Dunleavy tries to legitimize Alaska’s return to a shameful past

As a federally governed territory, Alaska had no capacity to treat mental illnesses or disabilities. Alaskans with mental illness were treated as criminals. Those with mental illness, addiction, developmental disabilities or dementia were first jailed for being an “insane person at large.” Then they were sent, for what often amounted to a life sentence, to a federally contracted hospital facility in Oregon.

A key part of the movement for statehood was the effort to correct this terrible injustice — to decriminalize mental illness, keep people in need of treatment out of our jails and keep Alaskans in Alaska. That effort led to construction of a hospital in Anchorage specifically to treat people with mental disorders — the Alaska Psychiatric Institute, aka API. API was built precisely for the purpose of decriminalizing mental illness, to avoid the trauma and other harms caused by jailing Alaskans in psychiatric crisis.

The effort also led to creation of a million-acre land trust to provide funding to support treatment in perpetuity. The tawdry history of how that trust was dismantled and the resources frittered away for other purposes has been told — in large part as an outcome of the landmark litigation that led to re-establishment of the Alaska Mental Health Trust. It is a history all Alaskans should know.

History shows that since 1956, Alaskans have had to fight continuously to overcome the injustices and stigma of the past and ensure treatment is provided for ourselves, our family members, friends, neighbors and fellow citizens to recover from psychiatric crises. Doing so helps our state advance and prosper and is, of course, our moral duty. That moral duty was long ago enshrined in Alaska law, which requires our state government to provide hospitalization and treatment, not jail, for persons in psychiatric emergency. We are faced with a need to reinvigorate that fight.

Gov. Mike Dunleavy is now cynically trying to make an end run around the constitution, the Americans with Disabilities Act and Alaska courts in order to legalize what his administration has already been doing illegally. Dunleavy recently introduced two bills — SB 238 and HB 303 — that would let him take our mental health system back to those dark days before statehood. These bills would allow him to legally practice routine jailing of mentally ill Alaskans instead of rebuilding our failing mental health system to meet the state’s legal obligation to its citizens.

Dunleavy’s cynicism is breathtaking. His letter transmitting his bills to the Legislature claims they are directed toward “improving mental health treatment in the State." We should all be aghast at the claim that mental health treatment will “improve” by legalizing and normalizing the routine incarceration of citizens so vulnerable they are at risk of harming themselves or so gravely disabled they are unable to care for themselves. How can jailing them in worse conditions than criminal inmates endure while providing no treatment “improve” mental health treatment?

Reduced funding for and mismanagement of API over years has led to a long decline into dysfunction and resumption of the harmful practice of holding people in psychiatric crisis in jails pending or as an alternative to hospitalization. State government has been failing to meet its most fundamental duty to provide timely emergency hospitalization for people in mental health crises who are so ill they are either a danger to self or others or so gravely disabled they cannot care for themselves.

In October 2019, a Superior Court judge ruled that the state’s illegal practice of holding people committed for civil psychiatric evaluation in jails rather than at the Alaska Psychiatric Institute causes “irreparable harm." Inexplicably, rather than ordering the practice ended, the judge merely ordered the Department of Health and Social Services to develop a plan to minimize this practice while it resolved the disarray at API that caused it.

Despite acknowledging its failure to meet the state’s legal obligation to evaluate and treat mentally ill citizens in hospitals rather than jails, the Department of Health and Social Services continues the practice. Worse, Dunleavy now asks legislators to legitimize this discredited practice his own appointees have admitted is immoral and the court has found irreparably harms Alaskans when they are most vulnerable. Perhaps, now that it is clear that the Dunleavy administration has been planning to legitimize, not remedy the irreparable harms it causes, the court will find the courage to be more forceful.

Though we are handing $1 million each month to Wellpath to “manage” API, it remains in disarray and operates at anywhere from one-quarter to one-half its design capacity. Meanwhile, rather than fixing our failing mental health system, Dunleavy focuses on legalizing the harm it does. This affects a single class of individuals in our state — those whose illness is mental and not physical. It incarcerates them for the state’s convenience rather than funding and effectively managing our mental health system and psychiatric hospital so basic emergency services are available to treat them.

Centuries of scientific progress have demonstrated that mental illness is, as the American Psychiatric Association states, “a medical problem, just like heart disease or diabetes.” But this progress has apparently not overcome Gov. Dunleavy’s obvious prejudice toward Alaskans with a diagnosis of mental illness which allows him to believe it should be legal to jail rather than treat them during a psychiatric emergency.

Alaskans can be thankful that Gov. Dunleavy apparently does not view incapacity resulting from coronavirus as he does mental illness. If he did, he might be seeking authority to jail those of us who fall ill from the virus rather than building emergency capacity to evaluate and treat us.

I am hopeful that our legislators will reject the governor’s cynicism and refuse to hold even a single hearing on these outrageous bills. I am also hopeful that legislators will reject related, and similarly harmful legislation dealing with treatment of persons charged with crimes whose mental competence to stand trial is in question.

But I am a realist, so I urge all Alaskans to contact their legislators opposing these bills to assure Gov. Dunleavy does not succeed in legalizing the shameful practices of the past.

Russ Webb is a former deputy commissioner of Health and Social Services and a former chair of the Alaska Mental Health Trust board of trustees. As deputy commissioner, he oversaw API programming and directed planning for replacement of the original hospital, along with community services needed for it to operate successfully at its reduced 80-bed capacity.

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