In California, it is playing out with relentless familiarity: the death of Kelly Thomas at the hands of Fullerton police has led to the usual criticisms of the police and calls for better training and more compassion.
But Carla Jacobs, founder of the California Treatment Advocacy Coalition founder, and California's most astute mental illness advocate, notes in an interview that while police could always use better training in how to handle dangerous mentally ill individuals, the police are not always the villains: "When it comes to treating people with the most serious mental illnesses, the police will react where California's mental health system won't. Police are almost never out on a call regarding mental illness unless one condition is met: the mentally ill person has been abandoned by the mental health system. That's when they deteriorate, become psychotic, delusional and dangerous."
That happens too often. Ms. Jacobs remembers when mentally ill Edward Charles Allaway killed seven individuals on the Fullerton campus of California. "It was police who tracked him down." Ms. Jacobs' own sister-in-law was abandoned by the mental health system and shot her mother. Again: the police stepped in.
As Randall Hagar, Director of Government Affairs for the California Psychiatric Association who has been a relentless advocate for better care for the most seriously ill observed, "About 50% of people with schizophrenia suffer from anosognosia, the inability to recognize they are ill because the illness eliminates the capacity of the brain to exercise insight. Medications can provide the type of symptom reduction that can prevent violence."
California's mental health system needlessly and intentionally created their own horrific and violent catch-22: it refuses to provide any treatment unless the mentally ill person is well enough to recognize their need for it. All others are turned over to the police. And even their hands are tied until after the individual becomes danger to self or others. Mr. Thomas's family made multiple attempts to get California's mental health system to help Kelly. On the KFI John and Ken show, Kelly Thomas's sister said, "We tried everything... I feel it is the law that has kept us from keeping him in a place on his medication and healthy." The system refused to budge.
Law enforcement is desperate to return treatment of the seriously ill to the mental health system. Untreated seriously mentally ill not only put the public at risk, they put officers at risk. Michael Biassotti, Vice President of the NYS Chiefs of Police wrote movingly on police and mentally ill after an incident in NYS:
The last thing any police officer wants to do is pull out a gun. It's a sign that something has gone terribly wrong. But increasingly officers are being forced to pull out their guns, and often it's to protect the public from someone with untreated mental illness.
Chief Biasotti believes a big part of the solution is returning treatment of the mentally ill to the mental health system through greater use of Assisted Outpatient Treatment ("Laura's Law" in California). The National Sheriff's Association agrees.
Laura's Law allows courts to order certain individuals who are too ill to recognize their need for treatment to accept treatment as a condition of living in the community. It returns care of the mentally ill to the mental health system. Research in Nevada County, the one California County to implement this optional law shows it works and saves money.
Californians should stop blaming law enforcement for the failure of the mental health system. Put the blame where it really belongs: on a mental health system that refuses to focus its resources on treating the most seriously mentally ill.
The mechanism -- Laura's Law, and the funding, Prop 63 is available. What's lacking is leadership.
Follow DJ Jaffe on Twitter: www.twitter.com/MentalIllPolicy
The reason that many do not come forward to treatment is the stigma (instant and without remorse)
loss of civil rights, danger of being killed by police, forced to take powerful dangerous chemicals based on the "opinion" of another human being?
But beyond that, I am disturbed by your tendency to characterize yourself as an "advocate" for persons with mental illness/health conditions. I am proud to say I am one myself, and I fight a constant battle against stigma (discrimination is a much better word).
What other population, in today's society, lacks so many basic civil rights - who can be victims of violence, forced 'treatment' with powerful and dangerous medications and physical violence, poverty, homelessness...the list goes on and on, yet you're out there constantly harping on the few (no more than any other population) that commit acts of violence (in this case, was a victim, which is more common to us).
What was it that Kelly Thomas did to make him more likely to be beaten to death than anyone else who might have been in that place at that time? If the person beaten to death by these policemen had been someone who was homeless due solely to poverty, you wouldn't have written about it at all. The place where the blame "really belongs", Mr. Jaffe, is with the policemen who brutally beat this man to death, not with the mental health system or with anyone or anything else. Using this murder to argue for laws further restricting the right to refuse psychiatric treatment is like using a brutal rape to argue for laws restricting what kind of clothing people can wear in public.
There are so many new ideas out there that are PROVEN to work, to save money, and reduce violence. But the drug companies, hospitals and their lobbyists, the media, won't give these ideas the time of day. It's all about medication, control, force, violence. If some of these new ideas were given more consideration (i.e., peer-run services, mobile respite, WRAP Planning, empowerment of peers, better employment prospects), the "need" for the badly broken system to become even more draconian will shrink, probably dramatically. I'm fighting for basic rights for people in hospitals in my State, despite the fact that it was mandated by a law passed 13 years ago. That's disrespect - no, it's a civil rights violation. But I don't suppose you're interested in that; AOT will send more people to hospitals to face further violence, coercion, and chemical cocktails.
And by the way, as someone who takes medication, I have nothing but praise for Robert Whitaker. Whether or not I agree with him, it is clear that he does top-notch research and raises questions that are profoundly important to society. That's why the medical establishment is working so hard to shut him up!
I also note (with admiration) that Kelly's father Ron Thomas (who knows about both sides from being the father of someone with mental illness and a former Law Enforcement Officer) has endorsed implementation of Laura's Law
http://psychrights.org/research/Digest/Effective/OpenDialogue2yfollowupehss0204.pdf
Maybe with the right approach this person would have been at work rather than presumably in a constant fear of the world and maybe of his treating psyciatrist. And these sort of tradgedies would be much rarer than they already are. The 'mentally ill' do not pose a danger to society particularly and anyhow no one is in a postion to predict such occurences. Please promote more humane treament for persons with extreme states of mind, they will benefit by being included in society and society will be the better for it. Face your fears and you may find you have nothing to fear....
The Open Dialogue approach is based on giving people the opportunity to retreive their liberty from the mental prison of 'mental illness'. It involves bringing all interested parties together to discover what the real problems are. This approach uses medication appropriately. It is not a no medicine approach. Mostly they don't have to use medicine and when they do its time limited mostly. The service works effectively unlike the standard medical model. The latest study, a meta-analysis on the effectiveness of anti-psychotics show modest gains. The authors said "Our findings show improvements of limited clinical relevance."
http://bjp.rcpsych.org/content/198/5/341.abstract?sid=1e1d2c4f-dd01-48df8525-c25bd0ad8b6f