Hospitalizing the Mentally Ill

There are times when human social systems produce consequences that are so blatantly stupid and yet so all-embraced that one feels instantly weary when asked for constructive comment. An example of such is the subject of Karl Fleming’s excellent article (“The Case for Hospitalizing the Mentally Ill,” Opinion, Nov. 15).

Where people with major mental illnesses are concerned, the important hospitalization aspects of their care have been taken out of the hands of physicians, the only professionals expert in the care and treatment of these illnesses, and placed in the hands of pseudo-omniscient judges and attorneys and those yapping little pests allowed into hospitals to see to it that patients’ rights are protected against the psychiatric bogyman. The law is clear. The responsibility for determining whether a mentally ill person is in need of continued hospital care is given to court commissioners and judges. Any attempt to educate, case by case, by the psychiatrist in, ha, ha, charge, is actively avoided.

The patient, of course, thinks it’s wonderful that that distinguished old symbol of wisdom in the black robe doesn’t think he is ill. Generally, the patient didn’t think so either. So off he goes to the streets where I have seen them, year after year, my old patients, young then, middle-aged now, with hope, then, but none now, filthy, diseased, talking with the voices inside their heads, mentally and physically deteriorated beyond any hope that I had once had for them.

If not for this major example of legislative and interpretive stupidity, every mentally ill person on the streets today could be hospitalized and restored to his maximum mental potential. Then it is up to the community to provide decent living environments that ensure that there is no return to the primitivism so sought after for them by the civil-libertarian crackpots.

The care and treatment of the mentally ill is a medical responsibility, not a legal one.

JOHN A. NILSEN, M.D.

Los Angeles