Article on Kendra's law

[confused]

http://www.msnbc.msn.com/id/22435155/

We have a similar law in California, Laura's law, but it's rarely implemented

[MiaB]

To qualify for forced treatment under Kendra's Law, among other criteria, a person must have been hospitalized twice within the previous three years; must have shown violent behavior toward himself or others in the previous four years; and must need treatment to "prevent a relapse or deterioration which would be likely to result in serious harm to the person or others."

I don't think I like the sound of this, particularly the paragraph I've quoted above. At one time I qualified for all the criteria mentioned for "forced treatment" (what a bloody horrible term). Between 2004 and 2006 I was hospitalised five times (voluntarily, but keeping my job depended it). I fit the serious harm to oneself thing b/c in 2005 I slashed my arm so badly I needed 14 stitches. BUT did I need a COURT ORDER? Screw that. And what a random period of time to choose. So much can happen in 3 years with regard to whether or not we stabilise on our meds, and what if something new is released into the med market? (edit - actually, given those timelines, I STILL fit the criteria for "forced treatment")

I can see its merits in extreme cases, but there's a whole big slippery slope going on here. What consitutes "extreme"? Or "severely endangered"? My being unable to drive anywhere without contemplating heading the car off a bridge or into the nearest telephone pole? The fact that because I have both cut and burned myself badly, in addition to a suicide attempt a few years back, I have needed stitches so many times that one of my forearms looks like a horror experiment of some kind?

So, who can really make this kind of decision completely objectively? Every judge who has a case brought before him/her is going to look at it through the lenses of their own prejudices of what MI is about, regardless of the fact that they're supposed to be impartial.

Again, in the light of the Virginia shooting etc, I can understand the impulse behind the law. But to me it smacks of nannying and "caretaking" (which is a red flag word for me). And even something more sinister, like trying to "weed" MI people out of mainstream society b/c extreme mental illness is scary to deal with.

What happened to grassroots psychiatric staff taking responsibility for the patients they work with??

As far as forced outpatient therapy goes, I really don't know. I DO think there's a bit more merit in that than chucking someone in a psych institution and throwing away the key. More power to those it helps, and may it stay free of abuse and condescension (the caretaker thing), so that those who go in are treated like adults and not defective children.

Had something as detailed as Kendra's Law been in place, with its high expectation of accountability, officials might have been forced to monitor whether Cho got treatment, supporters of such measures say.

also, I find this line somewhat bizarre. What do they mean? The minute the guy started exhibiting severe psychiatric pathology, his doctor should have reported him to the cops? MORE slippery slopes here. Are we living in a Big Brother society now? Yes, Cho was very, very sick and what he did was evil, but it's NOT a done deal that someone who speaks of madness and anger is going to run on the same kind of horrific killing spree. It calls doctor-patient confidentiality into question. If for example, my pdoc and tdoc acted on some of the things that I've told them - in this context over in the States I'd probably be the one being locked up.

</rant>

[Penny Century]

I have lived in New York, and I have qualified, under the above quoted criteria, for forced treatment.

I think this law maybe goes too far.

I think it is important for people to have access to mental health services regardless of their ability to pay, and I think some people are unaware that they need treatment... but the wording of that law is simply too broad.

[MiaB]

the wording of that law is simply too broad.

I agree- I think it's a CYA thing - deliberately keep it as widesweeping as possible so that any conceivable case can be squeezed under its auspices.

[Maddy]

In OK anytime you are put in the nut hut against your will, you have to go in front of the "mental health court." Then the court decides what to do with you. Whether it's in-patient or out-patient court commit. I've never heard of anyone going to mental health court and NOT getting a court commit. If it's out-patient, then you only spend half the day at the hospital. That way they can monitor you and make sure that you get at least your morning, noon and afternoon meds. They also make sure to check you at least once a week to make sure you're taking them.

They've been doing this since at least 1994 that I can tell you. (AKA - since I've been in the system)

Things have been like this for years in various states. Why it's only now starting to get people's panties in a wad, I just don't know.

