As an addendum to yesterday’s post on Laura’s Law, here’s another not so positive view of mandatory treatment for the mentally ill. Courtesy the Anderson Valley Advertiser.
Laura’s Law & Chemical Lobotomies
by Roanne Withers
It’s extremely unlikely that having a Laura’s Law mental health program in Mendocino County would have prevented the shockingly tragic murders of Fort Bragg City Council member Jere Melo and the Mendocino Land Trust’s Matthew Coleman. Purportedly their assailant, Aaron Bassler, was afflicted with some form of serious mental illness, possibly schizophrenia. Nor would Laura’s Law have forced Mendocino County Mental Health to engage with James Bassler, Aaron’s father, and address parental worries about a 35 year-old son’s mental decline.
If Aaron Bassler actually qualified (and that’s a huge maybe), and if he was a willing client of a county’s Laura’s Law program and taking anti-psychotic medication, he probably would not have been not been able to murder Coleman or Melo. The medications used to treat serious mental illness range from helpful to causing a chemically induced lobotomy (sometimes permanently). However, nothing in Laura’s Law allows anyone to force an individual to take psychotropic medication. A mentally ill man could skip his weekly Haldol shot appointment and head for his gun stash in the woods lickety-split.
But politicians needing to do something, anything to assure their voters that they will protect the public from rampaging madmen are easy marks for the Laura’s Law ruse. The grief-torn families of victims and delusional murderers alike are also easy targets.
Laura’s Law was conceived and initially authored by New York psychiatrist E. Fuller Torrey who advances his forced medication agenda through his Treatment Advocacy Center website and through his powerful and widespread non-profit organization, National Alliance of Mentally Ill (NAMI), a support entity for family members of the mentally ill. Much like his first success, New York’s Kendra’s Law, Dr. Torrey seeks to manipulate voters’ and legislators’ emotions by having the legislation named after a person, preferably a young woman, who has been horribly murdered by a mentally ill man who refused to take psychotropic medication. Who wouldn’t want to protect young women from horrible deaths at the hands of crazed ghouls?
The use of villainized photos like the ones of Aaron Bassler published in newspapers and internet sites around the globe are part of Torrey’s campaign package. Torrey also inflates murder statistics and exaggerates the danger posed by those suffering with serious mental illness. Though discredited in most rational circles, Torrey’s PR machine is sophisticated, his following very large, and his tactics very effective. He even admits to sensationalizing violent and tragic events involving the mentally ill as a technique for moving the public and legislators to support his agenda. Recent scientific review shows that the public’s perception of criminally violent mentally ill offenders is greatly exaggerated thanks to Torrey.
In reality, the chances of anyone being murdered by someone with schizophrenia are about one in 14 million. You have a much better chance of being killed in a car accident or struck by lightning. And the murder rate is actually the same for someone with or without a psychotic disorder. (Its recent editorials advocating for Laura’s Law, the wine industry-biased Santa Rosa Press Democrat couldn’t be expected to note that the murder rate is much higher for people under the influence of alcohol.)
Most states have some form of law on the books that allows for forced medications. These laws are rarely invoked for reasons having to do with effectiveness and ethics. State budget cuts eliminated the Mentally Ill Offender Crime Reduction (MIOCR) program, but CONREP, the state prison conditional release program for mentally ill offenders, has a forced medication component.
In California, Laura’s Law allows for county boards of supervisors to permit county mental departments to set up so-called assisted outpatient mental health treatment demonstration programs or AOTs. Assisted is a euphemism for “court ordered” and demonstration means “highly experimental.” Since its enactment in 2003, only one county in California has implemented the law — Nevada County, where the law’s namesake, Laura Wilcox, was murdered by a mentally ill man. (There is also a tiny, temporary experimental AOT program in Los Angeles County.)
So far, every county in California that has undertaken serious review of Laura’s Law and its mental health program has backed away. Laura’s Law is scheduled to sunset (go away or morph into something else) in 2013. Dr. Torrey and his legion of NAMI supporters are working to have it evolve into a forced medication program virtually erasing many of the civil liberty protections achieved by mental health clients over the last 40 years.
The California Mental Health Directors’ Association, which advises its 58 county mental health directors who, in turn, advise county boards of supervisors, diplomatically detests Laura’s Law. The law mandates a treatment program with a nightmare of contradictory mandates, vague direction and impractical details absent a funding source. The Rand Corporation’s 2002 review of every known program and scientific study nationwide couldn’t advise the state legislature one way or the other if obtaining a court order for a mentally ill person to take his or her psychotropic medications was worth the considerable expense a county would have to assume to obtain the order.
