By E. Fuller Torrey. While it is true that many people used to be locked up in mental hospitals that didn’t belong there, and deinstitutionalization freed a number of people who weren’t sick, the opposite extreme, of no one locked up until after they have committed a violent crime, leaves a number of problems unsolved. If you have a brain disorder that causes you to *not know* you have a brain disorder, should your right to refuse treatment be respected?
The author makes the point that while most persons with mental illness are harmless, aware that they are ill, and want to recover if possible or control their symptoms at the least, there is a small fraction of the population that is really dangerous and/or endangered. Not only do some brain-disordered people assault others, they may also become victims of violent crimes. What you have are families with a member who is ill and unable to manage their need for safety. You have sufferers threatening and killing their families. You have family members who endure threats until they can’t stand it anymore, and kill the sufferer. You have sufferers who are not able to defend themselves from muggings and sexual assault. You have families who would gladly pay for inpatient treatment programs, but who cannot compel their loved one to participate.
The question is, how to persuade or coerce patients into accepting treatment who unaware of their illness and currently have the right to refuse? The author presents some examples of programs that are reducing violence and victimization. One appoints, not a conservator, but a paymaster who withholds government benefits from the patient if he does not comply with court-ordered treatment. Another offers better housing benefits for compliance.
I am glad to know there are alternatives to a return to large mental hospitals and widespread involuntary commitment. But we are going to need a lot more to really serve the needs of families with a mentally ill member.
