President Obama said the federal government has to do something meaningful to prevent future shootings, like the recent massacre of 26 children and adults at a school in Newtown, Connecticut. Here is what the federal government can do to prevent violence related to mental illness:
Here is what states should do.
States should make greater use of Assisted Outpatient Treatment, especially for
those with a history of violence or incarceration. AOT allows courts to order certain mentally ill people to stay in treatment as a condition of living in the community. AOT works. New Yorkers remember Larry Hogue, the “Wild Man of 96th Street,” who kept getting hospitalized, going off meds, terrorizing neighbors, and going back into the hospital. Connecticut does NOT have an AOT law on the books (see these facts about the Connecticut mental-health system), and we can’t say for sure if it would have helped in this case, but all states should have one to prevent similar incidents.
• States should make sure their civil-commitment laws include all the following, not just “danger to self or others: (A) Is “gravely disabled”, which means that the person is substantially unable, except for reasons of indigence, to provide for any of his or her basic needs, such as food, clothing, shelter, health or safety, or (B) is likely to “substantially deteriorate” if not provided with timely treatment, or (C) lacks capacity, which means that as a result of the brain disorder, the person is unable to fully understand or lacks judgment to make an informed decision regarding his or her need for treatment, care, or supervision.
• When the “dangerousness standard” is used, it must be interpreted more broadly than “imminently” and/or “provably” dangerous.
State laws should also allow for consideration of a patient’s record in making determinations about court-ordered treatment, since history is often a reliable way to anticipate the future course of illness. (Currently, it is like criminal procedures: what you did in the past presumably has no bearing, so the court may not know past history when deciding whether to commit someone. In fact, there are ways to know which mentally ill individuals become or are likely to become violent.)
– D. J. Jaffe is executive director of Mental Illness Policy Org.
DJ Jaffe is the founder of Mental Illness Policy Org http://mentalillnesspolicy.org which provides the media and public officials with unbiased information about "serious" mental illness from a pro-treatment perspective. It covers issues of violence, deinstitutionalization, not guilty by reason of insanity, assisted outpatient treatment, involuntary commitment, involuntary treatment and other issues.
DJ has been advocating for better treatment for individuals with serious mental illness for over 30 years.
DJ has served multiple terms on the board of directors of the Metro-New York City Alliance on Mental Illness, New York State Alliance for the Mentally Ill, and National Alliance on Mental Illness. He is a member of the Leadership Council of the National Alliance for Research on Schizophrenia and Depression. He was a cofounder and former board member of the Treatment Advocacy Center in Arlington, VA.