Mentally Ill - Mandatory Treatment!?

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This terrifies me to the core, being an aspie. While this sort of mandate can definitely help SOME who need it, I have this chilling feeling that this woman is so "happy" because she has no other choice. "Be happy or we will imprison you in a mental health institution."

NEW YORK - Susan Wezel had been committed to the city's hospital wards more than a dozen times in 10 years. Her psychosis was so deep and debilitating that she lost her career and her relationship with her son, as she refused to take her medication or follow treatment.

But because of a New York state law, Wezel hasn't been hospitalized in more than a year. She doesn't wander the streets alone at night anymore. She takes her medication willingly. She even has plans to follow her dream of singing at a neighborhood nightspot, something that was unthinkable 18 months ago.

Wezel and her caseworker agree that the transformation occurred because of the law, which allowed officials to force Wezel into an outpatient treatment program after she was discharged from a hospital

Known as Kendra's Law, it is considered one of the most far-reaching mental health statutes in the country. It gives great latitude to doctors, social workers and relatives to take mentally ill people before a judge to force them into treatment, and it provides money for clinical services.

Just how far states can go to get mentally ill people into treatment is a key issue in Virginia. The state is struggling with changing its mental health system after a mentally ill gunman shot and killed 32 students and teachers at Virginia Tech in April before killing himself.

"All of this has saved my life," Wezel, 50, said in an interview at her caseworker's office in Queens. As part of the treatment order, she was given immediate access to a caseworker who closely monitors her through visits and phone calls. If Wezel fails to comply with her treatment, she can be picked up by police and taken to a hospital.

Wezel's experience with forced treatment underscores one of the most controversial issues in the care of the mentally ill. Seung Hui Cho, the Virginia Tech gunman, had been ordered into outpatient treatment, but officials didn't monitor whether he received it, and he never did.

Had something as detailed as Kendra's Law been in place, with its high expectation of accountability, officials might have been forced to monitor whether Cho got treatment, supporters of such measures say.

Rarely used outpatient law
Virginia has an outpatient treatment law, but it is rarely used. Judges interviewed since the Virginia Tech rampage have said that they prefer institutionalization for the most severely endangered patients. Some judges said they think that ordering outpatient treatment is a waste of time because the lack of resources would make follow-up nearly impossible.

A survey conducted this year by the Virginia Supreme Court's Commission on Mental Health Reform found that judges used the outpatient treatment option in 5.4 percent of cases during the month studied.

Kendra's Law, named after Kendra Webdale, a 32-year-old woman who was killed in 1999 when she was pushed in front of a New York City subway train by a severely mentally ill man, allows courts to use a much lower standard than Virginia's to force outpatient mental health treatment.

To qualify for forced treatment under Kendra's Law, among other criteria, a person must have been hospitalized twice within the previous three years; must have shown violent behavior toward himself or others in the previous four years; and must need treatment to "prevent a relapse or deterioration which would be likely to result in serious harm to the person or others."

Across the country, supporters of such programs, known as preventive outpatient commitment laws, have called them pragmatic approaches in addressing the needs of the millions of mentally ill people who are not in institutions.

But there is intense debate among experts and policymakers about whether coercive statutes would be necessary in cases in which states increase the availability of services to the mentally ill.

Maryland does not have an outpatient commitment law. The District has a standard like Kendra's Law, but it is used sparingly.

The Supreme Court commission in Virginia recommended this month that the state expand the use of outpatient treatment for those who don't meet the criteria for forced hospitalization. The panel also called for specific procedures to monitor those receiving outpatient treatment and suggested ways to enforce it. But lawmakers also expect debate over a more expansive law that mirrors the New York statute when the General Assembly convenes next month.

"These arguments over outpatient commitment are some of the most emotional and contentious debates you'll find in mental health law," said Jeffrey Swanson, a professor of psychiatry and behavioral sciences at Duke University who is involved in a three-year study of Kendra's Law for the state of New York. "It really goes to the heart of whether we believe community mental health care can be effective without coercion and at what point we're willing to say that coercion might be necessary, legitimate and humane."

The New York statute outlines the responsibilities of local mental health agencies, spells out monitoring requirements and incorporates provisions for ordering noncompliant mentally ill people into hospitals. Those who are taken into outpatient treatment under Kendra's Law get immediate access to services. The petition process can be started by a roommate, parent, spouse, adult child or sibling, a hospital director or a caseworker, among others.

