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COVER STORY:
Treating the Mentally Ill
May 4, 2001    Episode no. 436
Read This Week's November 7, 2008
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LUCKY SEVERSON: This is a retreat near Knoxville, Tennessee.

Once a meeting place for the civil rights movement, this day, it is the site of a conference of people claiming another right. A controversial one -- the right, they say, of the mentally ill not to be forced to have treatment.

DAVID OAKS (Former Patient): For several hundred years, mental patients have been killed, oppressed, locked up, lobotomized. It's only been in the last 30 years that psychiatric survivors themselves have been organizing, fighting back.

Leonard Roy FrankLEONARD ROY FRANK (Former Patient): Today, we have persecution of mental patients. In the Middle Ages, there was an inquisition that persecuted witches.

SEVERSON: They call themselves "psychiatric survivors." Most have been diagnosed as paranoid schizophrenic, or manic depressive.

They're here to fight against a wave of new laws that can force the mentally ill to get treatment in their homes and neighborhoods, whether they want it or not.

A lot of these new laws are fashioned after one in New York called Kendra's Law. Kendra Webdale was killed in January 1999 when she was pushed in front of a subway by a mentally ill man named Andrew Goldstein. He was not taking his medication at the time. Hence, Kendra's Law.

Before Kendra's Law, states could hospitalize people whose actions showed they were a danger to themselves or others. The new laws say the mentally ill can be forced to get treatment in their communities if doctors think they might become dangerous.

MR. OAKS: Where you are on the forced drugging issue depends which side of the needle you're on and we've been on the sharp end of the needle

SEVERSON: Darcy Gruttadaro is an attorney at the National Alliance of the Mentally Ill. NAMI, as it's known, is a voice for families of the mentally ill.

DARCY GRUTTADARO (National Alliance of the Mentally Ill): We're talking about individuals who have not, who are not interested in voluntary treatment. They've refused over a period of time to participate. They are showing signs that they are deteriorating.

SEVERSON: Dr. E. Fuller Torrey helped write Kendra's Law. He is a psychiatrist who studies human brains for signs of schizophrenia and head of the treatment advocacy center in Arlington, Virginia. But he is not held in high regard by the people who consider themselves survivors.

Survivor's Group(to Dr. Torrey): I met a few days ago outside of Knoxville with a number of former mental patients -- they call themselves survivors. They have become activists, and for them, you are not the most popular person around.

DR. E. FULLER TORREY (Treatment Advocacy Center): Oh, I think that's being very kind actually. I'm very aware of that.

SEVERSON: Dr. Torrey thinks Kendra's Law is long overdue, that society needs to be protected from violent mental patients.

DR. TORREY: There's absolutely no question that people with severe mental illnesses who are not on medication, I emphasize, not on medication, are more dangerous than the general population.

Until we treat people who need to be treated, we're going to continue to have these acts of violence, like Andrew Goldstein -- like the fellow that came in and shot up the Capitol.

SEVERSON: But critics, like Sally Zinman, an activist for the mentally ill, charge that Dr. Torrey is perpetrating a myth. More fiction than fact, according to a recent University of Virginia study.

SALLY ZINMAN (Activist): All the research that has been done says that people with mental disabilities, psychiatric disabilities, mental illness, are no more violent than the general population, the latest research says, with the exception of when you start mixing in drugs and alcohol.

SEVERSON: No one ever accused Judy Koczar of being a danger to society, but she's forced to take medication and attend counseling under Kendra's Law. Judy was sexually abused by a family member. She's dangerous, but only to herself. She says cutting or burning herself used to be the only way she could express her feelings.

Judy KoczarJUDY KOCZAR: In a way, they did push me in the right direction. But I wasn't a violent person and that's what Kendra's Law was for. And that's not who I am. I would never hurt anybody else. It scares people into treatment and you're talking about mental health recipients and I don't think that they should be scared. You shouldn't treat people like that.

SEVERSON: She says if good treatment was available, mentally ill people would seek it, voluntarily. And she is not alone.

MS. ZINMAN: You wouldn't have these struggles if you gave them what they want. People don't go to a restaurant with bad food or food that's going to kill them or poison but if you give them good food they're going to go.

SEVERSON (to Dr. Torrey): Andrew Goldstein, the fellow who pushed Kendra onto the subway tracks, in fact, he had been seeking help?

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DR. TORREY: Andrew Goldstein did not stay on his medication and if Andrew Goldstein had been in an outpatient commitment. He would not have done what he had done.

SEVERSON: Dr. Torrey says there are too many Andrew Goldsteins out there who won't ask for treatment because 40 to 50 percent of the severely mentally ill don't realize they're ill.

DR. TORREY: It's inhumane, it's unethical to leave people who don't know that they're sick on the streets, in jail, 28 percent getting food out of garbage cans, for example. This simply is not humane. It's not ethical. It's not part of a civilized society.

Sally ZinmanMS. ZINMAN: The fact is, the overwhelming majority wanted services. You don't get it when you want it. There's no services available. They are not there. Zilch.

DR. TORREY: You can have the nicest services that you can imagine. You can set them up in the Hilton Hotel lobby and give free coffee and cigarettes and everything else and they will come and get your free coffee but they won't take medication because there is nothing wrong with them because the CIA implanted those computer chips in their brain that's causing their voices.

SEVERSON: Judy Koczar attempted suicide last Christmas. She has manic depression and borderline personality disorder. But she knows she's ill.

MS. KOCZAR: I take care of myself and if I need help I know it. When I've been that desperate I've called and tried to get help or told them I'm not feeling well; [that] I need this [and] I am taking care of myself.

U.S. MapSEVERSON: Thirty-seven states have now approved legislation similar to Kendra's Law.

The survivors are angry because they think Kendra's Law violates their basic human rights.

MS. ZINMAN: When you think about freedom -- that's all people want is freedom, and our country is based on freedom. When I walk around the United States and you see all these symbols for freedom and I was looking at a coin -- it says liberty on all the coins and that's all we want.

MS. GRUTTADARO: Nobody likes the idea of involuntary commitment -- not family members, not consumers, nobody likes it. But in some cases, it's necessary.

SEVERSON: They say there is also the stigma that goes with the label.

MR. FRANK: Generally, people who get diagnosed as mentally ill are amongst the most powerless and the most disliked, and the group that is held in the most contempt by the large majority of people in our culture.

SEVERSON: And, the survivors argue, if treatment is forced, it's not treatment.

GROUP OF PATIENTS: If it's involuntary it's not treatment. It's torture. Involuntary treatment is punishment; simple as that.

SEVERSON: The family organization agrees.

MS. GRUTTADARO: The most effective treatment is when a person wants to participate and is a willing partner in that participation.

SEVERSON: They believe treatment should be forced only after attempts to get patients in voluntary treatment have failed.

MS. GRUTTADARO: We don't see it as an either/or proposition. We think that it's very possible to have outpatient commitment laws in those, as a last resort, in those very few cases that it's necessary and that can exist with individual rights and due process rights protected.

SEVERSON: And Fuller Torrey cautions that the new laws should apply only to a subset of the mentally ill.

DR. TORREY: For anyone who is aware of their illness, who has insight into their illness, unless they have dangerousness, I would not advocate involuntary treatment.

SEVERSON: Perhaps some of the answer lies in more and better treatment services in the community.

MS. GRUTTADARO: What we need to do is invest in community care. That is really the issue.

SEVERSON: For whatever reason, whether these voices aren't being heard or whether America just isn't convinced, there seems to be no backing away from forced treatment of the mentally ill.

For RELIGION & ETHICS NEWSWEEKLY, I'm Lucky Severson.

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