National mental health group chooses W.Va. native as director

By Scott Finn, West Virginia Public Broadcasting

Studio lead: A native West Virginian is the new executive director of one of the nation’s leading advocacy groups for people with mental illness. Kurt Entsminger (Ents – min—ger) is the new leader of the Treatment Advocacy Center, based in suburban Washington D.C. In 2006, the Treatment Advocacy Center received an award from the American Psychiatric Association for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients.”

But the Center is a controversial force in the mental health world. For example, the group pushes for laws that require people with severe mental illness to take medications. Entsminger makes no apologies for the group’s philosophy. In fact, he says his own experience with bi-polar disorder shows that that Treatment Advocacy Center is right. Scott Finn reports.

Finn: Entsminger was born in Charleston and graduated from West Virginia University. He was a partner in two West Virginia law firms and spent four years as an Assistant U.S. Attorney in the late 1980s.

But now, he’s the new director of one of the nation’s most influential – and controversial – groups dealing with mental illness: the Treatment Advocacy Center. It started in the early 1990s when his bi-polar disorder threatened to ruin his life.

Entsminger: It was about 15 years ago that I was diagnosed with depression. And ultimately with the help and compassion of my wife was persuaded to undergo hospitalization, and when I did, I was ultimately diagnosed with bi-polar disorder. And as a result of that treatment and that care that my family had for me, I was finally able to get on the right treatment plan and able to function normally.

Finn: So you’re a big believer in treatment being able to affect people’s lives. Why do you think it is that so many people with mental illness resist treatment sometimes.

Entsminger: Well, I think there’s a number of reasons, but I think one of the most significant reasons for people who are severely mentally ill is that they simply don’t understand that they’re sick in the first place.

Finn: You understand that that’s a controversial…with some mental health advocates, that a controversial statement.

Entsminger: I understand that there may be some who dispute that. I understand that numerous studies have been done that demonstrate that the impairment of understanding is documented.

Finn: Did it happen in your own life? Did you have trouble recognizing your own mental illness.

Entsminger: I would have to say that those who were closest to me recognized it more clearly than I did.

Finn: How did your untreated bi-polar disorder affect your life?

Entsminger: It created a lot of side effects, frankly. It was not unusual for me to go weeks at a time with minimal sleep when I was going through a manic phase, and then finish a trial and go into a deep depression for several weeks.During the course of manic episodes, I was extremely irritable. I know it wasn’t fun to be around me. I’ve been told that by my wife and family and others as well.

Finn: Probably the biggest accomplishment of the Treatment Advocacy Center was the passage of Kendra’s Law, which is names after a young woman who was killed by a subway after she was pushed onto the tracks by a person with untreated schizophrenia. Could you describe Kenrda’s Law and the effect of it in New York and the other states that have passed it?

Entsminger: Kendra’s law is the law that was passed in 1999 in New York that provides for Assisted Outpatient Treatment. Instead of people having to first be determined to be an imminent danger to themselves or others, and then undergo hospitalization, Kendra’s Law provides a less-restrictive alternative, so people struggling with severe mental illness can continue functioning in the community, but at the same time receive treatment they need under the supervision and in connection with a court order.

The results are dramatic. A study shows that Kendra’s Law has reduced homelessness, hospitalization, arrests and incarcerations.

Finn: The critics of Kendra’s Law bring up civil rights issues. They say that mentally ill people have not committed any crime, and yet they’re being ordered by a judge to take their medication.

Entsminger: There’s no greater imprisonment that being psychotic. Ultimately what Assisted Outpatient Treatment is all about is providing a key and freeing these people from their psychosis, allowing them to function normally again. I don’t think there’s any great civil liberty than that, the ability to be able to be well and function normally. I would certainly say that is true from my own experience.

Finn: In 2006, the West Virginia legislature passed a version of Kendra’s Law. It allows several counties to set up outpatient commitment programs. Tom Rodd, who helps coordinate the program for the West Virginia Supreme Court says the program is just getting up and running in Kanawha County, and several other large counties may soon follow.

For West Virginia Public Broadcasting, I’m Scott Finn in Charleston.