"There was nothing I could do to get her into any help before this," said Chris Wezel, 50, Susan Wezel's husband.

New York officials say the law has been effective. They conducted a survey in 2005, when the measure was up for reauthorization. The study found that a sample of patients treated under Kendra's law were more likely to participate in care, take their medication and follow up with caseworkers than when they were not treated under the law.

In addition, for those treated under the law, homelessness, arrests, hospitalizations and incarcerations dropped at least 74 percent and as much as 87 percent, the statewide survey found. Other studies conducted by mental heath researchers over the years have found similar outcomes the longer that mentally ill people stay in such coerced treatment programs.

'Coercion does work'
"Coercion does work, if it's done the right way," said Mary T. Zdanowicz, former executive director of the Treatment Advocacy Center in Arlington County. She said that Virginia needs a law "that incorporates involuntary treatment, both inpatient and outpatient." Such laws get patients complete help the first time, rather than partial help over and over, she said.

But opponents of Kendra's Law say that the New York study did not use a control group for comparisons. The state's legislators were so skeptical of the available research that they called for a separate study and declined to make the law permanent. That study is due in 2009, and the law will come up for reauthorization a year later.

Advocacy groups and other mental health experts who oppose Kendra's Law say that it came with money for services, proving that coercion alone is not a solution.

The statute was accompanied by $32 million a year in state funding, much of it for medication and more caseworkers.

The law also affects a small population. Last year, about 1,800 New York residents fell under its guidelines at any given time, out of more than 400,000 mentally ill adults in the state, New York state health officials said.

"You have to consider the increase in services. It's not a slam-dunk to say that just because of the law itself, we have these better results," said Peter Beitchman, a longtime advocate for the mentally ill in New York City.

As opponents of the law have said, Andrew Goldstein, the schizophrenic man who pushed Webdale, had been denied outpatient services before the incident. He was told that there was no room for him at local treatment centers.

The issue of forced outpatient treatment resonates in Virginia because of the Virginia Tech shootings. Cho had been given an outpatient treatment order 16 months before the rampage. But it was never enforced by the local community services board or Virginia Tech's counseling center, and it was never specified which one was required to do so.

"Sometimes, those that need mental health treatment don't know they need help," said state Sen. Henry L. Marsh III (D-Richmond), who has unsuccessfully submitted bills like Kendra's Law in previous years and will do so again next month. Marsh will be chairman of the Senate Courts of Justice Committee next year, which will consider the legislation.

http://www.msnbc.msn.com/id/22435155/

I think it's a good idea for those who are seriously mentally ill. I don't think those who have serious mental illnesses that could badly affect society (like murdering or physically hurting others for example) should ever be rejected treatment simply because they don't have enough room at a local hospital. If something like this would ever become a law (since they said it was a study so far), it's probable that doctors would be more obligated to pick and choose people who actually need to be hospitalized for mental conditions. On the negative side it is kind of scary to force others to be medicated all the time; fortunately though they would have had to have been in a mental institution before this law applies to them. Hopefully they won't enforce this law wrongly, like putting people more people in mental institutions for bad reasons (like misdiagnoses for example). There can be very good and very bad results that can come from this. Hopefully most of the results will be good.

I have had mandetory drug and shock treatments that destroyed my ability to follow my career or even function in society. I had to be resuscitated (CPR) twice during ECT because they woudn't listen about my extreme sensitivity and bad reactions to drugs. They blamed me for not telling them and traumatizing them, but a week later with different doc and maybe staff, they went back to 'standing orders' for the ECT so I had to be resuscitated again. Now they lable me "long history of paranoia" when I fear drugs, so I can't get any medical treatment. I was labled Schizophrenic for believing in G-d and then side effects of the drugs induced psychosis which they use as proof of their diagnosis. How do the laws prevent abuse? Never will.

It is the funding that helps most by providing treatment to those who need it. Noone can get help here anymore for lackof funding, even with a special tax advertised to go for mental health, services were never restored. If adequate care is provided and still doesn't help, I would be glad to rethink the issue of allowing idiots to be in charge of poisoning or shocking the mental functions out of anyone they please.

