Oregon faces a moral crisis in how we care for our most vulnerable citizens. Today, individuals experiencing serious mental health symptoms who are unable to voluntarily engage in care often face an impossible dilemma: continued deterioration without intervention or arrest and prosecution.

We come to this issue from different perspectives but with a shared conviction. One of us, Bouneff, is the executive director of NAMI Oregon representing individuals who live with mental health disorders and their family members. The other, Kotek Wilson, is Oregon’s first lady and a former mental health practitioner who assessed clients for civil commitment. From both our viewpoints, it’s clear: Our current laws often prevent timely, life saving intervention.

Under today’s interpretation of Oregon law, if someone is experiencing acute symptoms of their mental health disorder it can be hard to obtain care. As practiced day-to-day across Oregon, if they’re not an immediate threat to themselves or an immediate threat to others, they don’t usually qualify for civil commitment. But with no other change in their condition, if they walk out of the emergency room and get arrested, they are likely to be compelled into care.

The question today isn’t whether to utilize commitment. Oregon is doing so right now. Only we are waiting for people to be arrested for a crime, and then compelling them into care. The goal of “aid and assist” restoration, however, isn’t recuperation and recovery. It’s to get someone well enough to prosecute them.

The human cost is immeasurable. We’ve seen patients lose their housing, access to medical treatment, relationships with loved ones, their long-term independence, and progress they’ve worked so hard for — all because the current criteria failed to acknowledge their acute need for care. In another state — 37 other states actually — practitioners have much greater ability to intervene before such devastating consequences. Being unable to provide care until someone is dangerously close to irreversible harm is causing moral injury to healthcare professionals, law enforcement and service providers. The system is currently set up so that even when it is crystal clear to a practitioner that a client is in danger and that they’re on the precipice of irreversible harm, we often still can’t intervene.

House Bill 2467A offers a path forward. This legislation:

Creates separate definitions for “danger to self” and “danger to others.”
Clearly defines “serious physical harm.”
Specifies the definition of “near future”.
Provides specific factors courts may consider when assessing danger to self and danger to others.
This legislation also creates an offramp for those who find themselves in jail and who would be better suited for the mental health system due to the significance of their medical and behavioral health needs, allowing them to be civilly committed and transported to a healthcare facility. Struggling Oregonians who need life saving mental healthcare will not find it in jail. This bill helps get them to the care that will allow long-term healing to begin.

Ultimately, the legislation resets the state’s criteria to a reasonable level. But we must be clear that if all we do is change criteria, we haven’t reached our goal of helping people better. Without investing in services, we will have the logjam we have today. The Legislature must also pass companion legislation to quickly add community residential treatment capacity and invest further in developing new residential facilities. And we also need to focus on helping people well before they ever reach criteria for commitment.

We can often see when a person struggling with mental illness is about to take a devastating fall. The job of practitioners — and communities — is to do what we can to catch them before they fall, instead of picking up the pieces afterwards. Right now, our laws are preventing us from doing that in far too many cases. It’s unnecessary, it’s cruel, and the Legislature has the opportunity to change this.

We urge the Legislature to support HB 2467A. We hope that clinicians will always be allowed to treat people in need. That people in crisis receive health care rather than a jail sentence. And ultimately, that commitments of any kind become rare because our health care system will be equipped to address individuals’ needs before they’re in crisis.

Aimee Kotek Wilson is first lady of Oregon. Chris Bouneff is executive director of NAMI Oregon.