The right to just say no

Supporters of AB 1421, the involuntary treatment bill, are calling it “Laura’s Law,” after Laura Wilcox, the young mental health worker who was allegedly killed by Scott Thorpe, a mental patient. Naming a forced treatment bill after a young victim may invest it with some emotional appeal, but the message communicated is twofold: (1) we should fear the violence potential of the mentally ill, and (2) their condition prevents them from making correct decisions about treatment.

Both of these notions are 19th-century relics, neither of which stands up under empirical study. Researchers at Duke University found that individuals with severe mental illness who were not taking medication were no more violent than other individuals. San Francisco police report only about 5 percent of violent altercations involve the mentally ill. And, a MacArthur Foundation report of 1995 showed that the mentally ill are just as competent as the medically ill in understanding the implications of proposed treatment options.

In truth, the mentally ill would do much better without psychiatric drug treatments. In the 1950s, Yale University researchers began tracking 269 “chronic schizophrenics” at Vermont State Hospital. The head of the hospital asked them what they needed. They told him they needed jobs, friends and a decent place to live. The staff began housing these people in a homelike setting in the hospital. They received vocational counseling and jobs, and were linked to family and friends on the outside. When researchers checked back 20 and 25 years later, over half of these former patients showed no signs of mental illness. These were patients previously considered hopeless because they were poorly educated and could neither dress themselves nor tell time.

The mental health profession needs to clean up its act and produce real cures for mental illness. To the extent that treatment decisions are externally imposed on a patient, that patient’s motivation to succeed is reduced. As Justice Stevens wrote in his dissenting opinion in Washington v. Harper (1990): “(t)he efficacy of forced drugging is also marginal; involuntary patients have a poorer prognosis than cooperating patients.” Current treatments fail, and involuntary treatment leads to even greater failure. There are no “safe” drugs. All drugs have harmful side effects. How could a drug that alters brain chemistry have no adverse effects? Let’s not cave in to fear-mongering and 19th-century stereotypes.