Wednesday, January 19, 2011

Rehka Basu Writes a Column that the New York Times' Maiden of Snark, Maureen Dowd Would Find Uncomprehensible

Basu: Empower families to protect mentally ill


Among all those devastated by the Tucson shootings is one couple that's also being hounded by reporters and feeling the sting of condemnation. These are the parents of Jared Lee Loughner, the 22-year-old accused of multiple counts of murder and attempted murder. If convicted, he could face the death penalty.

Amy and Randy Loughner have issued a statement expressing sorrow for the victims. Friends say they're crushed, though they've gotten understanding from an unlikely place. The husband of U.S. Rep. Gabrielle Giffords, a target of the shootings, told Diane Sawyer he'd be open to meeting them, that it's not their fault and "they've got to be hurting in this situation as much as anybody." Indeed.

Whatever they knew of Jared's mental problems, they couldn't control his actions. On the morning of the shooting, for example, when his father reportedly questioned Jared on a bag he was removing from his trunk, his son ran off, evading him. He once left home and broke off contact.

This is the cruel paradox for families of mentally ill adults who refuse help and don't acknowledge their illness. They get blamed, though under most state laws, they can't demand the relative take medicine or enter a psychiatric facility unless a court finds he's a danger to himself or others.

The premise is good: to protect the civil liberties of the mentally ill. But what if the illness prevents their recognizing they need help? Did the laws go too far?

A month ago, a Johnston woman, Andrea Addington, wrote the paper agonizing over her missing sister, who has been diagnosed with paranoid schizophrenia but doesn't acknowledge it. She has broken off most contact with family, and was recently evicted from her half-million-dollar central Iowa home, which was foreclosed on after her divorce.

Believing God would take care of her, she had made no plans, and refused her family's help. All the agencies the family called said she'd have to ask for help, and be on Medicaid or Social Security, or under psychiatric treatment to qualify for services. But she won't apply, and her sisters can't apply for her. Police spotted her sleeping in her car, and told her to move, saying they could do nothing, Addington said.

"I doubt she is eating now, with no money, and the temps in Des Moines area are supposed to be below zero the next few days. How much does it take to freeze to death? Or die of asphyxiation?"

She turned up in a shelter a few weeks later and has since moved in with an acquaintance, but Addington wonders when the next shoe will drop. She wants the law changed so she could help. She has found an ally in Treatment Advocacy Center, a national organization that aims to remove barriers to treatment.

It believes changes to state laws in the 1960s and '70s have resulted in many people going without needed treatment, becoming homeless, incarcerated, suicidal, victimized or prone to violent episodes. An estimated one-third of the nation's homeless suffer from extreme mental illness, as do about 45 percent of Iowa inmates.

Of course, not all mentally ill people are dangerous. Some can be very lucid on medication, but delusional off it. But the law may too narrowly define dangers to self. Someone not threaten suicide could still risk death sleeping outside when it's freezing.

The Treatment Advocacy Center has drafted a model law, combining civil liberties protections with acknowledgement that mentally ill people may not make good decisions for themselves.

It defines such patients as chronically disabled based on their history and unwillingness to comply with treatment. Any adult could file a petition for "assisted treatment" under certain conditions.

Iowa lawmakers grappling with mental health reform have a big job increasing access and funding for services. But they must also take a hard look at updating laws so families can help prevent mentally ill loved ones from falling through the cracks.