawsuit/settlement women aren’t supposed to be sent to jails/prisons (but instead supposed to be sent to DMH facility); nonetheless Ayesha Johnson died in a Boston jail after Section 35 commitment last year wbur.org/news/2021/09/1…
Though many/most advocates would like to end or fully reform Section 35, even efforts to end incarceration aspect has been met with considerable resistance. But coalition of advocates, clinicians have been working on it & hope for progress on this front this year.
Any best practices in current system:
- working on it, contact Deb Goldfarb @ BMC
- from hospital side, some success in calling court clerk to try to name sure people sent to DMH facilities
- working on it, contact Deb Goldfarb @ BMC
- from hospital side, some success in calling court clerk to try to name sure people sent to DMH facilities
Advocacy
- get involved in MOAR, criminal Justice & policy coalition
- if in Western Mass / Hamden County reach out to state reps to counteract influence of Sheriff Cocci
- educate colleagues (esp docs) about reality of section 35; they don’t always know!
- get involved in MOAR, criminal Justice & policy coalition
- if in Western Mass / Hamden County reach out to state reps to counteract influence of Sheriff Cocci
- educate colleagues (esp docs) about reality of section 35; they don’t always know!
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