Mental Health Laws Get Renewed Attention After Little Rock Tragedy

State Rep. Nicole Clowney, D-Fayetteville

Midmorning gunfire in Little Rock’s Hillcrest neighborhood on a spring Saturday earlier this year drew more than attention to a crime scene. The startling incident attracted scrutiny of the sometimes chaotic intersection between the legal system and mental health care.

Corey Alexander, 46, was arrested and charged with first-degree murder and first-degree battery in the shooting of her elderly parents. Ray Alexander, 83, was slain, and Charlotte Alexander, 77, was critically wounded.

Was the tragic event destined to play out like it did? Or was it a failing of the system, a possibly preventable outcome if the state’s mental health laws had received some overdue attention?

Even now, Arkansas legislators are beginning the process of gathering input to improve state law regarding the treatment of mentally ill citizens. The Mental Health/Behavioral Health Working Group was created to formulate policy proposals that will help fill statutory gaps.

Potential changes might arise from real life scenarios such as the deadly havoc at the Alexander home on April 23. The violence marked the second time the family’s private drama had spilled into public view.

Fifty days earlier, Ray Alexander had tried to get a court order to force his daughter into temporary detainment in a treatment facility because she was posing a threat to herself and others.

Corey Alexander

His March 4 petition to have Corey Alexander involuntarily committed for addiction treatment reads like a foreshadowing of the tragedy that followed. A portion of his filing with the Pulaski County Circuit Court reads:

“She is addicted to methamphetamine. She is doing the meth daily. She is extremely psychotic, homicidal and suicidal. She says she has no intention of quitting the drugs. She is not in her right mind at this time. She thinks that me and her mother are dead.

“On yesterday while I was replacing a window in her apartment, she was crazy beyond her wildest dreams. She was talking about planning our funeral. She claims that she has ordered weapons and was talking all out of her head.

“I have never seen her acting like this or talking out of her head like this. She is exhibiting strange and bizarre behavior and bipolar tendencies. She has mood swings.

“She is scaring us. She is threatening and is saying that she wants to kill people that she believed have killed us. She believes that me and her mother are imposters. She is very delusional and paranoid. She is threatening to kill me and her mother because she believes that we are imposters and not her parents.”

Ray Alexander

Despite his concern that his daughter posed a danger, the Little Rock businessman’s efforts to have her involuntarily admitted for treatment evaporated.

At a March 9 hearing, Corey Alexander consented to voluntary admission, and that ended the involuntary action. In his brief order dismissing the case, Pulaski County Circuit Judge Shawn Johnson cited § 20-47-224. That statute reads:

“At any time during the involuntary admission period, a person may be converted to a voluntary admission status if the person’s treating physician or treatment staff psychiatrist files a written statement of consent with the court.

“The court shall dismiss the action immediately upon the filing of the statement.”

“That’s the common procedure when we get in those consent to treat hearings,” said Margaret Lickert, deputy prosecutor for involuntary admissions in Pulaski County. “The involuntary petitions are dismissed pursuant to the statute.”

The provision requiring the dismissal of the involuntary action should be amended to give the judge more leeway in determining the best course, according to some.

“The law needs to be rewritten,” said Bettina Brownstein, a Little Rock attorney. “Arkansas’ mental health laws are disgraceful.”

Once the playing field shifts from involuntary to voluntary, the matter exits the legal system and falls to the health care system.

“The lawyers and judges don’t have anything more to do with it,” said Russell Bynum, a Little Rock attorney. “What happens afterward, that’s between the patients and their health care providers.”

If the case had gone the involuntary commitment route, Alexander could have been admitted to a designated treatment facility for up to 21 days. The law requires that within 48 hours of admission, an evaluation shall be conducted. The treatment team may petition the court for an additional 45 days of treatment.

It’s unclear what transpired during the six weeks between Corey Alexander’s treatment hearing and her arrest. Did she walk away from her voluntary treatment, or did she see it through?

In addition to murder and battery, Alexander also is charged with theft of property and breaking or entering. She awaits trial in the Pulaski County Detention Center.

Improving the System

The mental health/behavioral health working group is organizing to tackle seven areas to improve the system. Each reflects a subgroup of legislators focusing on a given issue.

► Access to high-quality services: Focus on the removal of barriers to mental health services, integrated behavioral health services, crisis services and specialty psychiatric emergency care.

► Substance abuse/co-occurring disorders: Focus on access to evidence-

based services for treatment of those in need or with two or more substance-use disorders and mental disorders.

► Rates, regulations, efficiencies and bed availability: Focus on considering the impact of rate changes on the provision of services, look at the opportunity for efficiencies and need for regulations and address the issue of bed availability.

► Suicide prevention: Focus on efforts to prevent suicide through training and recognition of warning signs.

► Services for special populations: Focus on the needs of high utilizers of mental health services, including those unsheltered, with frequent interaction with law enforcement or in transition and crisis.

► Prevention and early intervention: Focus on the services needed to meet mental health needs early (birth through adolescence) and the support services that provide the best opportunity for good mental health.

► Workforce development: Focus on Arkansas’ capability to meet the growing need for mental health services, i.e., addressing the gap between need and providers.

State Rep. Nicole Clowney, D-Fayetteville, is one among many legislators participating in the group from around the state.

“Hopefully, we’ll do better by our people,” Clowney said of the need to improve mental health laws and policies. “It’s a crisis in Arkansas and only getting worse. We’ve got to do something to intervene.”