Monday, May 23, 2005
May 20, 2005 ENEWS - TREATMENT ADVOCACY CENTER
ENEWS - TREATMENT ADVOCACY CENTER
TREATMENT ADVOCACY CENTER
Visit our web site www.psychlaws.org
May 20, 2005
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1. TREATMENT ADVOCACY CENTER PRESS RELEASE, May 18, 2005
2. BAKER ACT REFORM SUBJECT OF RADIO'S CRIMINAL JUSTICE FORUM
3. MEASURE WOULD FORCE MEDICATIONS - Kennebec Journal, May 19, 2005
4. KENDRA'S LAW WORKS AND SHOULD BE RENEWED - Albany Times Union, May 15, 2005
5. WORTH OF KENDRA'S LAW DEBATED - Rochester Democrat & Chronicle, May 15, 2005
6. JAIL: THE BEST TREATMENT FOR MENTAL ILLNESS? - American Daily, March 10, 2005
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TREATMENT ADVOCACY CENTER PRESS RELEASE, May 18, 2005
[Editor's Note: In the battle for treatment, there are many champions; yet each year we normally have only one award to bestow in recognition of extraordinary advocacy for those most affected by severe mental illnesses. This year, however, we selected co-winners for the Torrey Advocacy Commendation. There was simply no way to chose between Sheriff Donald Eslinger, Linda Gregory, and Alice Petree. For years this tragedy-forged triumvirate unrelentingly strove to bring assisted outpatient treatment to Florida - and this year they succeeded.]
NEWS
TREATMENT ADVOCACY CENTER
For Immediate Release
May 18, 2005
FLORIDIANS HONORED WITH NATIONAL MENTAL ILLNESS ADVOCACY AWARD
Mutual Tragedy Spurs Successful Reform Of Florida Law For People With Severe Mental Illnesses
ARLINGTON, VA - The board of directors of the Treatment Advocacy Center today announced that Seminole County Sheriff Donald Eslinger, Linda Gregory of Jacksonville, and Alice Petree of Sanford are the winners of its annual national mental illness advocacy award. The Treatment Advocacy Center (TAC) is a national nonprofit organization dedicated to removing barriers to treatment of severe mental illnesses. May is national mental health month.
Eslinger, Gregory, and Petree won this year's national Torrey Advocacy Commendation for their successful advocacy for a new mental illness treatment law in Florida. The TAC award recognizes the courage and tenacity of those who selflessly advocate - despite criticism and opposition - for the right to treatment for those who are so severely disabled by severe mental illnesses that they do not recognize that they need treatment.
The board of directors of the Treatment Advocacy Center voted unanimously to recognize all three Florida advocates in an unusual move that paralleled an unusual advocacy partnership. "We are impressed by their heart-felt efforts over more than four years to get a more humane treatment law for Floridians with severe mental illnesses," said TAC board secretary Dr. Fred Frese. "We commend Sheriff Eslinger, Linda Gregory, and Alice Petree for their incredible dedication and effectiveness in spearheading a complex and critical reform of Florida's outdated treatment law."
The Florida House of Representatives cited the TAC award in a resolution sponsored by Rep. David Simmons and Rep. Sandra Adams that recognizes these three advocates for "their successful advocacy in honor of Deputy Sheriff Gene Gregory and Alan Singletary and all people with severe mental illnesses who will benefit from their efforts."
The result of their work is Florida's new law, which took effect January 1, 2005, that allows assisted (court-ordered) outpatient treatment for people with severe mental illnesses, like schizophrenia and bipolar disorder, who have a history of noncompliance combined with either repeated Baker Act admissions or serious violence. Court-ordered outpatient treatment is a less restrictive, less expensive alternative for those who need intervention but do not require inpatient hospitalization. New statistics from New York, a state with a similar law, show that for those in the program, 74% fewer experienced homelessness, 77% fewer experienced psychiatric hospitalization, 83% fewer experienced arrest, and 87% fewer experienced incarceration. Individuals enrolled were also more likely to regularly participate in services and take prescribed medication.
On July 8, 1998, Deputy Sheriff Gene Gregory and Alan Singletary, a man with a history of severe mental illness, died in a 13-hour standoff. Seminole County Sheriff Eslinger vowed to not let their deaths be in vain, and created a Mental Health Task Force to advocate for reforms in mental health and substance abuse services and laws. With the unlikely team of Alice Petree, the sister of Alan Singletary, and Linda Gregory, the widow of Deputy Sheriff Gene Gregory, Sheriff Eslinger worked, through the task force and with other community groups and stakeholders, to increase awareness of the need for treatment of mental illnesses. With the leadership of the Florida Sheriffs' Association, the efforts of these advocates and the community network they helped to create resulted not only in reforming the Baker Act to allow for assisted outpatient treatment, but also in other beneficial programs for those with mental illnesses such as jail diversion, forensic treatment programs, mental health screening at a county correctional facility, funding for a detox receiving facility, a voluntary identification program, and law enforcement crisis intervention teams.
About The Award -The Torrey Advocacy Commendation is presented annually by the Treatment Advocacy Center's Board of Directors. The award is named for Treatment Advocacy Center president and founder Dr. E. Fuller Torrey, M.D., a nationally known and respected psychiatrist, researcher, and advocate whose unflagging resolve to remove barriers to treatment for people with severe mental illnesses sparked a national reform movement. Recipients make a substantial difference for their community through advocacy, awareness, research, or legislation in this field.
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BAKER ACT REFORM SUBJECT OF RADIO'S CRIMINAL JUSTICE FORUM
Tune in to hear about the fruit of our award winners' labor starting this Saturday. Linda Gregory and our executive director, Mary Zdanowicz, will discuss the new Baker Act law on "Criminal Justice Forum" - the law is a new beginning for Florida, but only if it is widely understood and implemented. Mary and Linda will explain the law and its importance, discuss how it works, and talk about the successes other states are having with similar laws. Criminal Justice Forum will air on Saturday May 21st at 12:05pm on WTAN 1340 AM in Clearwater; 1350 & 1400 AM in New Tampa.
You can also listen live from anywhere in the country via the internet at
http://tacenews.c.topica.com/maadxFfabhajBbfGwZEb/ (hit "listen Now" in upper left corner of page)
The program will air again on Tuesday May 24th at 11am on 1490 AM in Bradenton and 1280 AM in Sarasota. And, after then, the program will be posted in the Criminal Justice Forum online archives as a free download available at any time at
http://tacenews.c.topica.com/maadxFfabhajCbfGwZEb/
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KENNEBEC JOURNAL (ME), May 19, 2005
[Editor's Note: Advocates are still working to remove Maine from the short list of states that has no law for assisted outpatient treatment. That effort has garnered the endorsement of a powerful array of professional organizations and recently gained even more steam with the backing of the state department overseeing mental health services.]
