Dealing With the Dangerously Ill
Maryland and Virginia Offer Little Defense.

Sunday, May 21, 2006

"What do I have to do, have him kill someone to get him treatment?"

That is the prophetic question a Reston mother asked mental health professionals shortly before her son beat her to death with a baseball bat in her home nearly eight years ago. History repeated itself this month when Pamela Jones was killed in her Fairfax City home by her mentally ill 24-year-old son [Metro, May 14].

In the years between these two tragedies, Virginia has kept the same outdated law that requires the mentally ill to be "imminently dangerous" before their objections to treatment can be overridden, even though they may be too sick to realize that they are ill. Incredibly, Virginia families are often told that nothing can be done to get their loved ones into treatment unless they become homicidal or suicidal.

Maryland law is similarly restrictive, requiring that mentally ill people "present a danger to the life or safety of the individual or of others" before they can be involuntarily hospitalized. On May 14 Anne Arundel police shot and killed a young man who was exhibiting psychotic symptoms when he threatened them with scissors ["Arundel Officers Shoot, Kill Man, 18; 'Suicide by Cop' a Police Theory," Metro, May 15]. Clearly, he was dangerous in the moments before police shot him, but the proof of the severity of the young man's illness came too late to save him.

Waiting for someone to become dangerous is a prescription for tragedy. Worse, it is bad public policy based on emotion, not data. Not all people with mental illnesses are dangerous; in fact, most aren't. But some people with severe mental illnesses can be dangerous, particularly if they are not taking their medication. A recently published national study documented that schizophrenia patients with specific symptoms -- paranoid delusions, hallucinations, grandiosity, etc. -- were at least three times more likely to be violent than other schizophrenics.

The laws in Virginia and Maryland need to be changed so that decisions about treating mentally ill patients over their objections are based on the history of their illness and their current medical condition. We should be preventing mentally ill people from deteriorating into violence, not waiting for violence to happen before we act.

Psychiatric beds for patients in crisis are in short supply, so new laws also should facilitate court-ordered outpatient treatment, which has been shown to reduce violence, improve quality of life and reduce the stress of those who care for the mentally ill at home.

This region is still reeling from the deaths of two Fairfax police officers at the hands of another psychotic young man ["Officer Fatally Shot Outside Police Station; Slaying Is 1st in Line of Duty in Fairfax; Gunman, 18, Is Killed After Opening Fire," front page, May 9]. Much was made of the fact that Michael Kennedy crept out of a window at a Maryland psychiatric hospital just weeks before the killing. But the truth is that he just as easily could have walked out the front door. Maryland's weak law couldn't keep him in treatment; nor could Virginia's. It is long past time to change these laws, in memory of those lost and in defense of those still endangered.

-- Mary T. Zdanowicz

is executive director of the Treatment Advocacy

Center, a nonprofit organization dedicated to

removing barriers to treating

severe mental illnesses.

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