For the severely mentally ill who need treatment to avoid hurting others, and will actually benefit from treatment, this all sounds great. Thing is, once you give people power, like social workers, abuses happen.

I am sure the governments of most countries including ours have done this. Anyone who spoke out against the Clintons had an accident or committed suicide. Yet I support my government and like law and order. It would be better if I could rationalized why they did it. It cost them money, not me, so what did they gain??? My husband at the time did gain, but not smart enough to plan it, just opportunity for the attorney to get the children from me. I was gotten out of my house, but didn't want to be there anyway. Maybe they noticed oddisms and went for the kill. I think we have lost enough freedoms. This is too dangerous to support for the few who might be served.

from CCHR

Violence is the only case that should be allowed.

According to New York Lawyers For The Public Interest:

There are major racial, ethnic, and geographic disparities throughout New York
State in the implementation of “Kendra’s Law”. Black people are almost five times as
likely as White people to be subjected to this law – which dramatically reduces freedom
of choice over their treatment and their lives - and Hispanic people are two and a half
times as likely as non-Hispanic White people. People who live in New York City are
more than four times as likely to be subjected to orders as people living in the rest of the
state. Also, contrary to how it has been sold, the law is used mainly on people with
multiple psychiatric hospitalizations but no histories of hurting others.

http://64.233.169.104/search?q=cache:HJ ... cd=2&gl=us

Maybe if NY had devoted the funds to housing and medical care to the mentally ill in the first place maybe this woman wouldn't have died.

McSquared, the disparities of the mentally ill may be due to the lack of medical services these groups receive, because whites tend to get their mental ill family members help. There's a great deal of discrimination against ill family members in the "minority" communities.

Also, the police may be using this law as a way to get people off of the street without due process and get them out of their hair.

There's all kinds of wrong with this law. If only, if only...

Mentally Ill - Mandatory Treatment!?


Well, on both sensible and humanitarian grounds, when a person / human gets ill, regardless of what sorts of illnesses he / she is suffering from, should the person / human get treated or not ?


Next, when that ill person / human is being treated, should he / she be treated accordingly and humanely ?, and in the case of mentally-ill people / human, should he / she deserve to the least extent, all the due respects and basic human rights from the ones treating them in accordance to both the natural and innate concepts of human values, moral principles and other humanitarian grounds which are eulogized and exalted as the pillars of any human societies and human communities as well as the legal context of human rights -


The basic rights and freedoms to which all humans are undisputedly entitled, often held to include the right to life and liberty, freedom of thought and expression, and equality before the law. ?



McSquared, the disparities of the mentally ill may be due to the lack of medical services these groups receive, because whites tend to get their mental ill family members help. There's a great deal of discrimination against ill family members in the "minority" communities.

Also, the police may be using this law as a way to get people off of the street without due process and get them out of their hair.

There's all kinds of wrong with this law. If only, if only...


In regard to the remarks above, well, I could only conclude such scenarios and phenomena as symbolising and mimicking "the law of the jungle" - the principle that one needs to be very determined and prepared to harm any targeted others in order to be achieve one's personal goals by any means regardless of any conscience and moral inhibitions and feeling no misgivings at all about any of such actions.


In addition, what I wish to say is that all these nobly exalted human values, moral principles and other humanitarian grounds are also the key concepts that distinguish a human being from a "beast" in accordance to the basic and underlying definitions, principles and concepts of these human / moral principles and other humanitarian values ( I mean no offence).


Next, if "the law of the jungle", both overt or the ones cloaked and "justified" by any sinisterly and plausibly sophistic arguments and euphemisms were to supersede, replace and prevail over all these basic human values, moral principles and all other humanitarian grounds as well as the basic concepts and legal contexts of human rights, then I should conclude that all such people / "humans" practising "the law of the jungle" especially against the mentally-ill humans, well, such people / "humans" doing such a thing are simply selfishly apathetic and callously conscienceless. And as such, such a scenario would actually be something really pathetic and saddening.


In such a connection, for the ones, especially the people / "humans" deliberately "practising" "the law of the jungle" "upon" the pitiful mentally-ill people, especially the ones who are in sorry plights for whatever reasons, especially the ones that are sinisterly, hypocritically and misleadingly "justified", well, such people / "humans", along with their parents, siblings, teachers, friends, peers and any other persons related to them, in fact should feel ashamed of themselves for all these dishonourable acts and abuses of such people / "humans".