MEASURE WOULD FORCE MEDICATIONS
By Gary Remal
AUGUSTA -- Debate about legislation that would speed forced medication on hospitalized psychiatric patients has grown into a larger battle likely to result in a clash in the Legislature.
Sen. John Nutting, D-Leeds, backs the idea of forcing mentally ill people living in community settings to take medication or face rehospitalization. He said he will introduce a measure to allow it.
The Legislature's Health and Human Services Committee is scheduled to discuss the proposal today at 3 p.m.
Known as "outpatient commitment," forcing medications on psychiatric patients is a highly charged issue in the mental health community -- with patients, medical professionals and some family members fighting over the power to control courses of treatment.
Nutting said outpatient commitment in New York during the past five years reduced the percentage of people with mental illness in New York jails by 28 percent.
He said compliance with prescribed medication also increased to 91 percent.
"Most of the states, 42, have it," Nutting said.
But Helen Bailey, public policy director at the Augusta-based Disability Rights Center, opposes Nutting's proposal. In response to concerns, Nutting said criteria for its use have been tightened, with the method not recommended for people younger than 21.
Nutting said such changes helped convince state Deputy Health and Human Services Commissioner Brenda Harvey to drop her opposition.
"We built a coalition supporting the bill that includes the Maine Psychiatric Association, the Maine Medical Association, the Maine Chiefs of Police Association, the Maine Sheriffs Association, the Maine Nurse Practitioners Association, as well as hundreds of parents (of the mentally ill) in support groups across the state," Nutting said.
Bailey, a lawyer who represents mental health patients in hospitals and community programs, said she and other advocates for the mentally ill want changes to the law that would get drugs to hospitalized patients faster.
Harvey said she changed her mind because Nutting's revised legislation called for increased support for people with mental illnesses living in their communities to help head off rehospitalization.
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ALBANY TIMES UNION, May 15, 2005
[Editor's Note: Some mental health departments and treatment providers take a "show me" attitude when assisted outpatient treatment comes to their state, but almost always experience with the treatment mechanism creates an appreciation for its ability to reach the most recalcitrant cases. In 1999, the New York State Department of Mental Health was less than enthusiastic when Kendra's Law was proposed. That department now vigorously endeavors to make Kendra's Law permanent.
Dr. Mary Barber's attitude was similarly transformed by running the assisted outpatient treatment program in Ulster County.]
KENDRA'S LAW WORKS AND SHOULD BE RENEWED
By Mary Barber
Five years ago, Kendra's Law brought assisted outpatient to New York state. The program mandates outpatient psychiatric treatment through a court order for a small population with severe mental illnesses, mostly schizophrenia, who are too ill to make informed treatment decisions.
As the law expires this year, we at Ulster County Mental Health Department urge continuation of assisted outpatient treatment with state funding to ensure the long-term viability of the law.
We were initially skeptical about the program. It was an unfunded mandate that added only a couple of new intensive case management slots. We believed the law had no teeth and that court petitions would not change the behavior of a patient truly resistant to treatment. We guessed that case management resources might help some patients, but that court orders would add little beyond that.
We feel much differently after five years of experience with the law.
Kendra's Law makes counties responsible for their most high-risk, high-need people. With that responsibility comes the opportunity to exert more centralized control over housing, treatment and case management resources, which benefits the system as a whole.
Much of the effectiveness of assisted outpatient treatment comes from making providers accountable. The law allows and requires close communication among all providers. This helps avoid fragmentation of care and patients slipping through cracks in the system.
Assisted outpatient treatment also supports providers in helping those hardest to help. Providers are more willing to take in severely ill and high-risk patients when they know the assisted outpatient treatment team will help oversee these cases, including developing new strategies if patients become symptomatic or a particular housing or treatment arrangement doesn't work.
Many patients feel compelled to follow court orders, even knowing that the most severe consequence if they do not follow their treatment plan is being taken to an emergency room (something most of the patients who are placed on petitions have already experienced numerous times). We have witnessed many amazing successes for people on petitions.
The petitions, with their specific treatment plans, provide a much-needed consistency for patients. In the past, these patients have often been shuffled among different clinics, hospitals and jails. They have been given multiple short trials of different medications, with little communication between different parties involved in their care. The treatment plan written in a patient's court petition follows that patient for the duration of the petition and is adhered to by all involved providers. This consistency is crucial.
Intensive case management and oversight by the assisted outpatient treatment coordinator and psychiatrist benefit patients on enhanced services -- voluntary services that some patients accept in lieu of court orders. For some patients, however, adding services is not enough, and a court order is necessary.
We have conducted 90 assisted outpatient treatment investigations. Of these, 47 people received enhanced services and 15 have gone on to require a court petition. For this significant minority, court is an important addition. The most common reason for our county to not renew a petition at its expiration has been improvement by the patient to the point that he or she could participate voluntarily in treatment, which speaks to the positive effect these petitions have. For many, this is the first period of stability they have experienced in years.
Over a three-year period, among people on assisted outpatient treatment in Ulster County, hospital and jail stays are estimated to have been reduced by 3,500 days and 1,000 days, respectively. Clearly, assisted outpatient treatment petitions have saved patients from more restrictive institutional settings, saved our community money and kept our community safer by avoiding the incidents that lead to jail and hospital stays.
The centralized management of Ulster County's assisted outpatient treatment program by a coordinator and psychiatrist is key to its success, but this centralization is not cheap. Our local government fully funds the coordinator and psychiatrist positions, and our attorney hours. We have been fortunate as a county to have a legislature willing to support this level of service. In other counties, where these resources are lacking, enforcement of the law may not be as active.
We urge the state Legislature to renew Kendra's Law and to provide more funding to support it. This will ensure that programs will survive through difficult local budget cycles. It will also ensure more consistency across counties, rather than being dependent on the good graces of each local government.
Our initial doubts have been soundly invalidated by assisted outpatient treatment successes. Now that we know it works, let's support it fully.
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ROCHESTER DEMOCRAT & CHRONICLE, May 15, 2005
[Editor's Note: The parties in New York debating Kendra's Law have differing opinions on exactly what the future of the program should be, but we have been pleased that among what they do agree on is that the program should have a future. We have no doubt that Joyce Claypool is pleased as well.]
