Thursday, July 24, 2014
YOLO COUNTY NEWS
99 CENTS

How many have to die before we act?

RichRifkinW

By
From page A10 | June 11, 2014 |

Every time a person with untreated schizophrenia goes on a killing spree — such as in Isla Vista on May 23 where former Santa Barbara City College student Elliot Rodger murdered six and wounded 12 others before taking his own life — some will point out that “the mentally ill are statistically no more likely to be violent than anyone else.”

The problem, of course, is that fact is entirely beside the point.

The issue is not whether all people with all sorts of diagnoses of mental illness, including those with minor maladies, pose a danger. The question is how likely it is that a person experiencing psychotic delusions, who has a history of violence or threats of violence and is not being treated, will cause mayhem.

The evidence suggests those individuals are extremely perilous — not just to others, but to themselves.

According to the Treatment Advocacy Center, “Suicide is the number one cause of premature death among people with schizophrenia, with an estimated 10 percent to 13 percent killing themselves. Suicide is even more pervasive in individuals with bipolar disorder, with 15 percent to 17 percent taking their own lives.

“The extreme depression and psychoses that can result due to lack of treatment are the usual causes of death in these sad cases. These suicide rates can be compared to the general population, which is approximately 1 percent.”

Family members of those with untreated mental illness are often at risk. According to Department of Justice statistics, when a spouse kills his mate, 12.3 percent of the time the defendant had a history of untreated mental illness. That’s 15.8 percent when a child is killed by his parent, 17.3 percent for a sibling murdered by a sibling and 25.1 percent when a parent kills his child.

In a typical year, about 5 percent of all murders in the United States are committed by individuals with a history of untreated mental illness, according to Bureau of Justice Statistics.

The National Institute of Mental Health estimated that 7.7 million Americans in 2010 had schizophrenia or bipolar disorder. The NIMH found that roughly 40 percent of people with schizophrenia and 51 percent with bipolar are not receiving treatment in a given year.

The fact that our gun control laws, compared with those in most other advanced countries, are lax adds to the societal danger of people with severe and untreated mental illness. Yet guns are not the heart of this challenge. They only compound it.

The primary problem is that we don’t require individuals with serious psychiatric disorders to receive treatment.

After each massacre, we say something needs to be done. And then we do nothing. After Virginia Tech; after the Tucson, Arizona, Safeway; after the Carson City IHOP; after the Aurora, Colorado, movie theater; after Sandy Hook Elementary School; after the Washington Navy Yard; after Isla Vista; and most recently after Seattle Pacific University; there are calls for change but nothing changes.

Seemingly no matter how many innocents die in these mad rampages, we will never adopt laws to keep guns out of the hands of the severely mentally ill.

Some gun enthusiasts point out, correctly, that a person experiencing a psychotic break can kill with a knife, too. For example, Rodger’s first three victims at UCSB were murdered with a knife. They ask, sarcastically, should we ban knives?

As much sense as it makes to forbid individuals with certain serious psychiatric ailments from owning firearms, it makes even more sense to require they get treatment, even if it must be forced on them. This needs to happen not just to protect society or family members. It must be done to protect those who have lost touch with reality and are a threat to themselves.

In California, thanks to former Assemblywoman Helen Thomson of Davis, who wrote the legislation, we have Laura’s Law. That permits a court to force treatment on a patient with a serious mental illness and a recent history of violence or threats of violence.

One reason this is necessary is because many individuals with psychiatric delusions lack the ability to understand and accept their condition. That is, they don’t realize they are sick. They think the voices they are hearing in their heads are real.

Medical doctors call this lack of awareness anosognosia.

Unfortunately, while Laura’s Law is on the books, it is almost completely unfunded. The California Department of Corrections and Rehabilitation has an annual budget of approximately $9 billion. The state, however, gives no money to provide for Laura’s Law.

The burden is on our counties. And since it passed in 2002, only Nevada County — where Laura Wilcox was murdered by a psychotic man who had refused treatment — has fully funded it. A few other counties have provided some limited dollars.

In June of last year, Yolo County adopted a pilot program, where at most, four patients can be forced by a court to receive treatment.

We likely will never stop all violent crimes by those with untreated mental illness. But all of us — especially those with severe psychiatric maladies — would be better off if people like Elliot Rodger and Adam Lanza were forced into treatment before they get ahold of weapons and tragedy ensues.

— Rich Rifkin is a Davis resident; his column is published every other week. Reach him at Lxartist@yahoo.com

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Discussion | 5 comments

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  • Rich RifkinJune 09, 2014 - 12:58 pm

    "Laura Wilcox was murdered by a psychotic man who had refused treatment." .............. Coincidentally, I have a connection to the Wilcox family. My cousin (who happens to be a psychologist and an renowned expert on "madness") is their neighbor and a close friend of Laura's parents in a very remote part of unincorporated Nevada County. Along with just two other families, they live nearby on the same gravel road.

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  • Greg JohnsonJune 09, 2014 - 8:03 pm

    Interesting piece Rich. Thanks for submitting it. I agree with your reasoning. I am not a gun nut, or gun owner. I have done a bit of target shooting about once every decade and find it mildly enjoyable. However, it does drive me crazy when anti-gun folks seem to believe we can solve the problem with gun control. People who meticulously plan mass murders will not hesitate to purchase guns illegally. On the other hand, I see no downside to banning large clips and assault rifles, and increasing background checks, even if this saves only a few lives.

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  • Rich RifkinJune 09, 2014 - 8:26 pm

    I should point out, Greg, that we have restrictions in California regarding the sale of guns to some people with mental illness. If you Google "Mental Health-Related Prohibited Categories in California," you will find all 9 categories. One problem, I was told by a person affiliated with the Yolo County Sheriff's Department, is that many licensed psychotherapists never report their patients, and it is that category which could most easily restrict those with violent fantasies and so on. The reason, often, is that the possible victims of these "thoughts" are general, and without an identifiable victim, the doctor does not have to report his patient. A second issue, the same person told me, is that even when a person cannot legally buy a gun, it is still very easy to buy one from a non-dealer, or the person (due to the nature of our heavily armed society) may just have family members with guns and he can get ahold of those. I am not sure if it still is an issue of internet sales, but that was partially the case with the Virginia Tech killer, who ordered his ammo online.

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  • Greg JohnsonJune 10, 2014 - 3:54 pm

    I definitely agree that the key to stopping this kind of behavior is at the source (health professionals) and not by weapon legislation. There are just too many ways people can easily kill each other if the wan to.

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  • Elaine Roberts MusserJune 11, 2014 - 11:03 am

    "As much sense as it makes to forbid individuals with certain serious psychiatric ailments from owning firearms, it makes even more sense to require they get treatment, even if it must be forced on them. This needs to happen not just to protect society or family members. It must be done to protect those who have lost touch with reality and are a threat to themselves." Excellent observation. Every time we have a mass killiing by a mentally ill person, the knee-jerk response seems to harp on the issue of gun control, yet there is mostly silence on the lack of mental health services, or laws that force certain mentally ill folks who are a danger to themselves and others to access treatment. I'm very glad Yolo County has decided to begin the process of putting teeth into Laura's Law by funding a pilot program. If successful, and citizens start demanding it, perhaps other counties will follow suit. I believe the cost is ultimately greater if we ignore Laura's Law - the greater cost of loss of life, either the life of the mentally ill person who commits suicide or the lives of people they kill.

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