Lastly, which principles and courses of actions should any human beings choose to handle any affairs concerning and involving the other human beings, especially the mentally-ill humans ? Should that be "the law of the jungle" or the concepts of human values and moral principles and other humanitarian grounds that unquestionably define and distinguish the characteristics, behaviours and properties of human beings ?

Compassionate & Humane Treatments For The Mentally-ill People



Included below are some classic paintings advocating compassionate and humane treatments (in contrast to deliberate physical abuses, brutalities, maltreatments, tortures, cruelties, ridicules, derisions, disparagings, mockings, humiliations, and other forms of subtle purposeful malicious acts) for the mentally-ill people who are totally unable to defend and protect themselves at all :


"The engraving of the eighth print of William Hogarth's A Rake's Progress depicting Inmates at Bedlam Asylum :


The Hospital of Saint Mary of Bethlehem, a London mental hospital commonly known as Bedlam, sold admission tickets to the public in the 18th century, becoming a popular tourist attraction. In this engraving by English artist William Hogarth, part of his series A Rake’s Progress (1735), two women (seen in the background) tour the hospital, watching the mentally ill patients for their amusement. The hospital became notorious for its miserable conditions and cruel treatment of patients."


http://upload.wikimedia.org/wikipedia/c ... ress_8.jpg


"Dr. Philippe Pinel at the Salpêtrière, 1795 by Robert Fleury. Pinel ordering the removal of chains from patients at the Paris Asylum for insane women


French physician Philippe Pinel supervises the unchaining of mentally ill patients in 1794 at La Salpêtrière, a large hospital in Paris. Pinel believed in treating mentally ill people with compassion and patience, rather than with cruelty and violence. This painting, Pinel Frees the Insane from Their Chains, was completed by French artist Tony Robert-Fleury in 1876."


http://upload.wikimedia.org/wikipedia/en/d/de/Pinel.jpg



Other Related Information :

http://www.curezone.com/forums/fm.asp?i=1641232#i

http://www.curezone.com/forums/fm.asp?i=1411132#i

http://www.curezone.com/Forums/fm.asp?i=1419521#i

http://www.curezone.com/forums/fm.asp?i=1422662#i

http://www.curezone.com/forums/fm.asp?i=1422668#i

http://www.curezone.com/forums/fm.asp?i=1398878#i

http://www.curezone.com/forums/fm.asp?i=1411771#i

From a medical-ethical perspective, the issue revolves around the ability for a patient to make an informed refusal to consent to therapy. No matter how debilitating the illness, if a person is fully compos mentis that person is free to refuse treatment.

Where things become fuzzy is where the person will become a danger to themselves (but not to others). The state of the law varies from jurisdiction to jurisdiction about what impact that danger has on the ability to form a refusal to consent.

A danger of harm to others is, of course, a no brainer.

Difficult subject, I fear that if "mental health law" is used to oppress people then people will try harder to hide any mental health condition. In some conditions a person may have the insight to know that they need to seek help, but if seeking help is going to bring the sky crashing down then they might make a point of not seeking help.

_________________
Health is a state of physical, mental and social wellbeing and not merely the absence of disease or infirmity I am not a jigsaw, I am a free man !

Diagnosed under the DSM5 rules with autism spectrum disorder, under DSM4 psychologist said would have been AS (299.80) but I suspect that I am somewhere between 299.80 and 299.00 (Autism) under DSM4.

I'm against the law because it forces people to take meds they may react badly to. While I get psychiatric services voluntarily, I'm still trying to get a new med I was prescribed out of my system because it made me a zombie and I slept all the time, and I was at the lowest dose. I'd hate to think what would happen if I was being forced to take it. I think a psychiatrist should have had to take lots of different powerful psych meds themselves at some point in their life to be qualified to force anyone to take meds, and only be allowed to under the most extreme circumstances.

As for involuntary outpatient treatment, California has a little known law that can allow that in some cases but I've never heard of it being used. When I was in outpatient treatment once there was an emotionally disturbed guy there who was forced to be there by their conservator, and not only did he accomplish nothing while there because he didn't want to, he sometimes interfered with the treatment of others.

Involuntary treatment of the mentally ill should only happen if there is grounds to order them inpatient or into some other institutional setting.