WORTH OF KENDRA'S LAW DEBATED;
Statute On Requiring Treatment For Mentally Ill Expires June 30
By Erika Rosenberg, Albany Bureau
(May 15, 2005) - ALBANY - For 15 years, Joyce Claypool watched as her brother's life was taken over by paranoid schizophrenia.
He went through bouts of hospitalization and homelessness. Fights with the police landed him in jail. He did things like stalk a woman, jump out of a moving car and cut himself. And he always maintained that he wasn't sick.
"He has no insight into his illness at all," said Claypool, who lives in Albany.
About five years ago, her brother was ordered into treatment by a court under a new law named for Kendra Webdale, a 32-year-old woman who in 1999 was pushed to her death in front of a New York City subway train by a schizophrenic man.
It hasn't been a panacea, but the court-ordered treatment has given Claypool's brother and their family more stability and peace than they've known in a while. He lives with his mother, and trips to the hospital are less frequent.
"The only thing that works is Kendra's Law mandating him. If he has to take the medication, he takes the medication," Claypool said. "Life has been so much better the past five years."
Now legislators are weighing what to do with the law setting up court-ordered treatment, which expires June 30. Some families and groups want to see it made permanent, but others are raising questions about why the law doesn't seem to be uniformly applied across the state and whether using the court system is a good way to help the mentally ill.
Lawmakers say they are likely to take a middle course of extending the law for several more years and ordering more study of it.
"I think the wisest course now is to extend it for three to five years, get the appropriate research and see if we can deal with the concerns of most advocates," said Sen. Thomas Morahan, R-New City, Rockland County, chairman of the Senate's mental health committee.
His counterpart in the Assembly, Peter Rivera, D-Bronx, held hearings on the law in Buffalo and New York City.
"It's a good law. All the parents who came and testified said that but for Kendra's Law, they would be living lives of desperation," Rivera said.
Not All Agree
The law is strongly supported by Gov. George Pataki, Attorney General Eliot Spitzer and the state chapter of the National Alliance for the Mentally Ill, one of the leading groups for families of mentally ill people. Both Pataki and Spitzer have proposed bills making the law permanent. "We don't see any point in continuing a trial period for a law that has definitively proven itself to be successful," said Assistant Attorney General Brian Stettin.
But another influential lobby group, the Association of Psychiatric Rehabilitation Services, is pushing for further study. Its director, Harvey Rosenthal, said the law was adopted in an atmosphere of fear of people who are mentally ill and under the false premise that many of them are violent. Rosenthal said that what's needed is better, more accessible treatment, not court coercion.
"I think it's unconscionable that people should have to go to court," Rosenthal said. "It's an inappropriate mechanism. The real answer is better services."
Since the law was adopted in August 1999, seven months after Webdale's death, more than 10,600 cases have gone to the courts and about 4,100 court orders have been issued. An additional 3,000 people have committed to voluntary agreements with counties to participate in outpatient mental health treatment.
In most cases, county mental health officials seek the court orders, sometimes on behalf of families. State psychiatric hospitals also try to obtain court orders for patients they are releasing but fear will not participate in outpatient treatment. Families can directly file for a court order, but that rarely happens.
How It Works
Under the law, there's a psychiatric evaluation and court hearing before a mentally ill person is placed under a court order. The person must have a history of hospitalization, violence, failure to stay in treatment or take care of herself, or other serious problems.
Someone who is an immediate danger to himself or others can be involuntarily committed to a psychiatric hospital; in contrast, Kendra's Law is aimed at people who can live in the community but need regular care to avoid hospitalization, suicidal tendencies and violence.
"Kendra's Law is not about the mentally ill in general. It's about a very special population of mentally ill folks who don't take their medicine or comply with other treatment," Stettin said.
A state study of the law found that 71 percent of people under court-ordered treatment had schizophrenia and 13 percent had bipolar disorder. The average court order lasts 16 months.
The Office of Mental Health report found that court-ordered treatment helped many, but not all, of the people involved to take their medicines and participate regularly in mental health services. Life skills, such as preparing meals, taking health care advice and keeping appointments, also improved.
The proportion of people abusing alcohol or drugs fell from about 45 percent to 23 percent, while those threatening suicide or hurting other people fell from 15 percent to 8 percent, according to the report.
"The patients are doing a lot better. There are fewer people roaming the streets, unmedicated and unmonitored," Stettin said.
Numbers Vary
Court orders are used much more frequently downstate than in most of upstate. While about 60 percent of cases in New York City led to court orders, just 16 percent of those in Monroe County did.
Officials and advocates aren't sure why, but they guess that counties have different philosophical approaches, and some might prefer to make voluntary agreements.
Kenneth Glatt, Dutchess County's commissioner of mental hygiene, said he was initially skeptical about the law and considered it toothless. People who defy their court orders aren't thrown in jail, though police can pick them up and take them to a hospital. But now Glatt acknowledges that the court orders have made a difference.
"The psychological impact of a court order has proven effective," he said. "It somehow is enough to touch the healthy part of them. It's really voluntary compliance."
But people ordered into treatment under Kendra's Law often don't like it. Some fight the court orders, and more than half of about 80 interviewed for the state report said they were angered or embarrassed by the experience.
Those around them, however, say the mentally troubled people sometimes have to be forced into doing what's good for them.
Jack Goldstein, a 48-year-old Rochester man who has depression and works at a community program to teach life skills to mentally ill peers, said he wants to use the law to get help for a troubled friend. The man is schizophrenic, living on the streets and sleeping in the woods. He carries books, magazines and clothes around in a soggy garbage bag that has been rained on, Goldstein said.
"I know when he was in the hospital, when he was on meds, he was a different person," he said. "We're trying, and I'm hopeful that he'll qualify for the program, because he really needs housing, first of all."
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AMERICAN DAILY, March 10, 2005
[Editor's Note: Just as it respects neither nationality nor race, severe mental illness has no political affiliation. Whether it is with legislators, newspapers, or political commentators - the effort to reform treatment laws does not fall within boundaries marked by terms like liberal and conservative or Democrat and Republican.
Below a member of the right looks at the plight of untreated psychiatric disorders.]
OPINION: JAIL: THE BEST TREATMENT FOR MENTAL ILLNESS?
By Paul M. Weyrich
My brand of conservatism is cultural conservatism. It's a completely different strand of thought than extreme libertarianism which sees no real place for government at all. Cultural conservatism believes in limited government and we often work in coalition with sensible libertarians and more free-market-oriented conservatives on important issues upon which we agree, namely reducing the size of the Federal Government. One important distinguishing feature of cultural conservatism is that we believe in upholding the importance of traditional values in a community. We also are concerned for those who cannot truly care for themselves but we place more faith in private and religious institutions than in government bureaucracies to truly help those in need.
