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Hartford Courant

November 2, 2001

Reprinted with permission. Copyright 2001 Hartford Courant. All rights reserved.

OPED
Lacking Reason, Options, Action - Connecticut's Laws Claim Another Life

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

Debbie Hall's family suffered a double tragedy recently.

Debbie was killed in September and her son, Aaron Azeredo, was arrested. He is accused of stabbing her to death.

The family's unimaginable grief and sadness, anger and frustration, are all the worse because Debbie Hall's death was completely preventable. There were myriad times that the train of events culminating in her death could have been diverted. But too many things were lacking.

A lack of reason

Aaron Azeredo has schizophrenia. His mother had tried repeatedly over the years to get appropriate and consistent treatment for his mental illness, attempting to place him in an inpatient mental health facility. Over and over, say family members, she was told that nothing could be done because he was not considered dangerous

Connecticut law prohibits mental health professionals from intervening unless someone can be proven to be a danger to himself or herself or to others.

Azeredo had past assault and drug convictions. He was released from prison on Sept. 14 after serving time for assaulting an officer. He checked himself out of an emergency room just hours before his mother was slain. There was much in his history to warrant concern.

But Connecticut does not allow courts to consider past psychiatric history and deteriorating symptoms. Being sick and irrational is not enough. In this case, his lack of reason may have made Azeredo homicidal before anyone could intervene.

A lack of options

Studies have shown that approximately half of all patients with schizophrenia and bipolar disorder, the two most severe forms of mental illness, have markedly impaired awareness of their illness. Such individuals often refuse to take medication because they are incapable of knowing that they are sick.

Many people with these diseases who do not believe that they are sick will take medication only under some form of assisted treatment. Forty-one states allow assisted outpatient treatment - court-ordered treatment in the community.

Connecticut is one of only nine states that does not permit the use of this valuable treatment mechanism.

Patients are often not hospitalized long enough to stabilize and are then returned to the community unmonitored. For many, this creates a cycle of repeated hospitalizations and incarcerations.

In study after study, assisted outpatient treatment has been proven to put an end to this cycle for many. The most comprehensive study demonstrated that long-term assisted outpatient treatment reduced the risk of arrest by 74 percent for a subgroup of those with a history of multiple hospitalizations as well as prior arrests or violent behavior. It also reduced the probability of violence by 50 percent and hospital admissions by up to 72 percent.

A lack of action

Connecticut had a chance to make a difference.

Flash back to June 25, 1999, in Bristol. The Rev. Robert J. Lysz is bludgeoned to death with a candlestick in St. Matthews Church. Michael L. Ouellette, a man with a history of mental illness, is charged with Lysz's murder. Ouellette, diagnosed with bipolar disorder, would act irrationally when he failed to take his medication, according to his family. He had a past history of violence, including stabbing a 17-year-old girl, but his family had been unable to get him to accept consistent treatment. Held in jail immediately after the killing, Ouellette injured two corrections officers in a struggle.

After the Rev. Lysz's death, Connecticut law was changed to allow the state to monitor those diagnosed with some mental illnesses to ensure they are taking their medication, but only if they agreed.

Without addressing the option of assisted outpatient treatment or the faulty dangerousness standard, the so-called Father Lysz Law did not accomplish its admirable goal of making sure that nothing like this ever happens again.

Aaron Azeredo's mother sent him to the emergency room the evening before she was killed. But the law permitted Azeredo to check himself out before doctors could evaluate him.

Father Lysz and Debbie Hall deserve the legacy of an effective change in Connecticut's law - one that would allow consistent community treatment of mental illness by court order when necessary, and one that would have prevented Aaron Azeredo from deteriorating to the point of dangerousness.

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

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