New Mexico court-mandated pathway to mental health care

Both systems have been the subject of significant changes by Congress in recent years as lawmakers seek to address the intersecting issues of homelessness, mental health and public safety.

The changes have received mixed reviews from advocates and families of people with severe mental illness, but most agree there are major gaps that leave the system inadequate, including a shortage of health care providers and high costs of treatment. Some argue that the new law relies too heavily on the legal system to manage behavioral health issues.

“But in New Mexico, we don’t have any programs like that. So it’s kind of like an open road,” said public defender Tess Williams, citing recent legal changes that direct some mentally ill defendants into community-based programs.

The new law has also raised concerns from liberals who say the reforms could infringe on the freedoms of new Mexicans.

But Maestas framed recent changes in Congress as a “rational” response to today’s realities.

“We are recognizing the problems that exist in the modern world and devising modern legal structures to address those problems,” he said.

Senate Bill 3, passed earlier this year as a priority bill by Gov. Michelle Lujan Grisham, defines “substantial harm to self” and “substantial harm to another” in New Mexico’s mental health law, and Maestas, the bill’s sponsor, said the changes will ensure the law is applied consistently across the state.

The bill focused on reforming civil commitments, the process by which a court mandates treatment after a personal tragedy in which a family member dies by suicide despite efforts to stabilize their mental health.

“At the end of the day, it comes down to how do we get our loved ones the help they deserve,” Maestas said. “If your loved one has behavioral health issues and is suicidal, how can you prevent that person from ultimately committing suicide?”

He continued: “Either tell the judge to put them in jail for a year, or petition the court through this outpatient treatment aid law.”

SB 3 would update definitions in New Mexico’s Mental Health and Disabilities Act and the state’s Outpatient Treatment Assistance Act to clarify what it means for people to cause “substantial harm” to themselves or others. This includes an increased likelihood of self-harm or death, or an inability to care for oneself. Previous versions of the law did not specifically provide for the latter.

The bill was signed by the governor in March and goes into effect on May 20th.

SB 3 received broad bipartisan support, with Republican Sen. Crystal Brantley of Elephant Butte signing on as the bill’s lead sponsor.

The bill aims to confront “hard truths,” she wrote in a message. new mexican.

“Too often, we have seen cases where dangerous behaviors have been identified, but the tools to meaningfully intervene are either unused or unclear,” Brantley wrote. “SB 3 was designed to close that gap and ensure that when someone poses a risk to themselves or others, we have an avenue to act decisively while preserving due process.”

But not everyone supported SB 3. Disability rights advocates have expressed “grave concerns” that the bill would take away constitutional freedoms and lead to forced medical treatment for people with disabilities.

Some say the state has not allocated enough funding or established adequate care networks to ensure those ordered to outpatient assisted treatment receive treatment or intensive case management services to guide the treatment process.

The Legislature allocated $3 million in 2024 to fund seven pilot programs across the state aimed at both repurposing capacity and supporting outpatient care. In the First Judicial District, which includes Santa Fe, Rio Arriba and Los Alamos counties, the money paid for a program manager and a single court “navigator” to help connect defendants in diversion programs with services.

Stacey Boone, senior manager of statewide behavioral health for the New Mexico Court Administration Department, said a request for more funding is pending.

SB 3 does not change who has the authority to petition the court for a civil commitment, but family members, police and health care workers can all do so, Maestas said. Members of the House Judiciary Committee sought to specify that a “qualified mental health professional” is required to make the first report that someone may be a danger to themselves or others due to mental illness.

They later killed the amendment in the House of Representatives after law enforcement leaders expressed concerns that the bill would be “unworkable.”

Maestas framed the bill’s proposals as a prudent way to promote behavioral health treatment.

“We’re giving modern society the tools to get people into behavioral health treatment and overcome their current situation,” he says.

House Bill 8, an omnibus public safety bill passed in 2025, makes major reforms to the criminal competency process in response to concerns that the system does not provide “sufficient tools” to assist criminal defendants with competency issues, said bill sponsor Rep. Christine Chandler, D-Los Alamos. It expanded the option of court-ordered mental health treatment, rather than release or dismissal, for people charged with misdemeanors and misdemeanors.

Criminal competency reform began with a simple truth, Chandler said. “We see people suffering.”

“They have serious mental illnesses,” she continued. “While they may not be dangerous, and I stress that the vast majority of people do not have serious mental illness, they are incapable of making decisions that promote their welfare.”

When a defendant’s competency, or ability to participate in his or her own defense, is called into question in a criminal case, a mental health evaluation by a forensic expert is initiated.

There are two possible outcomes for a defendant who is determined to be insane by the court. Either the case is dismissed or the prosecutor requests a dangerousness hearing. The defendant, determined to be dangerous, will be admitted to the New Mexico Behavioral Health Institute in Las Vegas for treatment.

But this system leaves people who are not dangerous and have not been charged with serious crimes with no treatment options.

“Unless they are charged with a serious crime and there are no concerns about their dangerousness, there is no mechanism to recover these people or get them treated in a formal way,” Chandler said.

HB 8 is intended to provide “additional pathways” to treatment by expanding the list of crimes that designate defendants as dangerous, allowing for outpatient and community-based competency programs, and creating a path for district attorneys to refer defendants to outpatient treatment, she said.

Since he first proposed reforming the state’s criminal competency law, Chandler has acknowledged that it would require additional infrastructure for mental health treatment.

HB 8 was signed in conjunction with the state’s major investments in behavioral health and regional approaches to expand access to care. But supporters say the state is far from achieving full access.

“This will be a work in progress,” Chandler said. “And like all things, if it needs tweaking, do it.”

Local members of the National Alliance on Mental Illness, a grassroots organization dedicated to improving the lives of people with mental illness, are calling for more and better treatment options available to families and a more integrated system of care.

NAMI Santa Fe Board President Betty Cisneros Schober noted that there is uncertainty for families who call 911 to deal with a loved one’s mental health crisis. The call could result in a response by a social worker from the City of Santa Fe’s Alternative Response Unit, or it could lead to a law enforcement response and place your loved one in the criminal justice system.

“Should I call or should I ease my anxiety and hope for a better tomorrow?” she said. “Because you never know what the outcome will be after you make the call.”

Meanwhile, Santa Fe County’s crisis triage center, La Sala, is only open during business hours, but “of course not all of these crises happen during those hours,” she said.

Tom Stark, vice-chairman of the local NAMI board, said the care system was “all very siled and often at odds with each other”.

“There are some real bright spots with this system, but it could be much better connected,” he says.

Staff writers Phaedra Haywood and Nicholas Gilmore contributed to this report.