Conservatives such as Tommy Thompson, when he was Governor of Wisconsin, demonstrated that concern when he promoted welfare reform. Many people in his state were ticked off - rightly so -- that people would receive government checks in lieu of working. They would have children without being able to support them independently. Thompson realized that the hardworking taxpayers had a legitimate gripe. He also knew that the welfare recipients were really the biggest victims. The government helped to lock them into poverty without providing the motivation to improve their lot in life.
Worse, the odds were that their children would also become trapped in that same poverty. Thompson pushed the boundaries by obtaining waivers from the Federal Government to permit the State Government to require welfare recipients to hold jobs in order to receive their benefits.
Wisconsin's efforts to break the cycle of poverty that started under Thompson continue.
CATO Institute issued a state report card on welfare reform last year. Wisconsin received an "A" for its program. "Thanks to Wisconsin's innovative Work First and Pay for Performance programs, plus the very real threat that nonworking people will simply be cut off, almost 67 percent of welfare recipients are working," wrote CATO Institute welfare policy analyst Jennifer Zeigler.
Thompson's leadership in reforming welfare helped to trigger a national revolution for the better. Wisconsin's welfare reform helped demonstrate to the poor that they could break the government chains that perpetuated their poverty. Left to the will of the government's bureaucrats in the state social service agencies, it's unlikely that welfare reform would ever have occurred.
Some people are truly helpless. America's mentally ill have been placed on the streets, often ill prepared or not being provided the medical care they need. This started during the 1960s when the state-operated hospitals for the mentally ill fell under fire for their poor management. Organizations such as the American Civil Liberties Union exacerbated the problem by pushing for deinstitutionalization. A lack of affordable housing, particularly the disappearance of single-residence occupancy housing, helped to exacerbate the problem. Turning the mentally ill out of the institutions brought about results that proved to be as disappointing as when they were in mismanaged institutions.
The result is that many mentally ill are homeless, wandering the streets, sometimes even posing a danger to the community, because their illness is untreated. It's quite likely you have seen an unkempt person acting belligerently, even threateningly, behaving in a manner as no rational person ever would dream of behaving. That person is mentally ill and the likelihood is that he has fallen through the cracks of our system particularly if he has no family or comes from one without the means to pay for expensive treatments.
However, there is a new de facto hospital for the mentally ill: America's prison system. The mentally ill, left to fend for themselves, often end up running afoul of law enforcement because of their aggressive behavior. Some very well may have broken the law but quite often the police do not understand the mentally ill person is displaying symptoms of illness. The police often do not realize that the mentally ill have grandiose feelings and that makes them very difficult to handle, adding to the burden already upon the police.
The problem is that the prisons are no place to house those who truly are mentally ill. When Cheri Nolan, Deputy Assistant Attorney General, Office of Justice Programs, testified before the House Judiciary Committee's Subcommittee on Crime, Terrorism and Homeland Security last year she stated: "If the crime is serious, incarceration is the appropriate response, regardless of whether the perpetrator has a mental illness. Our policy is clear: we will not absolve someone of any responsibility for committing a crime simply because he or she has a mental illness."
Nolan explained that many of the mentally ill are jailed for committing low-level crimes only to be placed on the streets where they will once again commit the same crimes. In this case the justice system is equivalent to the dog chasing its tail endlessly. The mentally ill who are jailed are strong candidates for return visits once they are released. Ms. Nolan testified that the Los Angeles County Board of Supervisor's Task Force on Incarcerated Mentally Ill found that 90 percent of the county's inmates who have mental illnesses are repeat offenders. Too many mentally ill leave jails where their needs for treatment have not been provided, ending up on the streets without the needed connections for treatment, housing and the support services they need and the result is they end up in prison once more.
Many localities and states are failing to come to terms with the problem of the mentally ill. The Treatment Advocacy Center says eight states do not mandate treatment in the community setting - Connecticut, Maine, Maryland, Massachusetts, Nevada, New Jersey, New Mexico and Tennessee. This can help push the mentally ill into the hands of law enforcement and prison guards rather than medical personnel. Pennsylvania's law governing the treatment of the mentally ill has required since the mid-1970s that dangerousness be a determining condition for arrests. Philadelphia's Police Chief ordered that the mentally ill be arrested for disorderly conduct rather than placed into custody under the Mental Health Act. The Treatment Advocacy Center in a February 2005 briefing paper on "Law Enforcement and People with Severe Mental Illnesses" says "That practice continues today when officers and deputies find there is no way to get psychiatric help for a person who is psychotic but not yet obviously dangerous."
Steve Leifman, a Judge who sits on Florida's Eleventh Circuit, which covers Miami-Dade County, explained the problem in a letter posted on January 9, 2005 on the Miami Herald's Miami.com website: "[People with mental illness] are arrested and jailed for minor offenses and nuisance behavior, such as disorderly conduct or trespassing. Once incarcerated, they remain jailed eight times longer - and at a cost that is seven times greater - than those without mental illnesses arrested for the same offenses." The Judicial Circuit upon which he serves instituted a program to divert the mentally ill from the criminal justice system to obtain treatment for their illnesses. Law officers have received training in how to recognize and to better deal with the mentally ill. Leifman wrote that the recidivism rate among the mentally ill in Dade County has fallen dramatically and that taxpayers are saved over $2.3 million annually.
Memphis' police force has a special crisis intervention team which personnel specifically are trained to handle people with mental illnesses. The Treatment Advocacy Center states that police's Crisis Intervention Team (CIT) personnel "learn to interact with people with mental illness who are in crisis in a way that de-escalates, rather than inflames a tense situation. CIT officers can also divert a person to a mental health treatment facility rather than jail when appropriate." Portland, Oregon, Seattle, Houston and San Jose are some other cities that are using similar approaches.
More effort needs to be put forth to assure the police understand the problems of the mentally ill and how best to deal with them. In many cases sensible treatment is vastly preferable in terms of cost and compassion than incarceration. A return to institutionalization may be warranted for some hard-luck cases although it will be important to administer the facilities well to prevent the scandals that helped fuel the drive for deinstitutionalization in the first place. It's important that the law enforcement and the courts seek to provide appropriate responses to the mentally ill who have yet to commit true crimes of violence. Ensuring they receive treatment may even help to prevent even worse crimes from occurring. "Go directly to jail" is not the right path to take in such cases.
