In 2005, there were 3,000 severely mentally ill patients for every one hospital bed. Today we have fewer than 100,000 mentally ill patients in state hospitals. This is a national problem.
People with paranoid schizophrenia and bipolar disorder are the ones who desperately need long-term hospital care, but for so many this is not available. Antipsychotic medication, developed decades ago, is not a cure, but it allowed many schizophrenics to function in society. Many people with severe mental illness have no idea they are ill and either don’t start or else stop taking their medication. Many, like my sister, do not want the stigma associated with mental illness.
When did we get on this track that you practically have to be foaming at the mouth and hiding under a bed before you can be hospitalized against your will? In 1975, the Supreme Court restricted involuntary hospitalization in the case of O’Connor v. Donaldson, and any treatment of a mental patient had to take place in the “least restrictive environment.” Subsequent court decisions have prevented mandatory treatment except in the case of emergencies. It took 10 years before a psychiatrist took my sister to court in Nassau County and won the right to treat her against her will. The doctor noted that there was already significant damage to my sister’s brain from lack of treatment.
Laws regarding the mentally ill are erroneously based on the premise that mental illness is some sort of lifestyle choice. According to the National Alliance for Mental Illness, the annual cost of untreated mental illness in the United States is $100 billion.
We need to re-examine the American mental health care policy of the past 50 years. Federal court decisions establishing rights to refuse treatment and restricting involuntary treatment should be reconsidered. We should replace “least restrictive environment” with “most therapeutic environment possible.” Lastly, legislators should reject those who want to put restrictions on psychiatric hospitalization or treatment with psychiatric medication.
Roselle Park, N.J.
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