State's failure to protect its own

March 16, 2000|By E. Fuller Torrey and Mary Zdanowicz

GEORGE AND Gloria Jean Shenk, David Meyers and Jennifer L. McDonel should not have been shot to death, and Joseph Palczynski, their alleged attacker, should not have been allowed to remain in the community without proper monitoring and treatment for his brain disease.

The horrific incidents that occurred in the past week in Bowleys Quarters tragically reflect the deadly pattern of what happens when schizophrenia and manic-depressive illness -- the two severest forms of mental illness -- are allowed to progress untreated.

That police say the shooter had a history of mental illness and violence should not be a surprise. Nearly 1,000 homicides are committed each year in the United States by people with untreated mental illnesses. These murders -- about 5 percent of the estimated 20,000 homicides nationwide -- are a testament to the failure of deinstitutionalization.

Studies have shown, however, that people who take medication for their mental illness are no more prone to violence than the general public; findings indicate that violence among those being treated is reduced by half.

But in Maryland, 40 percent of the people with schizophrenia and manic-depressive illness are not receiving medical treatment because of the way the state's mental illness treatment law is written.

When individuals refuse treatment, Maryland law prevents them from receiving appropriate medical care until it is too late. The law prohibits treating individuals over their objection -- until they pose a danger to themselves or others. In other words, a person must have a finger on the trigger of a gun before any medical intervention will be prescribed.

Many states have abandoned the dangerousness standard for treatment. Instead, these states consider other factors, such as whether a person's behavior is deteriorating toward dangerousness; whether the person is unaware that he needs treatment; and whether the person has a history of violent behavior or of not taking medication.

This is critical when dealing with the care of the severely mentally ill. Nearly half of the people who have schizophrenia or manic-depressive illness lack insight into their illness. Because the disease affects their ability to assess themselves, they simply do not realize they are sick and in need of continual treatment.

They cannot recognize that the symptoms of their illness -- hallucinations, delusions, paranoia and withdrawal -- are, in fact, symptoms.

Since they do not believe they are sick, they see no reason to apply for services and medication that would allow them to recover to a productive, normal life. Maryland's woeful failure to provide appropriate treatment and ongoing care for patients discharged from hospitals has sent many individuals with the most severe forms of brain disease spinning through an endless revolving door of hospital admissions and re-admissions, jails and public shelters.

In addition to his mental illness, police say Mr. Palczynski has a long history of domestic violence, disruptive behavior and many brief hospital stays.

The legal standard for assisted treatment should be the need for medical care, not dangerousness. Society has an obligation to save people from degradation, not just death. Most individuals with severe mental illnesses who have experienced severe deterioration in rational thought can live in the community with the proper medication.

For some, like Mr. Palczynski, living in the community must be contingent upon taking prescribed medication.

Maryland's laws miserably failed Joseph Palczynski, his victims and their families. Strong assisted treatment laws would help prevent such tragedies in the future and give every Marylander the chance to live a safe and productive life.

Dr. E. Fuller Torrey is president and Mary T. Zdanowicz is executive director of the Treatment Advocacy Center, a nonprofit group working to eliminate barriers to treatment of severe mental illnesses.

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