Paul M. Weyrich is Chairman and CEO of the Free Congress Foundation.
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Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy Center.
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TREATMENT ADVOCACY CENTER
Visit our web site www.psychlaws.org
May 20, 2005
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1. TREATMENT ADVOCACY CENTER PRESS RELEASE, May 18, 2005
2. BAKER ACT REFORM SUBJECT OF RADIO'S CRIMINAL JUSTICE FORUM
3. MEASURE WOULD FORCE MEDICATIONS - Kennebec Journal, May 19, 2005
4. KENDRA'S LAW WORKS AND SHOULD BE RENEWED - Albany Times Union, May 15, 2005
5. WORTH OF KENDRA'S LAW DEBATED - Rochester Democrat & Chronicle, May 15, 2005
6. JAIL: THE BEST TREATMENT FOR MENTAL ILLNESS? - American Daily, March 10, 2005
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TREATMENT ADVOCACY CENTER PRESS RELEASE, May 18, 2005
[Editor's Note: In the battle for treatment, there are many champions; yet each year we normally have only one award to bestow in recognition of extraordinary advocacy for those most affected by severe mental illnesses. This year, however, we selected co-winners for the Torrey Advocacy Commendation. There was simply no way to chose between Sheriff Donald Eslinger, Linda Gregory, and Alice Petree. For years this tragedy-forged triumvirate unrelentingly strove to bring assisted outpatient treatment to Florida - and this year they succeeded.]
NEWS
TREATMENT ADVOCACY CENTER
For Immediate Release
May 18, 2005
FLORIDIANS HONORED WITH NATIONAL MENTAL ILLNESS ADVOCACY AWARD
Mutual Tragedy Spurs Successful Reform Of Florida Law For People With Severe Mental Illnesses
ARLINGTON, VA - The board of directors of the Treatment Advocacy Center today announced that Seminole County Sheriff Donald Eslinger, Linda Gregory of Jacksonville, and Alice Petree of Sanford are the winners of its annual national mental illness advocacy award. The Treatment Advocacy Center (TAC) is a national nonprofit organization dedicated to removing barriers to treatment of severe mental illnesses. May is national mental health month.
Eslinger, Gregory, and Petree won this year's national Torrey Advocacy Commendation for their successful advocacy for a new mental illness treatment law in Florida. The TAC award recognizes the courage and tenacity of those who selflessly advocate - despite criticism and opposition - for the right to treatment for those who are so severely disabled by severe mental illnesses that they do not recognize that they need treatment.
The board of directors of the Treatment Advocacy Center voted unanimously to recognize all three Florida advocates in an unusual move that paralleled an unusual advocacy partnership. "We are impressed by their heart-felt efforts over more than four years to get a more humane treatment law for Floridians with severe mental illnesses," said TAC board secretary Dr. Fred Frese. "We commend Sheriff Eslinger, Linda Gregory, and Alice Petree for their incredible dedication and effectiveness in spearheading a complex and critical reform of Florida's outdated treatment law."
The Florida House of Representatives cited the TAC award in a resolution sponsored by Rep. David Simmons and Rep. Sandra Adams that recognizes these three advocates for "their successful advocacy in honor of Deputy Sheriff Gene Gregory and Alan Singletary and all people with severe mental illnesses who will benefit from their efforts."
The result of their work is Florida's new law, which took effect January 1, 2005, that allows assisted (court-ordered) outpatient treatment for people with severe mental illnesses, like schizophrenia and bipolar disorder, who have a history of noncompliance combined with either repeated Baker Act admissions or serious violence. Court-ordered outpatient treatment is a less restrictive, less expensive alternative for those who need intervention but do not require inpatient hospitalization. New statistics from New York, a state with a similar law, show that for those in the program, 74% fewer experienced homelessness, 77% fewer experienced psychiatric hospitalization, 83% fewer experienced arrest, and 87% fewer experienced incarceration. Individuals enrolled were also more likely to regularly participate in services and take prescribed medication.
On July 8, 1998, Deputy Sheriff Gene Gregory and Alan Singletary, a man with a history of severe mental illness, died in a 13-hour standoff. Seminole County Sheriff Eslinger vowed to not let their deaths be in vain, and created a Mental Health Task Force to advocate for reforms in mental health and substance abuse services and laws. With the unlikely team of Alice Petree, the sister of Alan Singletary, and Linda Gregory, the widow of Deputy Sheriff Gene Gregory, Sheriff Eslinger worked, through the task force and with other community groups and stakeholders, to increase awareness of the need for treatment of mental illnesses. With the leadership of the Florida Sheriffs' Association, the efforts of these advocates and the community network they helped to create resulted not only in reforming the Baker Act to allow for assisted outpatient treatment, but also in other beneficial programs for those with mental illnesses such as jail diversion, forensic treatment programs, mental health screening at a county correctional facility, funding for a detox receiving facility, a voluntary identification program, and law enforcement crisis intervention teams.
About The Award -The Torrey Advocacy Commendation is presented annually by the Treatment Advocacy Center's Board of Directors. The award is named for Treatment Advocacy Center president and founder Dr. E. Fuller Torrey, M.D., a nationally known and respected psychiatrist, researcher, and advocate whose unflagging resolve to remove barriers to treatment for people with severe mental illnesses sparked a national reform movement. Recipients make a substantial difference for their community through advocacy, awareness, research, or legislation in this field.
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BAKER ACT REFORM SUBJECT OF RADIO'S CRIMINAL JUSTICE FORUM
Tune in to hear about the fruit of our award winners' labor starting this Saturday. Linda Gregory and our executive director, Mary Zdanowicz, will discuss the new Baker Act law on "Criminal Justice Forum" - the law is a new beginning for Florida, but only if it is widely understood and implemented. Mary and Linda will explain the law and its importance, discuss how it works, and talk about the successes other states are having with similar laws. Criminal Justice Forum will air on Saturday May 21st at 12:05pm on WTAN 1340 AM in Clearwater; 1350 & 1400 AM in New Tampa.
You can also listen live from anywhere in the country via the internet at
http://tacenews.c.topica.com/maadxFfabhajBbfGwZEb/ (hit "listen Now" in upper left corner of page)
The program will air again on Tuesday May 24th at 11am on 1490 AM in Bradenton and 1280 AM in Sarasota. And, after then, the program will be posted in the Criminal Justice Forum online archives as a free download available at any time at
http://tacenews.c.topica.com/maadxFfabhajCbfGwZEb/
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KENNEBEC JOURNAL (ME), May 19, 2005
[Editor's Note: Advocates are still working to remove Maine from the short list of states that has no law for assisted outpatient treatment. That effort has garnered the endorsement of a powerful array of professional organizations and recently gained even more steam with the backing of the state department overseeing mental health services.]
