National Association for Rights Protection and Advocacy

 

From the Hartford Courant, July 27, 1999, page A11 (Op-Ed):

An Ineffective Idea

Involuntary Outpatient Commitment, While Attractive Doesn’t Work


Thomas Behrendt
Jamey Burden


The tragic death in Bristol of the Reverend Robert Lysz has focused public attention on the inadequacies of the mental health system. As in the past in the wake of such a tragedy, many rush in with easy answers and instant solutions that are no more than empty promises.

However, the assertion that an involuntary outpatient commitment (IOC) statute would have prevented this terrible tragedy is false. IOC is not a solution – it is not even a "band-aid," as some have suggested. Research data from states that have IOC statutes prove that it does not work. New York passed a law in 1994 establishing an IOC pilot program that was very closely studied. The findings (released in 1998) are unequivocal: There was no statistically significant difference between the court-ordered (IOC) group and the control (non-IOC) group.

In a review of the empirical studies on IOC, Maloy (1992) concluded that there is simply no evidence to suggest that IOC works. The sad fact is that in Connecticut resources allocated for mental health services have been shrinking dramatically. For too many years, policymakers have asked mental health clients and service providers to do more with fewer and fewer dollars. What we need is a wide spectrum of accessible, humane, recovery-based services that offer people choices with full respect for clients' dignity.

IOC does not prevent crime and it is unethical. Studies show that, in states with IOC laws, there is a "wider net" of unnecessary social control and, of course, explicit coercion; this results in a broad range of abuses.

This is not surprising. The reason it is not surprising is that IOC has nothing to do with treatment/services for people; it has everything to do with disempowerment, humiliation, and unwarranted domination of people's lives.

The proponents of IOC list a number of murders committed by persons diagnosed with psychiatric disabilities. This provides us with nothing, other than reinforcing myths about persons with psychiatric disabilities who for too long have been prejudiced by ignorance and stigma, and misinformation.

Studies consistently show that psychiatrists cannot predict future dangerousness in their patients (the American Psychiatric Association has stressed this fact time and time again in briefs to the United States Supreme Court).

Studies have demonstrated that the percentage of "normal people" who commit violent acts is between two and three percent whereas the percentage of persons diagnosed with psychiatric disabilities who commit violent acts is slightly less.

Sadly, persons identified as having psychiatric disabilities are at a significantly higher risk than "normal people" of being victims of violent acts. An example of the depth of stigma and prejudice already existing is evidenced in the following statistic: 77 percent of those characterized on television as having psychiatric disabilities are depicted as being dangerous.

The threat of forced "treatment" (i.e., IOC) causes people to avoid services. Coercion creates feelings of fear, anger, and resentment toward mental health services. Treatment and recovery from a psychiatric disability must include choice and self-efficacy.

Given that 42 states have IOC statutes, we know that the perpetrator of the horrible murder of Reverend Lysz has passed through some of them (reports have indicated that he moved around quite a bit). How did IOC help this man in those states? Social control and healing are mutually exclusive concepts; there is no method by which to enjoin them.

 

Thomas Behrendt is the legal director of the Connecticut Legal Rights Project. Jamey Burden is a candidate for a master’s degree in social work and an advocate for people diagnosed with psychiatric disabilities.

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As background, Connecticut does not have IOC. Advocates there were successful in fighting off legislation three years ago. Since then, neither government officials nor NAMI of Connecticut has pushed for it. Beginning in July 1999, Amy Pagnozzi, a columnist at the Hartford Courant, has written several columns attacking the legislature and mental health department for not enacting IOC, blaming various sensational murders (the latest being the killing of a priest) on the lack of IOC, and misciting facts and figures courtesy of TAC. This columnist’s articles have created such a stir that the state is almost certain to see legislative proposals for IOC later in the year.


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