He Butchered a Shrink,
Doctors Didn't Believe
He Would Be Violent.
* * *
Law Protects Psychos
From Confinement.
Public Put at Risk.
The savage murder of therapist Kathryn Faughey by the obviously demented David Tarloff raises the issue of why Tarloff, a known schizophrenic, was not confined in a state mental hospital?
Published reports indicate he has been mentally ill at least since 1991, and that he has had numerous clashes with the authorities. His most recent scrape with the law, the Sunday Post reported, came February 1, just eleven days before the murder. He had punched a security guard at St. John's Episcopal Hospital in Rockaway when he was not allowed to see his mother, who did not want to see him.
The Times has an exhaustive well-researched story on the case which appeared Monday on page A1, column 1, then jumping to B5. This is sensational placement for a local murder not involving celebrities. The story is long because beside recounting the crime, it also discusses why Tarloff was repeatedly found to be sane. The headline, BEFORE MURDER, TROUBLED QUEST TO FIND MOTHER, The by-line: by Cara Buckley and Al Baker, former Albany reporter; the lede:
"In the eight and a half months before his arrest in the fatal stabbing of a Manhattan therapist, a Queens man became so obsessed with his institutionalized mother that his father kept moving her from nursing home to nursing home, a law enforcement official said on Sunday.
READ MORE...
"Here is one suggestion that has been made: When a person is released from a mental hospital, treat it as if he/she were on probation from prison. Compel them to appear regularly before the counterparts of parole officers. Test their blood to make certain they are taking their medications. Check with their housemates. If they are not in compliance, send them back to the institution. The state has a duty to supervise the people it turns loose on the streets. And the oversight should be far more rigorous than it is today."
ReplyDeleteThis could work but I think only for patients who have been deemed violent or dangerous. I have had good friends hospitalized w/depression - good friends with very high-profile jobs and I can't imagine them submitting to probation or blood tests or calls to their families/housemates.
We do need parameters for this sort of surveillance.
The "safe" society is scary to those who appreciate freedom!
Budget cutting by reducing mental health facilities results in increased risk to society. Taxpayers are apparently willing to accept the small risk that they or their family will be the victim of a psycho rather than pay higher taxes so that those ill with mental health problems can receive the treatment that they need.
ReplyDeleteRey Olsen
This is the kind of "care" being given here in New York City:
ReplyDeletehttp://www.nypost.com/seven/01282008/news/regionalnews/mental_errors_517812.htm
It's not care, it's further abuse, and certainly does more damage than good. No wonder people come out of psychiatric care worse off than they were before.
I would be dismayed too Mr. Stern if I had spent the past week using every terroristic tactic possible to incite the public - only to discover that not everyone is as mindless as you would like to think they are. Is it possible that this guy a murderer out for revenge because he had been hospitalized against his will? And is it possible that the real paranoiacs here are those who try to frighten the public into believeing that this is the beginning of a terrifying new wave of crime. Or has the word murderer been eliminated from the dictionary and should we just shut down our criminal justice system? Come down off your pedestal Mr. Stern and don't be disappointed that the public is a lot smarter than the media thinks they are!
ReplyDeleteTracking patients after hospital discharge? What happened to medical privacy?
ReplyDeleteMuch of the problem is due to deinstitutionalization, and of course insurers, who refuse to equate illness of the mind with illness of the body.
Henry:
ReplyDeleteThis is a well thought-out column. The problem is that neither you nor anyone else seems to have a solution. Since mental health is not only a local problem it may be that on a national scale a solution applicable to all localities might be discovered. It is worth a try.
A.L.
I think your list of suggestions is extremely useful and only wish that you had ready access to the law to put them into effect. At the very least they whould be a part of every major city's health dept law.. - Meredith Mayer
ReplyDeleteFebruary 26, 2008
ReplyDeleteDear Henry Stern,
I have just read your commentary on the murder of Kathryn Faughey. I'm responding as a family member who became a mental health advocate in the mid-1980s. Let me first assure you that the mental health community's need to end violence by mentally ill individuals is possibly even greater than that of the general public. A 30-year downsizing of our mental health system has led to the abandonment of millions of Americans nationwide. I'm sure I don't need to remind you of the deinstitutionalization fiasco and the failure of communities play their intended role of offering needed supports, housing, and follow-up treatment. Although there has been episodic lip service to meeting the government's obligations, broken promises and endless commission reports are the reality.
