AIR MARSHAL SHOOTING IS SAD BUT NOT SURPRISING
People with mental illnesses like Rigoberto Alpizar nearly 4 times more likely to be killed in altercations with law enforcement than the general public

Arlington, VA – Rigoberto Alpizar’s death is making headlines because he was the first person killed by federal air marshals after September 11.

But tragic encounters between the mentally ill and law enforcement are most often the result of an old mental health treatment system than new security measures.

A combination of deinstitutionalization and poor treatment laws have left too many people with severe mental illnesses like schizophrenia and bipolar disorder without support. Unable to get the treatment they need, they instead deteriorate until someone – often a family member – ends up having to call 911.

Across the country, law enforcement officers – police, sheriffs, corrections officials, and now air marshals – are increasingly being forced by a weak system to become front-line mental health workers.

• Newspapers across the nation reported at least 50 deaths of people with severe mental illnesses in encounters with law enforcement in 2004.
• In 1976, the New York City Police Department took approximately 1,000 "emotionally disturbed persons" to hospitals for psychiatric evaluation. By 1998, this number had increased to 24,787.
• Florida law officers alone initiate nearly 100 Baker Act psychiatric examination cases each day – 40 percent more than burglary arrests.

In responding to the news of Rigoberto Alpizar’s death, the chairman of the House Aviation Subcommittee said: "The system worked exactly as designed."

Although he meant the homeland security system, that statement is also true about the mental health system.

The system is designed to require failure before someone can get help. In more than half of the states, someone must be “dangerous” before the courts can intervene to order them to get treatment.

The system is designed to protect a fuzzy notion of liberty while trampling upon real rights. Commitment laws have been stripped of all reason, refusing to acknowledge that nearly half of those who are refusing medication actually are unable to see that they are ill. The vast majority of those who received court ordered outpatient treatment in New York, for instance, retrospectively endorsed the value of the order in helping them get their lives back.

The system is designed to treat people only after it is too late. Ironically, if Alpizar had been captured instead of killed, he likely would have received the medication he needed from a jail cell. Our country has no trouble treating people from behind bars to ensure they can be tried and convicted – we just seem to have trouble helping them get the treatment they need to allow them to peaceably live out their lives.

Air marshals have a job to do, as do police officers and sheriff’s deputies. For the latter, much time is now spent intervening with homeless people who are delusional, transporting people with severe mental illnesses who need emergency evaluations to the hospital, and managing domestic disturbances, incidents of violence, and threats of suicide.

It is time to literally stop the madness.

People with severe mental illnesses who are taking medication are no more likely to be dangerous than the general population. But when they are not taking medication, that is no longer true. That means that these encounters are dangerous not only for the people who are ill, but also for officers – compared with the rest of the population, people with mental illnesses, usually off their medication, killed law enforcement officers at a rate 5.5 times greater.

Refusing to help people who are too ill to help themselves is not compassionate – it is deadly and short sighted.

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The Treatment Advocacy Center (www.treatmentadvocacycenter.org) is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

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