JEFFERSON CITY - A major overhaul of the state's system for committing mentally ill Missourians won Senate approval Tuesday -- but only after extended debate about how much power courts should have to restrict the freedom of the mentally ill.
Debate centered over a single word -- physical -- in current law defining when a person can be committed.
Current law allows commitment only if there is a likelihood of serious "physical" harm.
The original bill before the Senate would have removed the word physical, thus expanding when a court can order a person be held and treated in a mental health facility.
That word, said bill sponsor Sen. Joe Moseley, D-Columbia, makes it harder for people to get access to care.
But others, including Sen. John Schneider, D-St. Louis County, said by removing the word physical, he feared anyone might be able to be committed against their will.
"What I'm concerned about is a person who is not a physical harm would be locked away," Schneider told fellow senators.
On Schneider's motion, the bill was amended to retain the physical-harm limitation.
For supporters of the bill, leaving in that one single word, would strike a blow to basic purpose of the bill.
"Those guys aren't in the trenches," said Mark McBride, whose parents were killed by his brother Matthew in 1994. Their murders and the attention surrounding it prompted Gov. Mel Carnahan to appoint a 19-member Commission to study current involuntary commitment laws. "But yet those guys are the ones who make the decisions of what comes out here."
"You grade your general based upon the decisions he made from the information he got from the front line," McBride said. "Well, we gave him the information from the front line. One of our generals in there let us down, because he didn't trust us."
Opponents including the American Civil Liberties Union and Missouri Family Network, said they were concerned about removing the word physical from current law because it would widen the blanket of people that could possibly be committed to mental institutions.
"Physical was the big issue," said ACLU lobbyist Marsha Richeson. "If they leave it alone, we'll leave it alone. If they take physical out, we'll fight to put it back in."
But others said the issue is a lot bigger than that. It's about allowing people to access care.
"I think that no longer will the judge tell them that person has to injured, has to injure your daughter, your neighbor in order to get into the hospital," said Roy Wilson, Mental Health Department director. "All they have to demonstrate is this person who has a mental disorder and by virtue of that disorder through some likelihood of serious harm."
"We've told people there still has to be under this statute a clinical decision that this person has a mental disorder," Wilson said. "Somebody acting odd out in the community doesn't necessarily mean they have a mental disorder."
Other aspects of the 80-page legislation that received little or no Senate debate may make an even bigger impact on Missouri's mental health system:
"The whole idea is to get to people early and provide for early intervention," said Lyn Turner, director of admissions, discharge and transfer for the department of Mental Health. "To try keep them out of the hospital and try to treat them in other ways other than the hospital and other than involuntary commitment."