More recently, the science tells the California Mental Health Directors’ Association that the results of court ordered medication and treatment are exactly the same as that of voluntary services which cost far less. Additionally, county mental health directors are advised that (after reviewing limited short-term trial programs in LA and Nevada county), “there is little evidence to date with which to judge its effectiveness in California.”
The San Francisco Board of Supervisors recently backpedaled on its intention to implement Laura’s Law once they were fully informed of the myriad of problems with the law. San Francisco’s mental health director concluded that forcing psychotropic medications on targeted clients suffering from severe psychotic disorders would help these particular clients while noting that Laura’s Law doesn’t allow compulsion. It only gives the “black robe effect” (e.g., the symbolic power of the court and the seriousness of the need to comply with a court order to comply with treatment). San Francisco’s mental health director also pointed out the hidden court and legal costs of Laura’s Law and that the county “already has proven alternatives in place…”
Mendocino County has almost the same programs and faces the same costs as San Francisco, albeit on a much smaller scale. Bad law does not a good mental health program make. But NAMI members act like Dr. Torrey’s flying monkeys whenever there is an atrocity-opportunity to advance his cause. Their devotion has been cult-like for the nation’s leading proponent for forced mental health medication and treatment. However, this relationship is about to change. In 1999, with President Bush’s Surgeon General Report on Mental Health, it was abundantly clear that the science no longer supported Torrey’s particular “pharmaceutical model” of mental health treatment.
Until the early ‘80s or so, it was mental health’s assumption that a nutty mother was the cause of her child’s schizophrenia (similar to the previously unquestioned belief that the “refrigerator mother personality” caused a child to become autistic). Dr. Torrey, one of the country’s leading psychiatrists specializing in the treatment of people with schizophrenia, was at the forefront in dispelling these fallacies. He breathed organizational fire and life into NAMI, then a wisp of a national support organization for the families of those with serious mental illness.
Dr. Torrey is a hero to many families and god to some of the mothers who had their lives ruined or nearly ruined with psychiatry’s erroneous accusation that they were the cause of their adult child’s suffering. Dr. Torrey and NAMI proceeded to revolutionize mental health care in America.
According to investigative journalist Robert Whitaker in his 2002 multi-award winning book, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, “Their message was simple: Schizophrenia, bipolar disorder, and other serious mental illnesses are biological disorders, caused by abnormal chemistry in the brain, and medications help normalize that chemistry.” Torrey and NAMI were, however, very successful in marketing their message. As NAMI’s membership grew in the mid-1980?s the pharmaceutical companies that manufactured the medications started making billions of dollars.
Dr. Torrey introduced these pharmaceutical companies to NAMI and with the huge organizational funding that followed, NAMI became the largest and single most effective mental illness advocacy organization in the nation. Today, every state has a NAMI state organization, and 1200 counties, boroughs and parishes have a NAMI chapter. According to a US Senate investigation initiated by Whitaker’s Mad in America revelations, between 2005 and 2009, NAMI received 56% of its funding from psychotropic medication manufacturers.
In the last couple of years, this Big Pharma funding has become a significant battle between Torrey, NAMI members and the federal government’s mental health program funder, the Substance Abuse and Mental Health Services Administration (SAMHSA). With members (who were not aware of the funding source) in an uproar, NAMI is currently attempting to distance itself from its pharmaceutical company funding and replace it with SAMHSA funding. SAMHSA is not inclined to fund NAMI as long as it supports Torrey’s forced treatment agenda. Dr. Torrey is very unhappy.
By-and-large, NAMI’s education programs are outstanding. For anyone who has a family member with serious mental illness, the 16-week free Family-to-Family class is the single most comprehensive education and training available in the nation. But NAMI’s fanatical reliance on anti-psychotic medications as the only or the primary answer for symptom management is not only antiquated, it’s downright harmful.
This is not to say that such medications can’t be very helpful for some people. But medications are only as helpful as the level of skill and time involved by the prescribing psychiatrist, the availability of well-trained rehabilitation therapists and community support programs, the grounded support from family or friends, and the ability of the mentally ill person to take responsibility for his or her health.
Mendocino County, like many other counties in California, has a ghost ship of a mental health care system due to the downturn in the economy. But even when the economy was good, Mendocino County never did contribute general fund dollars to it mental health system. Most counties subsidize their systems to draw down more federal and state Medicaid dollars in order to be able to provide needed services. Mendocino County simply does without.
It’s true that there is a devastating lack of mental health services here and elsewhere. But the beleaguered system does work when it is properly funded. But asking that it be dismantled for most clients in order to provide highly expensive forced care to address a one in 14 million chance that it would prevent a murder is…nuts.
Roanne Withers is a member of the California Network of Mental Health Clients, a certified teacher of the NAMI Family-to-Family class, a former senior analyst with Mendocino County Mental Health, and cared for a family member with schizophrenia for 20 years.