I can't vote, I can't own a gun. I can however be permanently marked with indelible ink by means of a court order since I have a history of "wandering off". (I can't remember right now the precise wording, damn the nitey meds)

[Steve@3AM]

I'm not "knowledgeable and don't "qualify" but I have a bit of an issue with the "care taker" aspect of this as well. People may mean well, but whether it's drug laws or anything similar I don't think "society" can really protect us from ourselves. If someone self injures, even seriously - or even terminally - it can be a tragedy for many people. But all that I think can really be done is to make sure resources for help are readily available. Even that's not being done.

So would something like these laws work IF they were limited to the possibility of harm to "others" and were much more closely defined so that they were not as subject to potentially creative "interpretation"?

Just thinking, not advocating.

[MiaB]

Why it's only now starting to get people's panties in a wad, I just don't know.

I think that the reason why it has me so freaked out is that there's no legislature of this kind in my OWN country. Of course there are involuntary admissions forced by the state, but not along the same lines of this "clear the streets of the scary MI people" mentality, which is what I'm reading into the whole thing in question here. I may be be wrong because of the way the article itself was phrased, but it still sticks in my throat.

So would something like these laws work IF they were limited to the possibility of harm to "others" and were much more closely defined so that they were not as subject to potentially creative "interpretation"?

I think that even a tighter interpretation that limits itself to possibility of harm to others is problematic. Hell, I don't know what I'm trying to say. I've worked for the government in designing policies that eventually wound up before the president, but that's in my field, which is not health care. There is a HUGE gap between policy and implementation, and there are ALWAYS dangers in the way the policies themselves wind up being read in the courts or hospitals or wherever. We refer to it as the "unintended consequences" of a parliamentary act.

This situation just seems to me like policy-implementation-practice gone wild. Picture a bunch of government officials who are not fully educated in the MI field* writing up one of these things and having it put into law, THEN having it twisted and read however the target audience wants to read it, and be very, very afraid.

PS Maddy - I'm completely appalled that you're not allowed to vote!

* this is how it works here. On any policy design committee you'd have government officials and researchers, with 2 or 3 token experts in the field, then the document produced would be rushed up through the ranks til it lands on the Minister's desk, and from there, slapped in front of the President for his approval. THAT'S what gets published publically for people to do with it what they will.

[crazynotstupid]

That article had me frothing at the word "coerced". But you probably figured that...

I doubt I'd quite fit under any of the criteria. But I can't help but remember, about 3 years ago, when I got hauled off to jail... my fiancee was more concerned about me getting "help" more than anything else. They siad, I guess. "oh he'll get help".

Ha. The county DA told her, "well, he'll just do it again, stay away from him!" Everyone thought I was just another Bad Man. But, well, at least she and my family believed in me...helped me get through, and get actual help, that they'd all known I'd needed.

Shit on me if I'd let anyone "coerce" me into that! HELL no! And besides when I needed it, they didn't give it anyways, not even a simple eval, cuz well...I was jsut some other "violent offender".

Makes me wonder--our psych unit in town has been shut down for some time. Would I have gotten an eval had it still been going? SO--how good are these laws, if someone who really IS mentally fucked up just gets written off as some "violent asshole" so they don't have to undergo an eval that takes time and money an agency doesn't have? How good is the law gonna be if you live in the wrong city/county?

Isn't that always the case? It's $$$ bitch and it always will be. We out here on the edge know that. You read that article, even them snobs in NYC (shit I'm in MT, they're all snobs ) know that.

[MiaB]

Isn't that always the case? It's $$$ bitch and it always will be. We out here on the edge know that. You read that article, even them snobs in NYC (shit I'm in MT, they're all snobs ) know that.

so basically it's fear mongering and as I said, a sinister desire to rid society of all the nasty MI people. And you never got the psych evaluation that you needed CNS? That's disgusting.

The other thing that appalls me about this is that even though I qualify for enforced treatment, I'm taking my meds like a good girl, I'm doing the work with my tdoc and pdoc AND I'm holding down a stressful job. And yet in terms of this law they'd still want to lock me up. What happened to recognition of the achievement and hard work it took for me to get to this stage? I'm relieved I don't live over there.

And I'm still outraged that Maddy isn't allowed to vote. What happened to basic human rights??