MEASURE WOULD FORCE MEDICATIONS
By Gary Remal
AUGUSTA -- Debate about legislation that would speed forced medication on hospitalized psychiatric patients has grown into a larger battle likely to result in a clash in the Legislature.
Sen. John Nutting, D-Leeds, backs the idea of forcing mentally ill people living in community settings to take medication or face rehospitalization. He said he will introduce a measure to allow it.
The Legislature's Health and Human Services Committee is scheduled to discuss the proposal today at 3 p.m.
Known as "outpatient commitment," forcing medications on psychiatric patients is a highly charged issue in the mental health community -- with patients, medical professionals and some family members fighting over the power to control courses of treatment.
Nutting said outpatient commitment in New York during the past five years reduced the percentage of people with mental illness in New York jails by 28 percent.
He said compliance with prescribed medication also increased to 91 percent.
"Most of the states, 42, have it," Nutting said.
But Helen Bailey, public policy director at the Augusta-based Disability Rights Center, opposes Nutting's proposal. In response to concerns, Nutting said criteria for its use have been tightened, with the method not recommended for people younger than 21.
Nutting said such changes helped convince state Deputy Health and Human Services Commissioner Brenda Harvey to drop her opposition.
"We built a coalition supporting the bill that includes the Maine Psychiatric Association, the Maine Medical Association, the Maine Chiefs of Police Association, the Maine Sheriffs Association, the Maine Nurse Practitioners Association, as well as hundreds of parents (of the mentally ill) in support groups across the state," Nutting said.
Bailey, a lawyer who represents mental health patients in hospitals and community programs, said she and other advocates for the mentally ill want changes to the law that would get drugs to hospitalized patients faster.
Harvey said she changed her mind because Nutting's revised legislation called for increased support for people with mental illnesses living in their communities to help head off rehospitalization.
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ALBANY TIMES UNION, May 15, 2005
[Editor's Note: Some mental health departments and treatment providers take a "show me" attitude when assisted outpatient treatment comes to their state, but almost always experience with the treatment mechanism creates an appreciation for its ability to reach the most recalcitrant cases. In 1999, the New York State Department of Mental Health was less than enthusiastic when Kendra's Law was proposed. That department now vigorously endeavors to make Kendra's Law permanent.
Dr. Mary Barber's attitude was similarly transformed by running the assisted outpatient treatment program in Ulster County.]
KENDRA'S LAW WORKS AND SHOULD BE RENEWED
By Mary Barber
Five years ago, Kendra's Law brought assisted outpatient to New York state. The program mandates outpatient psychiatric treatment through a court order for a small population with severe mental illnesses, mostly schizophrenia, who are too ill to make informed treatment decisions.
As the law expires this year, we at Ulster County Mental Health Department urge continuation of assisted outpatient treatment with state funding to ensure the long-term viability of the law.
We were initially skeptical about the program. It was an unfunded mandate that added only a couple of new intensive case management slots. We believed the law had no teeth and that court petitions would not change the behavior of a patient truly resistant to treatment. We guessed that case management resources might help some patients, but that court orders would add little beyond that.
We feel much differently after five years of experience with the law.
Kendra's Law makes counties responsible for their most high-risk, high-need people. With that responsibility comes the opportunity to exert more centralized control over housing, treatment and case management resources, which benefits the system as a whole.
Much of the effectiveness of assisted outpatient treatment comes from making providers accountable. The law allows and requires close communication among all providers. This helps avoid fragmentation of care and patients slipping through cracks in the system.
Assisted outpatient treatment also supports providers in helping those hardest to help. Providers are more willing to take in severely ill and high-risk patients when they know the assisted outpatient treatment team will help oversee these cases, including developing new strategies if patients become symptomatic or a particular housing or treatment arrangement doesn't work.
Many patients feel compelled to follow court orders, even knowing that the most severe consequence if they do not follow their treatment plan is being taken to an emergency room (something most of the patients who are placed on petitions have already experienced numerous times). We have witnessed many amazing successes for people on petitions.
The petitions, with their specific treatment plans, provide a much-needed consistency for patients. In the past, these patients have often been shuffled among different clinics, hospitals and jails. They have been given multiple short trials of different medications, with little communication between different parties involved in their care. The treatment plan written in a patient's court petition follows that patient for the duration of the petition and is adhered to by all involved providers. This consistency is crucial.
Intensive case management and oversight by the assisted outpatient treatment coordinator and psychiatrist benefit patients on enhanced services -- voluntary services that some patients accept in lieu of court orders. For some patients, however, adding services is not enough, and a court order is necessary.
We have conducted 90 assisted outpatient treatment investigations. Of these, 47 people received enhanced services and 15 have gone on to require a court petition. For this significant minority, court is an important addition. The most common reason for our county to not renew a petition at its expiration has been improvement by the patient to the point that he or she could participate voluntarily in treatment, which speaks to the positive effect these petitions have. For many, this is the first period of stability they have experienced in years.
Over a three-year period, among people on assisted outpatient treatment in Ulster County, hospital and jail stays are estimated to have been reduced by 3,500 days and 1,000 days, respectively. Clearly, assisted outpatient treatment petitions have saved patients from more restrictive institutional settings, saved our community money and kept our community safer by avoiding the incidents that lead to jail and hospital stays.
The centralized management of Ulster County's assisted outpatient treatment program by a coordinator and psychiatrist is key to its success, but this centralization is not cheap. Our local government fully funds the coordinator and psychiatrist positions, and our attorney hours. We have been fortunate as a county to have a legislature willing to support this level of service. In other counties, where these resources are lacking, enforcement of the law may not be as active.
We urge the state Legislature to renew Kendra's Law and to provide more funding to support it. This will ensure that programs will survive through difficult local budget cycles. It will also ensure more consistency across counties, rather than being dependent on the good graces of each local government.
Our initial doubts have been soundly invalidated by assisted outpatient treatment successes. Now that we know it works, let's support it fully.
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ROCHESTER DEMOCRAT & CHRONICLE, May 15, 2005
[Editor's Note: The parties in New York debating Kendra's Law have differing opinions on exactly what the future of the program should be, but we have been pleased that among what they do agree on is that the program should have a future. We have no doubt that Joyce Claypool is pleased as well.]
