Doug Reuter grew up in the Twin Cities, lived in Eden Prairie, then settled his family in Owatonna. A Navy veteran and Metropolitan State graduate, he worked in business. He also served two terms in the Minnesota legislature. To battle boredom during long hours on the House floor in the Minnesota Capitol, Doug invented the very popular board game Sequence. His greatest legislative accomplishment was working to pass a law in another state, born out of a personal family tragedy.
In 1985, Rueter’s youngest child Joel Douglas Reuter was born in Minneapolis. Raised in Eden Prairie and Owatonna, Joel headed off to the University of Arizona for college. That’s when Joel was diagnosed with bipolar disorder and his behaviors became unpredictable and sometimes dangerous. In Arizona, Joel’s family could get him detained, treated, and stabilized. Reuter has said that system there saved Joel’s life more than once.
Joel was a smart kid. Very smart, in fact. As so often happens, that extraordinary gift was paired with mental illness.
Joel graduated, moving to Seattle to join a leading software engineering house, where his boss described him as “brilliant” and “irreplaceable.” For over six years, Joel’s mental illness was successfully managed with medication. Then things went haywire again, so Doug and Nancy jumped in to help their son.
Washington’s state laws and protocols were very different in terms of being able to reach out to help someone in crisis. Doug and Nancy Reuter tried again and again—later accounts put the number near 48—to get a designated professional to hold their adult son for evaluation. The answer was a version of the same sentence families still hear in Minnesota: “we cannot act until he is an imminent danger, or until he breaks the law.”
On July 5, 2013, during a psychotic crisis at home, Joel was shot and killed by Seattle police after a long standoff. He was 28. His parents learned of his death from a police tweet. They did not blame the officers who faced a man in psychosis with a gun. They blamed a mental health system that risked lives because there was no way to help service-resistant patients until it was too late. They turned that blame into a positive force to change state law.
Doug used what he learned in Saint Paul and worked to allow greater ability for families to intervene and get help for family members who are struggling with mental health. Reuter held a press conference in Washington where he grabbed the attention of the room by describing a fictitious new law he proposed to withhold all cancer treatment for patients until they reach stage-four, because that is exactly how the state was treating patients suffering from severe mental illness.
In 2015 Washington enacted Joel’s Law: if a crisis responder declines to detain, an immediate family member may petition a judge on a short clock and, if probable cause exists and voluntary care has been refused, obtain an order for an initial hold. It is a narrow tool. It does not create hospital beds. Ten years later, Washington families are increasingly using Joel’s law to get help for family members experiencing mental crisis.
Through tenacious lobbying, Doug and Nancy were able to see the bill attract near unanimous support. The program has grown and has seen a 266% increase in use since the COVID-19 pandemic of 2020, when mental health crisis calls grew by more than one-third. According to Reuter, more than 1000 families have benefited from the law, no doubt saving many lives.
Minnesota already lets an “interested person” start a Chapter 253B case. That is broader than Washington’s family list. What Minnesota still lacks is the specific device Joel’s Law added: a fast court review when the crisis or screening professional declines the initial hold. Pre-petition screening and the county attorney remain the gate. Families who know the pattern—the slipping medication, the rising threat, the adult child who cannot see he is ill—still get told to wait.
In the important balancing act that weighs liberty and safety, the state tilts toward the patient even when their mental health has deteriorated to the point when they can no longer stop self-destructive behaviors. Under the banner of “least restrictive” treatment, the state often puts patients, their families and the rest of us in harms way.
Anosognosia is an insidious disorder where the mind works against its own perceptions of reality and denies the illness others can plainly see. The patient may deny paralysis after a stroke, memory loss in dementia, or a psychiatric illness such as schizophrenia or bipolar disorder. This is not simply denial, but rather a dissociation that often causes a medical or public safety crisis. Joel suffered from anosognosia and it caused his death.
Many patients will not commit to any form of housing that involves treatment that includes sobriety or antipsychotic medications. 67% of people experiencing homelessness are also suffering from mental illness, substance use disorder, or both. Other studies put the number much higher.
American Experiment’s David Zimmer is leading new research looking at the intersection of mental health, housing and the criminal justice system in Minnesota.
We will be looking at the policy decisions that can be the difference between life and death for Minnesotans suffering through a mental health crisis, as well as the possible victims in their path. The fundamental question of liberty vs. freedom when it comes to involuntarily treatment and commitment should start with the patient and include the family members, caregivers, police, and the rest of us who all have an interest in this important debate.
Former Representative Reuter is not a bitter man. He does not blame the police officers who shot his son. He does not blame the legislators who vote to perpetuate a system that fails us. He blames a lack of knowledge and understanding, and that’s where he puts his efforts.
When asked if he believed the crisis that led to his son’s death would have been avoided if it happened after his law passed, his answer was immediate; “there is not a question in my mind” Reuter said.