Robin Lubbock / WBUR
Robin Wallace has worked as a counselor in addiction treatment. She has worked in private and state programs in Massachusetts and with people who were involuntarily committed to treatment.
So in 2017, as her 33-year-old son, Sean Wallace, continued to struggle with heroin use – after years of coping with mental health issues and substance use – she thought she was making the right choice in forcing him into treatment.
"His behavior was erratic," Robin says. "I think he had some mental health issues that were worsened by his use."
Sean's taking his own life.
The law known as Section 35
Robin has become one of several thousands of Massachusetts residents each year.
The law allows a family member, physician or police officer to ask the courts to involuntarily commit someone to substance use treatment. Dozens of states have civil commitment laws, but Massachusetts is more aggressive than most states.
In the last fiscal year, more than 6,500 Massachusetts residents were ordered into treatment this way.
After a court clinician in Hyannis, Mass., Reviewed Robin's request, a judge agreed that Sean's substance was dangerous and ordered it to be committed to 90 days of residential treatment.
Sean has begged his mother in court that day not to go that route. He was, where he would have been, he said he would not be able to continue his meditation.
"I thought he misunderstood," says Robin. "Because I could not conceive that there would be an opioid treatment program that would not provide medication-assisted treatment."
It turns out Sean was right. Although many providers say the medication is the gold standard in addiction treatment, it does not provide the medicine.
When we spoke with Sean in 2017 – shortly after he was committed about a month ago, he said the conditions were inhumane and that he was often placed in segregation, or "the hole" – though he had not committed any crime.
"I was punished for not eating," Sean told us. If you refuse your tray, I consider it a behavioral issue.
Hey spiraled to suicide
Sean So said in that interview that he was having trouble getting to his life in the Plymouth prison.
"I just feel different," he said. I feel scared I feel like I'm going to wake up and be back there. "
Less than a year after that interview, Sean killed himself. His mother said that he would not be able to hold a job. He ended up in a psychiatric hospital and was later charged on charges of trying to break into a house. Robin believes he is locked up for addiction treatment.
"I think he's trauma was very much triggered by him in the cell" at the local jail, she says. "He just felt like he could not take it anymore."
The sheriff would not comment, but documents at the local jail confirm that Sean tried to take his own life there; he later died from those injuries.
Sean's longtime partner, Heather McDermott, says he is never the same after his civil commitment.
"What a big, sad, depressed tumor that I was trying to bring back to life," McDermott says. "We had a home. I can not even believe we got here, and then – then he died."
Massachusetts is one of a few states that use prisons and jails to involuntarily commit to addiction treatment – and Massachusetts uses the approach more than most states do.
In an emailed statement, the Massachusetts Department of Correction said its mission is to promote public safety by providing a secure treatment environment. In Massachusetts, there is a lot more demand for treatment for addiction.
Hampden County Sheriff Nick Cocchi says that many traditional treatment centers are not willing to take those who want to have a declining inmate population.
"This is a very dangerous, acutely sick and – I would say – not so well-behaved population," Cocchi says.
Massachusetts, Massachusetts, Massachusetts, Massachusetts, Massachusetts, Massachusetts, Massachusetts. And some researchers, such as Leo Beletsky of Northeastern University, say more about it.
"Limiting someone's civil rights should be the last resort and only for those cases that are truly dire," he says.
Denise Bohan believes involuntary commitment saved her 33-year-old son's life. Families are desperate, she says, and can not reason with a loved one in the throes of addiction.
"This is a last resort, "Bohan says." It's not something you do, like, just on a whim. This is a desperate act of just trying to save your child's life. "
Several Massachusetts officials report that it is necessary for a patient to be treated as a candidate.
Already, a class action lawsuit against the state has been filed, charging gender discrimination – because massachusetts stopped sending involuntarily committed women to prisons in 2016, in response to a different lawsuit.
A longer version of this story originally appeared in WBUR's CommonHealth, Deborah Becker is a senior correspondent and host at WBUR. Her reporting on mental health, criminal justice and education.