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Psych in the News
Article: Mandating Treatment for the Mentally Ill


By Elaine Cassel

It's been a good news, bad news year for people suffering from schizophrenia. Publicity about crimes committed by people with schizophrenia has focused attention on the inadequacies of our legal systems and community mental health treatment model.

In New York City in 1999, two people suffering from schizophrenia, both with recent histories of hospitalization and violence, pushed strangers into the paths of oncoming subway trains. In one case, a woman was killed; another lost both of her legs.

As a result of these incidents, the New York legislature passed a law mandating treatment for the seriously mentally ill before they act out violently. Generally, people with paranoid schizophrenia who have a propensity to act out violently (based upon "instructions" from "voices" or from misperceptions that they are being threatened) will not be a threat if they are taking their medication regularly. The problem is that many don't take their medication for different reasons. Some are homeless and have no access to services for prescriptions and follow-up after release from hospitals; many more refuse to think they are ill and need medication.

The New York law allows interested people to notify the courts when a seriously mentally ill person is not complying with medication orders. The courts can refer the person for outpatient treatment without showing that they are in imminent danger to others. In most states, current laws can force people to be hospitalized or treated without their consent only if they pose an immediate danger to others or themselves.

Some argue that the New York law goes too far in forcing nonviolent people to receive treatment. Some say that the law is necessary to protect the individual suffering from the illness, as well as the public.

What do you think? If you were suffering from schizophrenia and were hearing voices that were telling you to commit acts of violence, would you want to be hospitalized? Chances are you would not believe the advice of your family and friends but would be listening to the voices. Therein lies the danger. How about if the person suffering were a member of your family? Would you commit them against their will? Why or why not?



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