The Future of Section 35: Involuntary Commitment for Addiction Treatment in Massachusetts
BOSTON – If someone in your family has a drug problem, can you force them into treatment against their will? In the state of Massachusetts, yes.
Section 35 allows for relatives, doctors, or police officers to petition the court to have someone involuntarily committed for substance abuse treatment. After a court appearance, a judge decides whether the evidence suggests that the person a) has an alcohol or substance use disorder, and b) that there is a “likelihood of serious harm to self or others” as a result of the addiction. If both conditions are met, that person will be sent to a treatment facility for up to 90 days. For men, some of those treatment facilities double as correctional facilities.
If a man is “sectioned” under Section 35, he may find himself spending up to 10 days in detox at the Ludlow jail before moving on when a bed becomes available, most often at another jail treatment center: 2 of the state's 3 treatment facilities for men are operated by the Department of Corrections. (Women are no longer placed in prison for involuntary civil commitments, as of 2016.)
Hampden County Sheriff Nicholas Cocchi says that lives are saved through this program at the county jail in Ludlow. WBUR reported on his comments to the press:
"This is not a jail. This is a former nursing home," Cocchi said. "There is no barbed wire here. Let's look at it for what it is: a change agent for people with addiction issues. We are a correctional facility with a treatment touch...I need to serve the people of my community," he said. "If we're saving lives, why would anybody want to stop?"
But the state legislature’s Commission on Section 35 has recommended that this program allowing correctional institutions to accept Section 35 individuals be discontinued. A bill has been proposed which would prevent men from being sent to jail for addiction treatment. And a lawsuit is pending (on the grounds of gender discrimination, since women are no longer sent to prisons) which alleges that these men are treated no differently from prisoners, and that the mental health treatment in correctional facilities is insufficient.
Still, the problem remains that beds are scarce at non-correctional facilities run by the Department of Public Health or the Department of Mental Health. Activists say this is the real problem that needs to be addressed. "It may be that right now families' only choice is this or nothing, but nobody should have that choice,” said Bonnie Tenneriello, an attorney with Prisoners' Legal Services, the group which filed suit alleging gender discrimination. “We need to give these people the option for civil commitment in a civilian setting."
For those facing the difficult decision to civilly commit a loved one, the important question is probably less about appearances and more about whether it works. Can a prison serve as a reliable and safe place for addicts to get help? The data is unclear, but commission member Leo Beletsky, a professor at Northeastern University, says that the state still doesn’t "...have a good sense of what's going on inside correctional facilities or how those patients are being treated."
There are questions about whether involuntary treatment is effective at all, regardless of the nature of the facility. The Section 35 commission cited a study that said: "The average time to relapse following commitment was 72 days, although 33.8% relapsed on the same day of their release."
Here's a look at the numbers and facts around Section 35 by WBUR. Massachusetts appears to be the only state that uses Department of Correction facilities for some involuntary commitments, even when the person has committed no crime.