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The Orlando Sentinel

October 27, 2000

Reprinted with permission. Copyright 2000 The Orlando Sentinel. All rights reserved.


OPED
Not treating mental illness is dangerous and deadly

By E. Fuller Torrey and Mary T. Zdanowicz

Sept. 6: Steven Wesley Robison was arrested and charged after his mother was gunned down and stepfather critically injured. Earlier that day, Robison bought a .22-caliber rifle used in the attacks.

Oct. 17: Kevin Thompson committed suicide with a handgun after a six-hour standoff at a mall.

These two tragic figures linked in headlines from Melbourne during the past month share a common legacy: untreated severe mental illness. Their families repeatedly tried to get help for them but were met with bureaucratic red tape from state health and law-enforcement officials who said nothing could be done unless there was evidence of danger.

These men symbolize Florida's need for stronger and more humane mental-illness treatment laws and the vulnerability and volatility that sometimes accompany untreated schizophrenia and manic-depressive illness, the two severest forms of mental illness.

Tragically, the state's Baker Act, which governs when a mentally ill individual will receive treatment, insists that a person demonstrate dangerousness to self or others before lifesaving treatment can be administered.

Florida's Baker Act has forced Florida's mentally ill to live on the outer edges of society, becoming nothing more than castaways left to fend for themselves in heavy psychosis on city streets and in jails and prisons.

Although the stories of these individuals are not unique, they are preventable.

Robison and Thompson are the most recent examples of the grim outcomes that can occur with untreated mental illness.

It seems clear that both of these men were severely psychotic.

Robison's mother died in a neighbor's back yard from hollow-point bullets shot through her back. What is most heart-breaking is that she called police just hours before the shooting, asking law enforcement to have her son committed under the Baker Act.

Police didn't believe that Robison was a danger to himself or anyone else.

Thompson's battle with mental illness ended with a bullet to his head after his standoff with police.

The brutality of untreated brain diseases is evident by one man who is charged with taking the lives of others and another man taking his own. Waiting for danger before intervention has had dire and expensive consequences for Florida:

� More than 15,000 Floridians with untreated mental illness are homeless.

� About 16 percent of state jail and prison inmates, roughly 16,000 people, are severely mentally ill.

� People with untreated severe mental illness are nearly three times more likely to be a victim of a violent crime.

� Ten to 15 times more suicides occur among those people with untreated, severe mental illness.

� More than 1,000 homicides in the United States are committed each year by people who have untreated mental illness.

These statistics can be attributed to the insidious nature of these illnesses.

Half of those suffering from schizophrenia and bipolar disorder don't realize that they are sick and in need of treatment because of a biologically based symptom, anosognosia. These individuals don't realize that the hallucinations, delusions, paranoia and withdrawal they're experiencing are symptoms. Because they don't know that they are sick, they refuse treatment.

Florida's assisted-treatment standard should be based on the need for medical care not dangerousness. Society should save people from degradation not just death.

Unfortunately, when people refuse treatment because of the effects of mental illness, Florida law forbids caring for them until it is too late.

In other words, an individual must have a finger on the trigger of a gun before medical intervention will be permitted.

Many states have abandoned the dangerousness standard that Florida still maintains. These states consider mental deterioration, being unaware of the need for treatment and having a history of medication noncompliance or violence, and they understand that the mentally ill are no more predisposed to violence than the general population when they are on the proper medications.

Today, 41 states have laws that allow for some form of assisted outpatient treatment to improve substantially the lives of those suffering from severe mental illness.

Studies have repeatedly shown that assisted treatment laws are effective in ensuring treatment compliance.

When will Florida legislators realize that being psychotic is mindless and deadly?


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