WORTH OF KENDRA'S LAW DEBATED;
Statute On Requiring Treatment For Mentally Ill Expires June 30
By Erika Rosenberg, Albany Bureau
(May 15, 2005) - ALBANY - For 15 years, Joyce Claypool watched as her brother's life was taken over by paranoid schizophrenia.
He went through bouts of hospitalization and homelessness. Fights with the police landed him in jail. He did things like stalk a woman, jump out of a moving car and cut himself. And he always maintained that he wasn't sick.
"He has no insight into his illness at all," said Claypool, who lives in Albany.
About five years ago, her brother was ordered into treatment by a court under a new law named for Kendra Webdale, a 32-year-old woman who in 1999 was pushed to her death in front of a New York City subway train by a schizophrenic man.
It hasn't been a panacea, but the court-ordered treatment has given Claypool's brother and their family more stability and peace than they've known in a while. He lives with his mother, and trips to the hospital are less frequent.
"The only thing that works is Kendra's Law mandating him. If he has to take the medication, he takes the medication," Claypool said. "Life has been so much better the past five years."
Now legislators are weighing what to do with the law setting up court-ordered treatment, which expires June 30. Some families and groups want to see it made permanent, but others are raising questions about why the law doesn't seem to be uniformly applied across the state and whether using the court system is a good way to help the mentally ill.
Lawmakers say they are likely to take a middle course of extending the law for several more years and ordering more study of it.
"I think the wisest course now is to extend it for three to five years, get the appropriate research and see if we can deal with the concerns of most advocates," said Sen. Thomas Morahan, R-New City, Rockland County, chairman of the Senate's mental health committee.
His counterpart in the Assembly, Peter Rivera, D-Bronx, held hearings on the law in Buffalo and New York City.
"It's a good law. All the parents who came and testified said that but for Kendra's Law, they would be living lives of desperation," Rivera said.
Not All Agree
The law is strongly supported by Gov. George Pataki, Attorney General Eliot Spitzer and the state chapter of the National Alliance for the Mentally Ill, one of the leading groups for families of mentally ill people. Both Pataki and Spitzer have proposed bills making the law permanent. "We don't see any point in continuing a trial period for a law that has definitively proven itself to be successful," said Assistant Attorney General Brian Stettin.
But another influential lobby group, the Association of Psychiatric Rehabilitation Services, is pushing for further study. Its director, Harvey Rosenthal, said the law was adopted in an atmosphere of fear of people who are mentally ill and under the false premise that many of them are violent. Rosenthal said that what's needed is better, more accessible treatment, not court coercion.
"I think it's unconscionable that people should have to go to court," Rosenthal said. "It's an inappropriate mechanism. The real answer is better services."
Since the law was adopted in August 1999, seven months after Webdale's death, more than 10,600 cases have gone to the courts and about 4,100 court orders have been issued. An additional 3,000 people have committed to voluntary agreements with counties to participate in outpatient mental health treatment.
In most cases, county mental health officials seek the court orders, sometimes on behalf of families. State psychiatric hospitals also try to obtain court orders for patients they are releasing but fear will not participate in outpatient treatment. Families can directly file for a court order, but that rarely happens.
How It Works
Under the law, there's a psychiatric evaluation and court hearing before a mentally ill person is placed under a court order. The person must have a history of hospitalization, violence, failure to stay in treatment or take care of herself, or other serious problems.
Someone who is an immediate danger to himself or others can be involuntarily committed to a psychiatric hospital; in contrast, Kendra's Law is aimed at people who can live in the community but need regular care to avoid hospitalization, suicidal tendencies and violence.
"Kendra's Law is not about the mentally ill in general. It's about a very special population of mentally ill folks who don't take their medicine or comply with other treatment," Stettin said.
A state study of the law found that 71 percent of people under court-ordered treatment had schizophrenia and 13 percent had bipolar disorder. The average court order lasts 16 months.
The Office of Mental Health report found that court-ordered treatment helped many, but not all, of the people involved to take their medicines and participate regularly in mental health services. Life skills, such as preparing meals, taking health care advice and keeping appointments, also improved.
The proportion of people abusing alcohol or drugs fell from about 45 percent to 23 percent, while those threatening suicide or hurting other people fell from 15 percent to 8 percent, according to the report.
"The patients are doing a lot better. There are fewer people roaming the streets, unmedicated and unmonitored," Stettin said.
Numbers Vary
Court orders are used much more frequently downstate than in most of upstate. While about 60 percent of cases in New York City led to court orders, just 16 percent of those in Monroe County did.
Officials and advocates aren't sure why, but they guess that counties have different philosophical approaches, and some might prefer to make voluntary agreements.
Kenneth Glatt, Dutchess County's commissioner of mental hygiene, said he was initially skeptical about the law and considered it toothless. People who defy their court orders aren't thrown in jail, though police can pick them up and take them to a hospital. But now Glatt acknowledges that the court orders have made a difference.
"The psychological impact of a court order has proven effective," he said. "It somehow is enough to touch the healthy part of them. It's really voluntary compliance."
But people ordered into treatment under Kendra's Law often don't like it. Some fight the court orders, and more than half of about 80 interviewed for the state report said they were angered or embarrassed by the experience.
Those around them, however, say the mentally troubled people sometimes have to be forced into doing what's good for them.
Jack Goldstein, a 48-year-old Rochester man who has depression and works at a community program to teach life skills to mentally ill peers, said he wants to use the law to get help for a troubled friend. The man is schizophrenic, living on the streets and sleeping in the woods. He carries books, magazines and clothes around in a soggy garbage bag that has been rained on, Goldstein said.
"I know when he was in the hospital, when he was on meds, he was a different person," he said. "We're trying, and I'm hopeful that he'll qualify for the program, because he really needs housing, first of all."
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AMERICAN DAILY, March 10, 2005
[Editor's Note: Just as it respects neither nationality nor race, severe mental illness has no political affiliation. Whether it is with legislators, newspapers, or political commentators - the effort to reform treatment laws does not fall within boundaries marked by terms like liberal and conservative or Democrat and Republican.
Below a member of the right looks at the plight of untreated psychiatric disorders.]
OPINION: JAIL: THE BEST TREATMENT FOR MENTAL ILLNESS?
By Paul M. Weyrich
My brand of conservatism is cultural conservatism. It's a completely different strand of thought than extreme libertarianism which sees no real place for government at all. Cultural conservatism believes in limited government and we often work in coalition with sensible libertarians and more free-market-oriented conservatives on important issues upon which we agree, namely reducing the size of the Federal Government. One important distinguishing feature of cultural conservatism is that we believe in upholding the importance of traditional values in a community. We also are concerned for those who cannot truly care for themselves but we place more faith in private and religious institutions than in government bureaucracies to truly help those in need.
