The Mental Health Minute

Articles and news about mental health issues

Opinion | Washington’s mental-health policies are killing people | Seattle Times Newspaper

The article below shows the frustration we all must feel as we try to balance personal rights with right to care.  The mentally ill have seen the entire gamut of care–from institutionalization and forgetting about them, to turning them out on the streets to care for themselves.

Obviously, neither of these solutions work for the patients.  When they were locked up in institutions, they had no say about care, treatment, or personal liberties–they were much like prison inmates.  When turned out onto the streets, they are met with life challenges that they, by virtue of being mentally ill, are unable to meet–sometimes, they cannot even recognize there are any problems.

With the economy putting more and more people at risk of homelessness and the accompanying increase in depressive disorders, and the decreasing funding for mental health treatment to both hospitals and community clinics, what are we to do to meet the needs of this very fragile section of our society?

Unfortunately, the brunt of the burden seems to then fall on the law enforcement community who may or may not be prepared to deal with the mercurial behaviors of this population.  These are people who do not follow instructions, or do not follow instructions well.  These often are disoriented people who are acting out delusional beliefs.  Our police really do have trouble dealing with this type of individual.  Our prisons are full of these people.  Is this the most cost effective and humane way of solving this issue?  To me it sounds like we have just figured out another way to institutionalize the mentally ill.

Washington’s mental-health policies are killing people

Washington state policy under the Involuntary Treatment Act is leaving too many people with mental illness to fend for themselves, writes guest columnist Mike Johnson. In extreme cases, people are dying, whether they kill themselves, or can’t help themselves or harm others.

By Mike Johnson
Special to The Times

RECENTLY, Joseph tried to jump out of a window on the fourth floor of the Men’s Shelter of the Union Gospel Mission in Pioneer Square.

A fellow resident in our addiction-recovery program pulled him back in, and we took Joseph up the hill to the Psychiatric Emergency Room at Harborview Hospital … again. A few months earlier, police stopped Joseph from jumping from an overpass. Despite this history, Harborview informed us they were releasing Joseph after only a couple of hours in care … again. They couldn’t hold him, they argued.

As the director of the Mission’s Pioneer Square facility, I work every day with precious people struggling with addiction and mental illness. Last week, I stood under the Alaskan Way Viaduct with a homeless man who could not speak, and could move only with great difficulty. Rats circulated unafraid among his bags as my heart broke for him. This case is extreme, but real.

My considered opinion is that Washington state mental-health policy is killing people. It may kill Joseph. It will certainly kill that old man under the viaduct. It killed Shannon Harps in 2008, the Capitol Hill stabbing victim of James Anthony Williams, who stayed at our shelter at one point. Williams had been involuntarily committed after shooting at people waiting for a bus, but was later released under supervision.

Our state’s Involuntary Treatment Act (ITA) specifies that a person can be required to receive treatment if they present an “imminent” threat of harm to themselves or others, or if that person is “gravely disabled.” These words get defined by policies: What does “gravely disabled” actually mean at involuntary-commitment proceedings? In general, it means “one foot in a grave.

“Thus Joseph couldn’t even get care on the night he tried to jump out of our building, because that moment had passed and he was no longer an “imminent” threat — he’s not on the window ledge any more. And the viaduct man can’t get care because he’s not so disabled as to be on the verge of death.

Washington state policy must find a middle ground between the 1950’s overreadiness to lock people up, and the overreaction of the late 1970s deinstitutionalization that closed down whole systems. Surely we can respect freedom and still help people literally unable to help themselves. We must refund inpatient beds and reopen care wards closed down, and then we must actually be willing to put people into them.

Our policy claims to protect civil rights, but my job lets me see a consistent side effect: to turn real people struggling with mental illness onto the streets where some will simply die, and others will — from time to time — kill. Again, these are extreme cases, but real.

King County has a dedicated funding stream to address mental illness and drug dependency, and some good people working toward improving our systems. But without a willingness to commit people to care, and without an inpatient bed anyway, will things really change? Don’t go out on a ledge to wait.

Mike Johnson is the director of the Men’s Shelter of Seattle’s Union Gospel Mission in Pioneer Square.

Opinion | Washington’s mental-health policies are killing people | Seattle Times Newspaper

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October 29, 2009 - Posted by | Mental Health | , , ,

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