Rules Separate Mentally Ill From Treatment

With 'Imminent Danger' Requirement and Scant Resources Keeping Help Out of Reach, Some Become Violent

There are discussions about mental health, debates about dollars, demands for more beds, mostly in general terms at the top of political and policy food chains.

Then there is real life -- and real consequences. Check out the first two weeks of this month:

May 1: A mentally ill 22-year-old man is convicted of murder for beheading his aunt in Arlington.

May 8: A mentally ill 18-year-old man drives into a police parking lot in Fairfax County, fatally shoots two police officers, then is shot and killed by police.

May 12: A mentally ill 24-year-old man allegedly stabs his mother to death in Fairfax City, then uses duct tape to seal the bathroom, where her body is found.

May 14: A mentally ill 18-year-old man in Anne Arundel County stabs himself, then menaces police and demands that they shoot him, which they eventually do. He dies.

The pace of violence hardly surprises those who deal with the mentally ill every day: social workers, police, parents, lawyers. They know how hard it is to get a sick person treatment, how few resources are available, how the money for help has declined.

And when a Michael Kennedy sprays a police parking lot with bullets, or a Matthew Pahno chokes his aunt to death and decapitates her, the veterans of the system bite their tongues and hope that the money and resources will somehow materialize.

Where once getting treatment for mental illness was almost too easy, causing psychiatric centers to become dumping grounds for the healthy and the sick, some experts said the pendulum has swung too far the other way, with most states requiring proof of a person's "imminent danger" to themselves or others before giving them treatment.

"Right now, we only deal with the extreme cases," said John C. Whitbeck Jr., a Leesburg lawyer who oversees a George Mason University law school program that helps families seeking help from the courts for mentally ill relatives in civil commitment hearings. "And that's not getting anything done because so many people need to be addressed at the middle level."

Whitbeck said a busy treatment center such as Fairfax County's Woodburn center in Annandale might evaluate 25 or 30 people in a single night but recommend perhaps four for further help. "There's nothing to address all these other people," he said.

"There've been increasing pressures to reduce beds everywhere," said Robert W. Keisling, former head of emergency psychiatric services in the District. "And there's been a dumbing down of the hospital system. Some of the folks doing assessments are not psychologists or psychiatrists, and there are a lot of stupid assessments being made."