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United Press International (UPI)

March 15, 2002

Reprinted with permission. Copyright 2002. All rights reserved.

OPED
Betting on the right horse to save lives

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

"The reality is that advocates must challenge criminal laws ill equipped to deliver justice for people like Andrea Yates who commit crimes while ravaged by a severe mental illness."

Mental health advocates rallied to save Andrea Yates' life, just as they do every time someone with severe mental illness could be sentenced to death for a heinous crime.

This is the mental health community's equivalent of closing the barn door after the horse has escaped. It is too little too late for the thousands of individuals who each year become violent because of untreated mental illnesses.

While the Yates case has captured the nation's attention, it is hardly an exception. Within days of the death of the Yates children, Kristin Anderson's 15-month-old son died of blunt force trauma injuries and stab wounds. Anderson, diagnosed with bipolar disorder, confessed that she twice jumped from a deck carrying her son in her arms, fatally stabbed him, and then burned his body in the backyard of a friend's home because "voices told me to jump off the balcony and follow the light." One month later, Mee Xiong of Minneapolis stabbed two of her children to death. Xiong had a long history of delusions and hallucinations, at least one suicide attempt, multiple hospitalizations, and a few years before had chased her children with a knife.

And just last month in San Francisco, Donna Marie Anderson killed her son to save him from being kidnapped into a non-existent child porn ring. Her family noted for years that she saw conspiracies everywhere as her condition progressively worsened. She still firmly believes she saved her son by stabbing him 15 times.

Attempting to fight the stigma that stems from such cases, the sacred mantra of mental health advocates is that "people with mental illness are no more violent that the general public." But that is only a half-truth. While people who are being treated are no more violent, non-treatment increases the risk of violence substantially.

Friends and families are lulled into a false sense of security, desperately wanting to believe that loved ones transformed by psychosis won't actually obey the voices in their heads. Only this deception can explain Russell Yates' testimony that "[a]t the time, I didn't think she was dangerous, none of us did," despite the fact that one psychiatrist who examined her concluded she was "one of the sickest patients I had ever seen."

There was ample evidence that Andrea was in desperate need of treatment and that her condition had been worsening for years. She had a long history of mental illness, including multiple suicide attempts. Voices had even instructed her to kill her first child. In the months before the tragedy, she stopped washing her hair and bathing. She barely ate or drank. Her best friend said she was virtually comatose, answering her questions with a single word. She paced like a "scared animal."

So why didn't she and thousands of others like her get adequate treatment?

An estimated 4.5 million Americans today suffer from the most severe mental illnesses, schizophrenia and manic-depressive illness. The National Advisory Mental Health Council estimates that 40 percent of these individuals, or 1.8 million people, are not receiving adequate treatment on any given day.

In a recent study, individuals with serious mental illnesses were interviewed to ascertain why they were not receiving treatment. The majority - 55 percent - denied having a problem that required treatment.

That is largely because almost half of those with schizophrenia and manic-depressive illness suffer from a neurological deficit called anosognosia, which impairs their awareness of their illness. Such people can truly believe that God is speaking to them, that the CIA is after them, or that they must kill their children to save them from Satan. They refuse treatment because they don't think there is anything wrong with them, or worse that agents are trying to poison them with the medicine. And in some states, if you refuse treatment - even if that refusal is because of the disease itself -courts cannot intervene unless you are an immediate danger to yourself or others.

If Andrea Yates was so sick, why did it matter if she was dangerous or not? If she was so obviously deteriorating, wasn't there a way to get her some help?

The horse that escaped from the barn is still running. Families have been misled again - they are told that nothing can be done for a loved one who refuses treatment for psychosis until they become dangerous. In most states this is not true - laws have been changed to allow for early treatment intervention, before someone becomes dangerous. The laws in the remaining states can and must be reformed.

The reality is that advocates must challenge criminal laws ill equipped to deliver justice for people like Andrea Yates who commit crimes while ravaged by a severe mental illness. Yet improving the criminal justice system will be a hollow victory if the untreated mentally ill are still condemned to it because advocates avoid the harsh realities of untreated mental illness. We must get the horse back in the barn by ensuring timely and effective treatment for individuals who refuse it because they don't think they are ill.

READ MORE
TAC's statement on the Andrea Yates sentencing | anosognosia | criminalization

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