. . . and Getting Treatment Shouldn’t Be This Hard

Margaret Laverne Mitchell, who was shot to death last Friday after she allegedly lunged at a Los Angeles police officer with a screwdriver, should not have been condemned to a life of homelessness nor should she have died at the hands of an officer ill prepared to deal with her mental illness. As described by her son, Mitchell was victimized both by her illness and by state treatment laws too weak to help her.

Homelessness, violence, incarceration, suicide and victimization are the cruel side effects of the two severest forms of untreated mental illness, schizophrenia and manic depression. Half of those who have these illnesses don’t realize they are sick and in need of treatment, nor do they recognize that their symptoms--hallucinations, delusions, paranoia and withdrawal--are, in fact, symptoms. And since they don’t know they are sick, they don’t take their medications, and this is perfectly acceptable in the eyes of the current law. The law prohibits treating individuals over their objections until they pose a danger to themselves or others. In other words, someone must have a finger on the trigger of a gun or be caught jumping off the Golden Gate Bridge before they get medical help.

Many states have abandoned the dangerousness standard for treatment, which California still maintains. These states consider factors such as mental deterioration, being unaware of a need for treatment and having a history of medication noncompliance or violence. Mitchell’s son tried repeatedly to get help for his mother but met with nothing but brick walls and bureaucratic red tape from state health and law enforcement officials. His mother had not tried to kill anyone, including herself, so their hands were tied.

In California, the 1969 Lanterman-Petris-Short Act, which governs the treatment of the mentally ill, is based on outdated, nonscientific ideas, not on current scientific studies. The fact that under this law, people with severe mental illnesses can be treated involuntarily only under the most extreme circumstances has had, and continues to have, dire consequences for Californians:

* California’s homeless total more than 49,000--one-third of whom are thought to have untreated severe mentall illness. That number is about the same as the population of Davis or San Rafael. This is an urban disaster, especially in cities such as Los Angeles, San Francisco and Santa Monica.

* Approximately 10% of the inmates of California jails and prisons are severely mentally ill. Many were arrested for minor crimes that were the direct consequence of their untreated illness.

* A California study reported that police now spend more time responding to mental health crises than to robbery calls. When police confront severely mentally ill individuals who are out of control, the encounter can turn deadly. Last year, for example, Tom Neville in Fresno, Brian Burgos in Los Angeles, Han Huynh in Ventura and Doron Lifton in San Francisco--all of whom were suffering from mental illness--died in police shootings.

* According to various studies, persons with untreated mental illnesses are 10 to 15 times more likely to commit suicide or die of accidental deaths; almost three times more likely to be the victim of violent crimes and, in the case of severely mentally ill women, two to three times more likely to have been raped.

* Nationally, it has been reported that approximately 1,000 homicides each year are committed by individuals with severe mental illnesses, almost all of whom were not being treated at the time.

In February, California Assemblywoman Helen Thomson (D-Davis) took a step in the right direction by holding a joint Assembly-Senate hearing on the criminalization of the untreated mentally ill. She, like many others around the country, recognizes that mandatory treatment for those too ill to understand their need for treatment is a more humane intervention than what we end up with now: mandatory nontreatment.

The legal standard for assisted treatment should be the person’s need for medical care, not his or her danger to self or others. Society has an obligation to save people from degradation, not just death. This does not mean that we will have to reopen all the psychiatric hospitals that were closed as a result of deinstitutionalization. Most individuals with severe mental illnesses who have experienced serious deterioration in rational thought can live in the community with the proper medications. But, for some, living in the community must be conditioned on medication compliance.

California’s laws miserably failed Margaret Mitchell and her family. Stronger assisted treatment laws would help prevent such tragedies in the future and give every Californian the chance to live a safer and more productive life.