OKPOLICY.ORG
In an opinion piece in the Tulsa World last weekend, Tulsa County District Attorney Steve Kunzweiler appears to find himself again at odds with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) over its interactions with the criminal legal system.
Kunzweiler, a committed and experienced prosecutor, was highly critical of ODMHSAS recently due to lengthy delays in making required mental competency determinations of whether defendants are competent to stand trial. He was also critical of ODMHSAS’s treatment program to restore competency inside county jails.
That issue came to the public’s attention when a federal class action lawsuit was filed by inmates awaiting competency evaluations. The case was recently settled with an agreement that will be reviewed by the Contingency Review Board in January.
In response to the settlement, announced last month, Kunzweiler said, “Today’s announcement of an agreed upon settlement in the class action lawsuit filed on behalf of detained inmates at the Tulsa County Jail, who languished multiple months due to the gross negligence of the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), is welcome news.”
That settlement has to do with people accused of a crime, but not yet convicted, whose trial has been delayed because there is a question as to whether they are competent to stand trial, i.e., able to understand the proceedings and aid in their own defense. If not, they must be restored to competency before standing trial.
The new issue over which Kunzweiler expresses concern is a request for proposal by ODMHSAS seeking a private hospital vendor for 100 beds to move people who have already been tried and found not guilty by reason of insanity outside of the state-owned Oklahoma Forensic Center in Vinita.
By law, these are people who committed a crime while mentally ill and who were either unable to understand the nature and consequences of their actions or were unable to differentiate right from wrong – and who have been determined by a court to be a person who continues to be presently dangerous to the public peace and safety because the person is a person requiring treatment. As Kunzweiler says, the crimes these people, who are ill, have committed are sometimes “horrific, if not unspeakable.”
According to Kunzweiler, “these individuals are often among the most difficult to treat, requiring intensive and specifically designed mental and behavioral health interventions.” He says treatment for these patients is a high-dollar expenditure, typically upwards of $900 per day per person. A hundred beds would cost around $33 million per year.
By law, these people remain in custody of ODMHSAS for treatment until a court discharges them, having found that the person is no longer a present danger to the public peace or safety. The court may order a conditional release when recommended by the Forensic Review Board.
Created in 2008, the seven-member Forensic Review Board determines which individuals are eligible for therapeutic visits, conditional release, or discharge, and then makes its recommendation to the court. The board consists of four licensed mental health professionals, a retired judge, one attorney, and one at-large member, all appointed by the governor with the advice and consent of the Senate.
It will be interesting to see if ODMHSAS gets any takers for its request for proposal. Although a $33 million contract sounds attractive, the type of treatment needed is likely very expensive to provide. And the cost to develop such a treatment program with no guarantee the state will continue to fund it properly sounds risky.
Ironically, ODMHSAS’s desire to offload these patients to the private sector is likely an effort to make room at the Oklahoma Forensic Center to speed up competency evaluations and treatment for people awaiting trial that was made necessary by the settlement agreement previously mentioned, and which Kunzweiler welcomed.
While all this is going on, it should be noted that the state is currently embarking on a large increase in new state-owned, in-patient psychiatric beds in Oklahoma City and Tulsa that may be in competition with private psychiatric hospitals already in existence in both communities.
Perhaps it would be better for ODMHSAS to dedicate 100 of these beds to the forensic treatment they are trying to send to the private sector and leave the treatment of non-criminal patients to the existing psychiatric treatment facilities.
It’s a complicated issue that seems ripe for collaboration with public psychiatric experts at ODMHSAS, private sector psychiatric experts, the professionals in the criminal legal system, and the Legislature.
