· 25% of individuals with schizophrenia were charged with a criminal offense during their lifetime, compared with 10% of community controls.
This most recent study is consistent with almost all recent studies on untreated serious mental illness and violence. Unfortunately, as National Review reported fifteen years ago the non-profit mental health industry continues to vigorously deny a relationship between violence and untreated serious mental illness for fear of causing stigma. This head-in-sand approach has prevented widespread implementation of programs that can reduce the violence and help patients live successfully in the community rather than behind bars.
The second study comes out of Duke University suggests what to do about increased violence among people with untreated serious mental illness. Researchers studied the cost of Assisted Outpatient Treatment (AOT). AOT (Kendra’s Law in New York and Laura’s Law in California) is a court order to stay in treatment as a condition of living in the community. It is only for the most seriously ill who have a history of failure to comply with treatment that has previously prevented them from becoming needlessly violent, incarcerated, homeless or hospitalized. Previous research shows AOT is highly effective at preventing these tragedies. But critics argued it was too expensive and diverted resources from higher functioning individuals. The new study lays those claims to rest.
Researchers found AOT does increase community based mental health care costs, but that the increase is dramatically offset by reduced hospitalization and incarceration costs. In the New York City sample, net costs declined 50% in the first year after assisted outpatient treatment began and an additional 13% in the second year. Savings were even greater outside the city. When researchers compared the group that was court ordered to receive care against a group that was not, savings for the court ordered group were about twice as large as those seen for voluntary services.
The conclusion from these two studies should be to make wider use of Assisted Outpatient Treatment. It allows individuals with serious mental illness to live safely in the community, rather than behind bars or in locked inpatient wards. It keeps public, patients and police safer and saves money.
Unfortunately, the mental health industry stands in the way. President Obama seems to be empowering them. While he started a high profile ‘national dialogue’ after recent mental illness related tragedies, he called on the non-profit mental health industry and Substance Abuse and Mental Health Services Administration (SAMHSA) to conduct it. Both continue to ignore the association between violence and untreated serious mental illness. He should have invited The Department of Justice. DOJ certified AOT as an effective crime prevention program, something SAMHSA has failed to do.
Other opposition comes from California Senate President Pro Tem Darrell Steinberg who has consistently backed the mental health industry's obstructionism instead of persons with serious mental illness and their loved ones.
The brightest light on the federal level seems to be coming from leaders like Rep. Tim Murphy (R. PA), a former child psychologist, and co-chair of the mental health caucus. He recently used his chairmanship of the House Energy and Commerce Committee Subcommittee on Oversight and Investigations to bring attention to the failures at SAMHSA and the need to more widely implement Assisted Outpatient Treatment. Hopefully important legislation will come out of that subcommittee. And in New York State, leaders like State Senator Catharine Young and Assembly member Ailleen Gunther have bucked the industry and sided with patients, public, and police and worked hard to enact and strengthen Kendra's Law.
These two studies show AOT is needed and it saves money. It's time for all states to make greater use of it.
Other opposition comes from California Senate President Pro Tem Darrell Steinberg who has consistently backed the mental health industry's obstructionism instead of persons with serious mental illness and their loved ones.
The brightest light on the federal level seems to be coming from leaders like Rep. Tim Murphy (R. PA), a former child psychologist, and co-chair of the mental health caucus. He recently used his chairmanship of the House Energy and Commerce Committee Subcommittee on Oversight and Investigations to bring attention to the failures at SAMHSA and the need to more widely implement Assisted Outpatient Treatment. Hopefully important legislation will come out of that subcommittee. And in New York State, leaders like State Senator Catharine Young and Assembly member Ailleen Gunther have bucked the industry and sided with patients, public, and police and worked hard to enact and strengthen Kendra's Law.
These two studies show AOT is needed and it saves money. It's time for all states to make greater use of it.
