Chicago Tribune editorial: The cost of madness on the streets 6 7 99

The drive during the past two decades to protect the rights of the mentally ill should not become a license to do nothing else. The mentally ill have a right to proper and compassionate medical attention - and the rest of the population has a right to expect that that care will also enhance public safety.

Whether it's the approximately 10,000 seriously mentally ill people who end up at Cook County Jail every year--which in effect has become the largest psychiatric hospital in Chicago--or the thousands of disoriented souls living on the city's streets year-round, all signs point toward a bankrupt, do-little state policy concerning the mentally ill.

In 1996, Illinois adopted a policy of "outpatient commitment" that tried to balance the rights of the mentally ill to independent living with public fears about their moving back into the community. That enlightened policy needs to be strengthened and enforced far more vigorously.

Indeed, the undoing of the well-intentioned deinstitutionalization policies in effect since the 1970s has been that many mentally ill people on their own are too sick or confused to stick to a medication regimen that would allow them to function normally.

The Mental Health Treatment Preference Act sought to have the mentally ill--while medicated and therefore lucid--sign a living will authorizing someone else to make sure they kept taking their medication. This assigned guardian could be a relative or someone at a community mental health center.

Unfortunately, ignorance and loopholes have rendered the law ineffective. According to the Illinois branch of the National Alliance for the Mentally Ill, most judges, who could order outpatient commitment as part of sentencing, do not understand the process or rarely use it.

The other factor is that the mentally ill person has to be sufficiently medicated and coherent in the first place before he can be expected to name a guardian. Otherwise, the only recourse is involuntary commitment until his condition can be stabilized--an alternative that needs to be used far more frequently.

Whether it's outpatient or involuntary commitment, the state must intervene more decisively to protect the mentally ill, and the public from unstable people like Russell Weston Jr., the untreated schizophrenic from Illinois who has been charged with killing two police officers at the U.S. Capitol last summer.

The drive during the past two decades to protect the rights of the mentally ill should not become a license to do nothing else. The mentally ill have a right to proper and compassionate medical attention--and the rest of the population has a right to expect that that care will also enhance public safety.