How many tragedies will it take?

Joel Seidel’s tragic death spurred reforms in Camden County’s jails, new diversion programs by police departments, and a federal lawsuit that was recently settled for $4 million. The one area that has yet to enact reforms? New Jersey’s mental health system.

New Jersey is still one of only eight states without the ability to order AOT for individuals who are unable to maintain their treatment in the community. Individuals like Joel Seidel, who according to news reports, had repeatedly refused to take medication for schizophrenia and had failed to complete outpatient treatment programs. An attorney for Seidel’s family explained that they hadn’t posed the $150 bail that would have released him because they were hoping he would be involuntarily committed to get the help he needed. Sadly, he never got that chance. His lifeless body was found about an hour before his scheduled court hearing on his involuntary commitment.

AB 2304, a bill that would finally provide New Jersey the opportunity to help those like Joel Seidel, sits in a committee awaiting action. It should be passed before the next senseless tragedy occurs.

Too late for Seidel, NJ could still save others

Joel Seidel, a frail 65-year-old retired stockbroker with schizophrenia, was stomped to death in 2004 in a Camden County, New Jersey, jail.

His cellmate, accused of the murder, was so violent he had been sent to jail from a psychiatric hospital after he raped another patient. Jail procedures in New Jersey have since been reformed to prevent vulnerable inmates from being housed with violent ones. Seidel’s family hopes those procedures will be made permanent in a settlement of a lawsuit against the county.

But what has been done to prevent people like Seidel ending up in jail in the first place?

Seidel “repeatedly refused to take medication for schizophrenia and had failed to complete outpatient treatment programs.” His family did not bail him out of jail because they believed that he “could only get help if he was involuntarily committed to a county psychiatric hospital” from the jail.

If his family had had some other way to ensure he would participate in treatment in the community rather than getting treatment via jail, he might be alive today. But the family’s hands were tied because New Jersey is one of only 8 states whose archaic law prevents court-ordered community treatment. Community treatment programs were available for Mr. Seidel – he was just too sick to realize he needed treatment. A court order might have saved his life.

A bill (S1093) that will help prevent other New Jersey families from facing the Seidel family’s dilemma and tragic loss passed the New Jersey Senate unanimously nearly a year ago. But it is still not law because the Assembly Human Services Committee has not even scheduled a hearing for the bill (A2304).

New Jersey must act now to make community services available to people like Joel Seidel who are too sick to participate voluntarily.

Cops in Crisis

Anyone who doubts that law enforcement are increasingly the ones responding to people with mental illnesses who are in crisis needs only to look in the newspaper.

Just in the past two days, we’ve seen these examples of how the safety of both law enforcement and citizens is compromised when the mental health community abdicates their responsibility to care for people with the severest mental illnesses.

• In El Paso, TX, a man with schizophrenia was fatally shot by a police officer after he threatened paramedics with a gun and threw bleach at officers during a psychotic break.
• A middle-aged man in Ohio was shot and wounded by police officers after the man beat a police officer with a lead pipe and threatened to shoot him. The man is described as having bipolar disorder.
• A grand jury has decided three officers in Texas were acting in self-defense when they shot a woman with schizophrenia in January. The police were called to the woman’s home and she charged at them with a 14-foot knife.
• Chicago police are involved in a lawsuit for fatally shooting a young man who had a mental illness. The officers were called to “diffuse the situation” while the young man was having a psychotic break. He threatened the officers with a knife.

Warped priorities

In Pennsylvania, still more hospital beds are being phased out – leaving precious few for anyone other than those accused of crimes.

Under a settlement of a lawsuit reached last year, the hospital agreed to phase out 210 of 304 patients, most diagnosed with schizophrenia, in the civil section over four years. The forensic section, for people accused of crimes, will be unaffected.

And in California, mental health workers, physicians, and pharmacists are rapidly shifting from hospital jobs to prison jobs, where pay is a remarkable 40% more. The result is significant staff shortages at the hospitals.

Although several of the state hospitals still accept patients committed through the civil courts, the vast majority of mental hospital patients statewide now are channeled through the criminal justice system … Abysmal medical and mental-health care in the state's prisons prompted federal overseers in two separate lawsuits to order the soaring pay increases as a way of luring competent clinicians to the California Department of Corrections and Rehabilitation.

The California debacle leaves Atascadero State Hospital with only 30% of its allotted psychiatrists. (And now the prisoners who are supremely ill and require inpatient psychiatric care cannot get transferred into Atascadero – and are being sent straight back to prisons, where hopefully all those newly hired medical professionals will find a way to treat them …)

It would be nice if the recent surge in concern over improving prison mental health care was paralleled by a concern for improving care in inpatient psychiatric hospitals. Alas, it seems that the search for quality inpatient beds is being totally abandoned in lieu of improving prison and other forensic beds.

As today’s Washington Post notes:

Patient advocates say the long-term solution to the problem is simple: Make
more beds available. ... [As one expert says] "There is no more expensive way to access the mental health system than through the court system.”

SHORT BITS

• One Florida judge gives the state 60 days to figure out how it will move mentally ill inmates out of Orange and Osceola jails and get them the treatment they need, saying “"I wanted to have something done today, but years of neglect of the mental health system is nothing something that's going to be fixed overnight."
• A Maine advocate applauds Robert Bruce’s lawsuit against the state claiming state negligence played a role in his wife's death at the hands of their son. The letter-writer noted “What a shame when the difference between life and death are a few pills a day, and you can't make your loved one take them. His fight isn't just for him, but for all of us who have been there.”
• A Virginia paper comes out in support of Virginia State Supreme Court Chief Justice Leroy Hassell’s Commission on Mental Health Law Reform.
• Kaiser Permanente is charged in skid-row dumping in Los Angeles, California.

Suing for justice

When factoring in the costs to society of not treating people, don’t forget to include that of lawsuits.

Grieving families whose loved ones were abandoned by the mental health system are too often left with no choice but to call law enforcement when the person they love stops medication and deteriorates. Many of those encounters – again, sometimes in spite of rigorous police training – end up in tragedy. Some family members turn to lawsuits.

In California, police had responded twice before to take Jesse Hernandez into custody for mental health reasons – he had schizophrenia and was off his medication. The first two times they took him in without incident. The third time, after a 2-hour standoff with the SWAT team, he was killed.

In Ohio, the sheriff is facing a $250,000 lawsuit from the grieving family of Nasir Abdi. Abdi was killed “when four deputies came to take him to a treatment center for his paranoid schizophrenia after his family called for help because he refused to take his medication and was hearing voices. The deputies said that Abdi lunged at them with a kitchen knife before he was shot.”