2013 Legislature must deal with mental illness

Published: February 10, 2013 

People with untreated mental illnesses don’t fund political campaigns or employ powerful lobbyists. It was easy for Washington and other states to skimp on their care after the economy went south five years ago.

It’s taken a whack with a two-by-four – an onslaught of preventable assaults and murders – to persuade some lawmakers that psychiatric care for the poor is not a luxury that can be dropped in hard times.

The massacre at Sandy Hook Elementary School was the catalyst. The killer may or may not have suffered from a psychosis, but – following other atrocities in Colorado and elsewhere – he taught the country how dangerous a disturbed man with a deadly weapon can be.

Three priorities need action from Legislature this year: care, involuntary commitment and access to guns. The three are closely interconnected.

Above all, the state must provide more therapy options to more people. People with serious psychiatric disorders tend to be poor, for obvious reasons. Few can afford the intensive treatment and continuing care they need.

Mental illness should not be equated with threat. The vast majority of those who live with some kind of disorder are harmless. But a small fraction – notably males with schizophrenia, a history of drug abuse and a record of violence – account for more than their share of attacks on others. They are especially prominent in mass shootings.

Lawmakers can lower that threat through simple humanity, by making psychiatric care more accessible to everyone who needs it but can’t pay for it. That means expanded outpatient therapy and case management, and it may mean restoring beds at Western State and Eastern State hospitals.

Involuntary commitment is part of this picture. Court-ordered treatment is necessary for those whose grave illnesses leave them resistant to care yet dangerous.

The 2010 Legislature wisely relaxed what had been ridiculous legal obstacles to involuntary commitment – but it didn’t pay for the additional treatment required. It’s time to sign the check.

It’s also time to require practitioners to alert police when they spot signs that a patient is potentially explosive. The bar for purchasing firearms should be high for such patients. Involuntary commitment is the usual disqualifier, but that happens far too rarely to flag most dangerous cases.

No judge in the state or federal judiciaries has ever held that a mentally ill and potentially dangerous man has a constitutional right to bear arms. And few of the severely sick will refuse treatment just to preserve their gun-buying privileges; they tend to have far larger worries.

Advocates do disturbed people no favors by defending their access to weapons. Lawmakers do the state no favors by denying them help.

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