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Albuquerque Tribune

July 24, 2003

Reprinted with permission of the authors. All rights reserved.

by E. Fuller Torrey, M.D., and Mary T. Zdanowicz, Esq.

Sgt. Carol Oleksak lies in a hospital bed, being treated for critical wounds inflicted by a man who could not get access to a hospital bed to be treated for his brain disease.

That man, Duc Minh Pham, was killed by law enforcement officers (July 7, 2003) after critically injuring Officer Oleksak.

In the past 10 years, Pham has been charged with crimes like breaking and entering, burglary, larceny, shoplifting and criminal damage to property - at least 50 arrests, according to Metropolitan Court records. These charges - and others - were regularly dismissed.

Pham had schizophrenia, which, according to news reports, rendered him incompetent for trial. Yet New Mexico law also says that as long as he was not dangerous, he could not be committed for treatment. Without the option for trial and treatment, he was repeatedly released back to the streets to commit another crime.

A better law might have saved Duc Minh Pham and Officer Carol Oleksak from their tragic and deadly encounter - earlier intervention could also have saved New Mexicans from the financial expense of Pham’s many arrests, incarcerations, and court dates. Unfortunately, the revolving door of jail, hospitals, and the streets that he was trapped in for almost a decade was halted not by a needed change in law, but by death.

People who are rendered incompetent by severe mental illness need treatment based on need, not on dangerousness.

And they deserve a law that supports the use of assisted outpatient treatment, court-ordered treatment in the community. This alternative is much less restrictive than a hospital and improves outcomes for severely mentally ill individuals.

People with severe mental illnesses are about four times more likely to be killed in an encounter with law enforcement than the general public; and the risk to law enforcement officers, as became sadly apparent in this case, is extremely high.

Even if a deadly encounter is averted, correctional officials often become the caretakers of people lost to these treatable illnesses.

Nationally, 16% of incarcerated people have a severe mental illness. In New Mexico, people with severe mental illnesses are incarcerated than are housed in the state’s remaining psychiatric hospitals. Pham himself was jailed repeatedly, sometimes for a few days, sometimes for months at a time.

By contrast, those placed under New York’s assisted outpatient treatment law had an 86% reduction in incarcerations.

Kendra’s Law participants also experienced an 86% reduction in homelessness. Approximately one-third of the homeless population have a severe mental illness - at times including Pham, whose existence on the streets is what led to his first encounter with police.

The New York program saw an 83% reduction in arrests. This could have helped Pham, arrested more than 50 times and arrested for everything from disorderly conduct to assaulting a police officer.

All New Mexicans could benefit from significant reductions in harmful behaviors, such as harm to self (45% reduction in New York) and harm to others (44% reduction).

New Mexico’s law ignores that the majority of those not receiving treatment for severe mental illnesses do not believe - indeed, are rendered physiologically incapable of understanding - that they are sick. Most will only accept treatment if ordered to do so.

In such circumstances, the battle to be returned to competency is the true civil rights issue, not the false “right” to be and remain psychotic.

And New Mexico law ignores that early intervention is important for clinical reasons, as well as for public safety. Studies have shown that delayed treatment increases treatment resistance, worsens severity of symptoms, increases hospitalizations, and delays remission of symptoms.

Waiting to intervene can condemn someone to a lifetime of more severe and continual illness.

New York’s law is named after Kendra Webdale, the victim of a man with untreated schizophrenia. Perhaps New Mexico should consider Carol’s Law - for a law enforcement officer who fell victim to the law she had sworn to uphold.

E. Fuller Torrey, M.D., is president and Mary T. Zdanowicz is executive director of the Treatment Advocacy Center in Arlington, Va., , a national nonprofit organization working to eliminate barriers to treatment of severe mental illness.