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New York Post

Monday, August 4, 2003

Reprinted with permission of the author. All rights reserved.

OPED
The killer and me

By Jonathan Stanley

From just inside the church door, the rifleman fired at strangers. One shot killed Eileen Tosner, a mother of five. Another fatally struck Fr. Lawrence Penzes at the alter. More would have been hit but for an ex-Marine's tackle.

By adopting new laws and using the ones it has, New York could have stopped those tragedies. I know: It could have been me in the back of that church. Peter Troy, sentenced for those Long Island murders last week, and I each have a severe mental illness. My untreated symptoms are not as consistently debilitating as Troy's schizophrenia, but my bipolar illness is the type with "psychotic features."

At the worst, I perched on a milk crate in the middle of a Manhattan deli, naked. Secret agents had followed me for three sleepless days and nights. They sought to capture me and study my powers - mind reading, telepathic control of animals, a mind-generated electronic beam. These had kept me free, but now I was cornered.

Fighting fire with fire, the agents directed radiation into the deli from a satellite dish. The floor seethed deadly. Only the crate insulated me. Stepping down brought pain, real and agonizing pain.

Imprisoned on a milk crate, my running was over. I hadn't hurt anyone, but - with a slight shift in my delusion-controlled world - I would have.

Troy, 34 at the time of the shootings, had been on and off medications since his illness struck at age 21; it is the difference between him and me. With proper care, the symptoms of severe mental illnesses can be tamed, at least rendered manageable. Without it, they can overwhelm - sometimes so intensely that the afflicted harm themselves or others.

I didn't believe I was sick. Neither did nor does Peter Troy. This is no doubt the result of anosognosia, a physiological effect of severe psychiatric disorders that renders people incapable of assessing their condition.

Laws, mechanisms and resources must be available to intervene when such symptoms run unchecked. What of these there are failed Peter Troy, and almost did me.

Eleven months before he entered that church, a doctor at Bellevue Hospital determined and reported that Troy needed court-ordered and -supervised outpatient treatment pursuant to Kendra's Law, which permits involuntary treatment if a relapse is likely to bring harm to the patient or another person. But Troy had already left Bellevue and wasn't found. The haphazard investigation was wait-listed, then closed.

Kendra's Law has worked spectacularly - the state Office of Mental Health reported this year on those placed under an initial six-month court-order under the law: 77 percent fewer were hospitalized in the half-year after the treatment mandate than were in the six months before it. And 85 percent fewer experienced homelessness, 83 percent fewer were arrested and 85 percent fewer were incarcerated.

But an unused law can't prevent catastrophe.

Troy was hospitalized again because of erratic behavior. This time, New York's inpatient-commitment law kept him from care: A judge denied a physician's application for continued hospitalization, for a person can only be held in a hospital if found to be a danger to himself or others.

That same standard threatened me. After being brought in from that deli, I was almost released from a psychiatric facility after the 72-hour observation period: I was deemed psychotic, but my flight from imagined adversaries was taken as proof both of my desire for self-preservation and lack of animus to others - I was no danger. But my father somehow got me to sign a voluntary admission form, saving me from another frenzied sally on the city's streets.

In authorizing hospitalization, other states look at the need for treatment, probability of deterioration, inability to function independently and incapability of making informed decisions. But New York law still refuses aid to those rendered irrational by psychosis in apparently nonthreatening ways. If New York won't treat people in such conditions until they become dangerous, it will get dangerous people.

I am exceedingly peaceful. Wednesday, Peter Troy was sentenced to prison for two consecutive life-terms for two murders. Yet when I look at him, I look at myself. I feel my fortune and his fate. And I wonder what will happen to the next ones like us.

When they lose their minds to these treatable illnesses, will their care be more than happenstance?

Jonathan Stanley has been a practicing attorney and is now the assistant director of the Treatment Advocacy Center (psychlaws.org), a national nonprofit dedicated to removing barriers to treatment for people with severe mental illnesses.