I am responding to an Op-Ed article written by E. Fuller Torrey of TAC published on May 28, 2010
I would like to reply here refuting Torrey's erroneous claims and scare tactics presented by his TAC organization, which they are using in supporting Kendra's Law, and other similar oppressive and poorly constructed laws throughout America.
Some would seriously question who this law could target, and how effective the forced treatment paradigm really is in protecting the public and those labeled mentally unstable. A more intrusive government and further reaching laws have seldom produced in actual real world results the lofty achievements they to often loudly proclaim. In reading this bill I see a lot of bureaucracy, some disturbing overreaching details, and not much comment sense.
We are a nation of laws. Yet, forcing drug treatment, and to use obligatory compliance methods/threats runs completely counter productive to taking a more effective and humane therapeutic approach toward this already stigmatized, labeled, & ostracized segment of our population.
This poorly constructed law really does open the door to lots of abuses way beyond just a few and quite rare deemed potentially dangerous mentally compromised offenders, and does very little to truly protect both the public and those suffering in emotional turmoil.
This law was based on those rare incidences of violence under taken by those few individuals under extreme mental distress (even though in the actual “Kendra” case the perpetrator was actively seeking intervention and help on his own to no avail or success prior to becoming unraveled into a violent and psychotic state which ended with tragic consequences).
We are fooling ourselves into a false sense of security/safety when we use the "Fuller Torrey" brand of fear mongering as a basis to validate forced treatment measures being burdened upon populations that are least able to legally represent themselves and their wishes. All these measures only secure into the law consequences before we even have any proof or the conviction of any actual crime being committed.
If you carefully read the bill being presented for permanent status and further extending the parameters of this law, I believe you will find some disturbing conclusions and factors written in this bill that are not based in scientific/medical fact or reality. What you will find is more intrusion into the lives of those inflicted with emotional disorders. I believe you will also find in this law an overwhelming emphasis on a forced drugging modality and long term outside control/intrusion into the lives of citizens that are only guilty of the non-crime of being at one time or another in emotional crisis, and then labeled mentally unhygienic as stated in this bill's text structure.
I will offer just two of many examples here of why we should be questioning the very foundations this bill and law are built upon.
From psychiatrist and author Dr. Danial Carlat - Carlat Psychiatry
"few laypeople realize how little we actually know about the underpinnings of [psychiatric] disorders....In virtually all of the psychiatric disorders--including depression, schizophrenia, bipolar disorder, and anxiety disorders--the shadow of our ignorance overwhelm the few dim lights of our knowledge."
"Our diagnostic process is shallow and is based on an elaborate checklist of symptoms, leading us sometimes to over-diagnose patients with disorders of questionable validity, or, conversely, to miss the underlying problems in our rush to come up with a discrete diagnostic label that will be reimbursed by the insurance company. We tend to treat all psychological problems the same way--with a pill and a few words of encouragement. Because of this rote approach to treatment, patients are often misdiagnosed and medications are over prescribed. In the end, we misserve our patients, failing to offer them psychotherapies that are sometimes more effective than drugs"
"The resulting frenzy of psychiatric diagnoses has damaged the credibility of everyone in the field."
"We like to see ourselves as neuroscientists, rationally manipulating levels of neurotransmitters like serotonin in order to get patients better. But the fact is that we have no clear evidence that chemical imbalances are at the root of any mental disorder....we don't know if changing levels of serotonin [by prescribing Zoloft or Celexa, or any other drug] is the actual curative mechanism. Nonetheless, we give patients elaborate explanations of how the drugs work chemically. It makes us feel more scientific, and gives patients a feeling of confidence in us, but it's little more than made up neurobable."
"The fact is that psychopharmacology is primarily trial and error, a kind of muddling through different candidate medications...." depending upon which company's sales rep or which academic "Hired Gun" recently made a pitch for one or another drug. Indeed, "when our most esteemed colleagues have essentially joined the marketing teams, it makes it that much harder for us to practice our craft responsibly."
And from Robert Whitaker award winning journalist and author - Mad In America - Robert Whitaker Blog
( The NY Times should as they say "Man Up" and at least review his newest book )
"Anatomy of an Epidemic"
"In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripled over the past two decades? Every day, 1,100 adults and children are added to the government disability rolls because they have become newly disabled by mental illness, with this epidemic spreading most rapidly among our nation’s children. What is going on?
Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals.
Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?
This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?
By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?
In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up."
Whether you choose to agree or disagree with this law, we all should consider the far reaching ramifications of laws like this one, before pulling the permanent trigger on them.
I would hope the NY Times would want to offer a balanced approach, and allow other opinions to be expressed in their op-ed editorial columns regarding this issue.
New York Times
Make Kendra’s Law Permanent
By E. FULLER TORREY
Published: May 28, 2010
ELEVEN years ago, when the New York Legislature passed Kendra’s Law, few could have foretold what a resounding success it would be. At the time lawmakers were searching for a useful response to the tragic death of 32-year-old Kendra Webdale, who was pushed in front of a subway train in Manhattan by a stranger who had untreated schizophrenia. The law, initially intended for a trial period of five years, permits state judges to order closely monitored outpatient treatment for a small subset of seriously mentally ill people who have records of failing to take medication, and who have consequently been rehospitalized or jailed or have exhibited violent behavior.
In 2005, Kendra’s Law was extended for another five years. In all, more than 8,000 people have been treated under its provisions, and the results have been striking. A 2005 study of more than 2,700 people to whom the law was applied found that, after treatment, the rate of homelessness in the population fell by 74 percent, the number who needed to be rehospitalized dropped by 77 percent and the number arrested fell by 83 percent. And a study published this year found that people receiving treatment under Kendra’s Law were only one-fourth as likely to commit violent acts, had a reduced risk of suicide and were functioning better socially than members of a control group.
It’s hard to imagine a stronger argument for making the law permanent. And yet, as it comes up for renewal this month, the state Office of Mental Health is recommending only a five-year extension. Why the hesitation? Apparently, the Office of Mental Health is ambivalent about its star performer. In its latest five-year Statewide Comprehensive Plan for Mental Health Services, Kendra’s Law is not even mentioned, and the program it supports — assisted outpatient treatment — is referred to briefly only twice.
Perhaps state mental health officials are responding to critics who consider the law politically incorrect because it mandates psychiatric treatment by court order, supposedly violating the patients’ freedom to choose or forgo treatment. But these are people whose illness interferes with their ability to understand that they are sick and need medication. They do not have the choice to live freely and comfortably, but only to be homeless, in jail or in a psychiatric hospital.
The people who could be treated under Kendra’s Law account for only one in 10 seriously ill psychiatric patients. But when these people are untreated, they also make up one-third of the homeless population, and at least 16 percent of the jail and prison population. These people are ubiquitous in city parks, public libraries and train stations. And a small percentage become dangerous, even homicidal.
The law has been a model of success, not only in New York but also in 44 other states that now have similar laws (including, most recently, New Jersey and Maine). Unfortunately, these laws are too rarely used. California, for example, has passed an equivalent to Kendra’s Law known as Laura’s Law, but has not enforced it. If it had, it might have prevented 36-year-old John Patrick Bedell from wandering the country last March, taking orders from his psychotic brain, despite his family’s frantic attempts to get treatment for him. Mr. Bedell ultimately shot two security guards at the Pentagon, and was shot and killed by the officers he injured.
Kendra’s Law saves lives. By keeping patients on medication, it also saves money that might otherwise be spent on rehospitalization, prosecution and incarceration. New York should take lasting advantage of both benefits by making the law permanent.