State Journal-Register editorial: Flexibility, Funding are Key, 5 5 02

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The State Journal-Register (Springfield, Illinois)

May 5, 2002

EDITORIAL
Our opinion: Flexibility, funding are key

"It should not take another Kendra Webdale or Andrew Sallenger for Illinois to begin serious reform of its mental health system .... It is clear that if we don't pay for proper treatment, we will still pay as much or more for prisons, mental health centers, and in cases such as Sallenger's, avoidable lawsuits."

LAST WEEK, 35-year-old Andrew Sallenger had a psychotic episode at his Springfield home. Police were called and had to restrain him. He stopped breathing during the ensuing struggle and died on Wednesday.

We don't know all of the facts surrounding Sallenger's death. We do know that he had a long history of mental health problems and, according to his family, had not been on his medication for two years. In 1996, Sallenger held his family at gunpoint for several hours. However, in the end, it was Sallenger who died, at least in part, due to his untreated mental illness.

Much more often than a scuffle with police, suicide is the end result of a mental illness. And in relatively rare occasions, the mentally ill person turns their irrationality and violent tendencies toward others.

ADVANCEMENT in drug therapy and other treatments have the potential to greatly reduce the tragic loss of life from mental illness, not to mention drug addiction, alcoholism or homelessness.

But in order for new therapies to work, the mentally ill need access to them. Sometimes that means others must provide that access without the consent of the person needing treatment. Civil libertarians are justifiably leery of making involuntary treatment and commitment laws too lax, but in Illinois a strong argument can be made that such laws are too restrictive, discouraging or even blocking access to treatment.

JOHN STANLEY, 36, serves today as the assistant director of the Treatment Advocacy Center in Arlington, Va., a nonprofit group dedicated to removing legal barriers to mental health treatment. However, 17 years ago, diagnosed as bipolar with psychotic tendencies, Stanley ended up naked in a Manhattan deli convinced death rays were being aimed at him from across the street.

At the apex of his illness, Stanley, like most with severe mental illness, had no idea he was sick or needed treatment. In part due to his own experiences, Stanley, an attorney, is convinced laws need to be flexible enough to get mental health treatment to those who need it.

"We are talking about overriding civil rights here, no question. But in my mind, civil rights are mostly focused on preserving and safeguarding an individual's right to choose to do what they feel is best for them. When they lose the ability to make that choice, the civil rights are hollow," said Stanley.

In the case of a person with a head injury, or with Alzheimer's disease or a severe developmental disability, others are able to make decisions concerning medical treatment because the person is considered "incapable of making an informed medical decision."

"It's the standard we use in every situation in our society when somebody's mental capacities are so impaired they can't make decisions rationally - every situation except for mental illness," said Stanley.

IN ILLINOIS the legal bar is set very high to get a court order for involuntary outpatient treatment or commitment to a mental health center. The court must find that a person is "expected to inflict serious physical harm upon himself or herself or another in the near future" or is "unable to provide for his basic physical needs so as to guard himself or herself from serious harm." By the time this standard is met, a tragedy has often already occurred.

In late 1999, New York reformed its mental health laws to make it easier to get assisted outpatient treatment for those with mental illness. "Kendra's Law" came about after a mentally ill man who was not being medicated pushed 32-year-old Kendra Webdale to her death in front of a New York City subway train.

It should not take another Kendra Webdale or Andrew Sallenger for Illinois to begin serious reform of its mental health system. Easing restrictions on involuntary treatment and commitment will not be enough. More funding is also needed, though the current budget actually cuts $19.5 million from community treatment programs. It is clear that if we don't pay for proper treatment, we will still pay as much or more for prisons, mental health centers, and in cases such as Sallenger's, avoidable lawsuits.