Team Care for the Mentally Ill

Re “Team Care Is a Better Way for the Mentally Ill,” Commentary, May 21: We echo Tanya Luhrmann’s suggestion that California invest in Program of Assertive Community Treatment. But recommending PACT instead of Assemblywoman Helen Thomson’s Lanterman-Petris-Short Act reform proposal betrays a profound ignorance of the real problem of untreated mental illness. LPS reform will ensure that individuals who would not otherwise participate in PACT treatment get the benefits that Luhrmann lauds. Contrary to Luhrmann’s theory, the man who pushed Kendra Webdale to her death in front of a subway train was a good candidate for outpatient commitment. He was not refused services; his care cost New York and the federal government more than $95,000 in the year before Webdale’s death.

Luhrmann neglects to mention that the most comprehensive study, which Rand recognized as the best available data, found that long-term outpatient commitment significantly reduced hospitalization, violence and arrests. Without Thomson’s reform, people like [Webdale’s killer] Andrew Goldstein will not benefit from PACT and will continue to drain precious resources without achieving the recovery they deserve.

E. Fuller Torrey MD

President

Mary Zdanowicz

Executive Director

Treatment Advocacy Center

Arlington, Va.

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Assembly Bill 1421 provides for the PACT program, which Luhrmann endorses in her commentary, along with an outpatient court order for people with mental illness who are so severely disabled they are unable to care for themselves and, because of the nature of their disorder, are not capable of giving informed consent for treatment.

I know from my own experience of having suffered manic-depressive disorder for over 30 years that I have done enough destructive things as a result of illness to fill a book. Most, if not all, could have been prevented had there been an intervention.

Thomson’s bill gives multiple protections for the civil rights of people who would be mandated treatment. With treatment, people with mental illness can lead productive, meaningful lives. AB 1421 will give them the opportunity to do so.

Katherine Minsk

Los Angeles

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Not only do I agree with Luhrmann’s article, but I wish to inform you of an innovative program providing the mentally ill that type of care in L.A. County. Of the 20,000 persons currently housed in Los Angeles County jails, an estimated 2,500 are diagnosed with mental illness, and close to 80% are homeless and suffer from substance abuse. As part of the CROMIO program (Community Re-Integration of Mentally Ill Offenders), staff from the Department of Mental Health, Probation Department and Sheriff’s Department have joined to provide community-based, intensive intervention services for the mentally ill.

CROMIO clients are offered mental illness diagnosis and treatment, drug/alcohol education and employment assistance. Service providers obtain suitable living arrangements within the community. CROMIO has broken the destructive cycle of homelessness, crime, mental illness and re-incarceration. Its success rate is high, and it continues to improve the quality of life for the mentally ill, proving to be a cost-effective, humanitarian way to treat these persons.

Deputy Michael J.

Clinkunbroomer

L.A. County Sheriff’s Dept.

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Now we have an anthropologist providing the diagnosis and treatment for mental illness. How is it that some individuals from the social sciences believe they are better qualified to diagnose and prescribe treatment for mental illness than trained psychiatrists? Unwilling to undergo the rigor of medical training and experience themselves, they refuse to believe that mental illness is a medical problem. They want to retain it as an environmental disease, an emotional consequence of family dysfunction or social pressures, and so on.

Roger West

Seal Beach