Conservatives such as Tommy Thompson, when he was Governor of Wisconsin, demonstrated that concern when he promoted welfare reform. Many people in his state were ticked off - rightly so -- that people would receive government checks in lieu of working. They would have children without being able to support them independently. Thompson realized that the hardworking taxpayers had a legitimate gripe. He also knew that the welfare recipients were really the biggest victims. The government helped to lock them into poverty without providing the motivation to improve their lot in life.
Worse, the odds were that their children would also become trapped in that same poverty. Thompson pushed the boundaries by obtaining waivers from the Federal Government to permit the State Government to require welfare recipients to hold jobs in order to receive their benefits.
Wisconsin's efforts to break the cycle of poverty that started under Thompson continue.
CATO Institute issued a state report card on welfare reform last year. Wisconsin received an "A" for its program. "Thanks to Wisconsin's innovative Work First and Pay for Performance programs, plus the very real threat that nonworking people will simply be cut off, almost 67 percent of welfare recipients are working," wrote CATO Institute welfare policy analyst Jennifer Zeigler.
Thompson's leadership in reforming welfare helped to trigger a national revolution for the better. Wisconsin's welfare reform helped demonstrate to the poor that they could break the government chains that perpetuated their poverty. Left to the will of the government's bureaucrats in the state social service agencies, it's unlikely that welfare reform would ever have occurred.
Some people are truly helpless. America's mentally ill have been placed on the streets, often ill prepared or not being provided the medical care they need. This started during the 1960s when the state-operated hospitals for the mentally ill fell under fire for their poor management. Organizations such as the American Civil Liberties Union exacerbated the problem by pushing for deinstitutionalization. A lack of affordable housing, particularly the disappearance of single-residence occupancy housing, helped to exacerbate the problem. Turning the mentally ill out of the institutions brought about results that proved to be as disappointing as when they were in mismanaged institutions.
The result is that many mentally ill are homeless, wandering the streets, sometimes even posing a danger to the community, because their illness is untreated. It's quite likely you have seen an unkempt person acting belligerently, even threateningly, behaving in a manner as no rational person ever would dream of behaving. That person is mentally ill and the likelihood is that he has fallen through the cracks of our system particularly if he has no family or comes from one without the means to pay for expensive treatments.
However, there is a new de facto hospital for the mentally ill: America's prison system. The mentally ill, left to fend for themselves, often end up running afoul of law enforcement because of their aggressive behavior. Some very well may have broken the law but quite often the police do not understand the mentally ill person is displaying symptoms of illness. The police often do not realize that the mentally ill have grandiose feelings and that makes them very difficult to handle, adding to the burden already upon the police.
The problem is that the prisons are no place to house those who truly are mentally ill. When Cheri Nolan, Deputy Assistant Attorney General, Office of Justice Programs, testified before the House Judiciary Committee's Subcommittee on Crime, Terrorism and Homeland Security last year she stated: "If the crime is serious, incarceration is the appropriate response, regardless of whether the perpetrator has a mental illness. Our policy is clear: we will not absolve someone of any responsibility for committing a crime simply because he or she has a mental illness."
Nolan explained that many of the mentally ill are jailed for committing low-level crimes only to be placed on the streets where they will once again commit the same crimes. In this case the justice system is equivalent to the dog chasing its tail endlessly. The mentally ill who are jailed are strong candidates for return visits once they are released. Ms. Nolan testified that the Los Angeles County Board of Supervisor's Task Force on Incarcerated Mentally Ill found that 90 percent of the county's inmates who have mental illnesses are repeat offenders. Too many mentally ill leave jails where their needs for treatment have not been provided, ending up on the streets without the needed connections for treatment, housing and the support services they need and the result is they end up in prison once more.
Many localities and states are failing to come to terms with the problem of the mentally ill. The Treatment Advocacy Center says eight states do not mandate treatment in the community setting - Connecticut, Maine, Maryland, Massachusetts, Nevada, New Jersey, New Mexico and Tennessee. This can help push the mentally ill into the hands of law enforcement and prison guards rather than medical personnel. Pennsylvania's law governing the treatment of the mentally ill has required since the mid-1970s that dangerousness be a determining condition for arrests. Philadelphia's Police Chief ordered that the mentally ill be arrested for disorderly conduct rather than placed into custody under the Mental Health Act. The Treatment Advocacy Center in a February 2005 briefing paper on "Law Enforcement and People with Severe Mental Illnesses" says "That practice continues today when officers and deputies find there is no way to get psychiatric help for a person who is psychotic but not yet obviously dangerous."
Steve Leifman, a Judge who sits on Florida's Eleventh Circuit, which covers Miami-Dade County, explained the problem in a letter posted on January 9, 2005 on the Miami Herald's Miami.com website: "[People with mental illness] are arrested and jailed for minor offenses and nuisance behavior, such as disorderly conduct or trespassing. Once incarcerated, they remain jailed eight times longer - and at a cost that is seven times greater - than those without mental illnesses arrested for the same offenses." The Judicial Circuit upon which he serves instituted a program to divert the mentally ill from the criminal justice system to obtain treatment for their illnesses. Law officers have received training in how to recognize and to better deal with the mentally ill. Leifman wrote that the recidivism rate among the mentally ill in Dade County has fallen dramatically and that taxpayers are saved over $2.3 million annually.
Memphis' police force has a special crisis intervention team which personnel specifically are trained to handle people with mental illnesses. The Treatment Advocacy Center states that police's Crisis Intervention Team (CIT) personnel "learn to interact with people with mental illness who are in crisis in a way that de-escalates, rather than inflames a tense situation. CIT officers can also divert a person to a mental health treatment facility rather than jail when appropriate." Portland, Oregon, Seattle, Houston and San Jose are some other cities that are using similar approaches.
More effort needs to be put forth to assure the police understand the problems of the mentally ill and how best to deal with them. In many cases sensible treatment is vastly preferable in terms of cost and compassion than incarceration. A return to institutionalization may be warranted for some hard-luck cases although it will be important to administer the facilities well to prevent the scandals that helped fuel the drive for deinstitutionalization in the first place. It's important that the law enforcement and the courts seek to provide appropriate responses to the mentally ill who have yet to commit true crimes of violence. Ensuring they receive treatment may even help to prevent even worse crimes from occurring. "Go directly to jail" is not the right path to take in such cases.
Paul M. Weyrich is Chairman and CEO of the Free Congress Foundation.
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Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy Center.
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