For example:
Psychiatric hospitals are overcrowded with people waiting for discharge with nowhere to go.
Community support programs have room for just 20% of eligible New Yorkers.
State-assisted housing has room for just 6.5% of eligible applicants.
The current over-reliance on medication alone, the most problem-prone aspect of treating a mental illness, does little to turn patients' lives around,
Community programs' staff turnover rates, due to meager salaries for difficult work, block patient progress.
Calls to make commitment easier by changing laws ignore the fact that commitment laws are flexibly interpreted. Appropriate change is held back by economics and politics.
Needed change has been suspended by a 2-decade controversy over forced medication (also called assisted outpatient treatment, or AOT). A 7-year AOT experiment (Kendra's Law) is now showing how ill-conceived it was. Touted as necessary for public safety, just 15% of Kendra's Law participants had "harmed others" before entering the program. And only the luckiest patients get the high quality support programs all AOT participants were promised.
I do hope you will read the website entry below (from www.stigmanet.org)
February 23, 2008 - News of the Week
DR. TORREY BLAMES "EVERY NEW YORKER" FOR KENDRA'S LAW FAILURE
Last week in Manhattan, Kendra's Law was unable to prevent a brutal murder. The assailant's father has told the New York Times that even court-ordered treatment under Kendra's Law had failed to end a long ordeal that began in 1991, when Leonard Tarloff repeatedly found himself working to get his son treatment for mental illness. (NYTimes 2/20/2008).
Yesterday Dr. E. Fuller Torrey, chief proponent of the law, skipped lightly over the law's failure in an Op-Ed for the New York Post ("Deadly Madmen," 2/22/08). Dr. Torrey began the Op-Ed by recalling murders committed in the 1980s and 90s. His manipulation of facts is familiar. First he created a violent backdrop by recalling 7 highly publicized assaults commited decades ago. He ignored news reports which at the time showed at least 5 of the 7 assailants were under psychiatric treatment (Michael Vernon), had been refused help (Andrew Goldstein), were discharged prematurely (Juan Gonzalez) and (Andrew Goldstein), were told to find help somewhere else (Kevin McKiever), or had no prior signs of distress (Colin Ferguson). Implying that violence has reached epidemic proportions, Torrey called violent acts an "endless list" of virtually identical cases all requiring forced medication.
Torrey cites his website's "Preventable Tragedies" database as proof that medication is the solution. That seems simplistic after one views the data. In 2006, I looked at the data in psychlaws.org's "Preventable Tragedies" database (unfortunately many entries are now deleted). This impressive resource contains clues to the mental health system's weaknesses. Focusing on 66 homicide cases nationwide in a 6-month period, I found that a significant number of assailants were reportedly taking medication or showed meds in their toxicology reports. Many case summaries showed the homicide assailants had been prematurely discharged from or refused entry to treatment facilities. Histories of violence and problems with alcohol and substance use had plagued many of the assailants. While the data show that many assailants did indeed go off medication, this does not mean the medication was effective. Antipsychotic meds are said to be ineffective for people who have non-psychotic personality disorders. It is puzzling that Torrey has closed his mind against successful violence prevention alternatives such as "Housing First" and castigates anyone who disagrees.
Dr. Torrey not only shuns the fact that Kendra's Law was unable to prevent David Tarloff's murder of Kathryn Faughey. He shows no interest in what may have gone wrong. He does not acknowledge the dire scarcity of housing, special services, and high quality programs promised under Kendra's Law. He shows no concern for people who are forced to take medication that may cause them problems. He faults protectors of civil rights when he surely knows that commitment laws are interpreted flexibly and reflect society's economic and political priorities.
Torrey never questions Kendra's Law --- a 7-year experiment that has consumed an inordinate amount of time, energy and resources -- and blames the Faughey murder on everyone else including "every New Yorker for not demanding a system that works."
The Treatment Advocacy Center's inability to face reality seems obvious in the following examples: New York's official evaluation of Kendra's Law (2005) reported improvement rates of program participants who had caused "harm to others." Before entering the program, just 15% of the participants had previously harmed others. After six months in the program, 8% had harmed others. The Treatment Advocacy Center cites these figures as proof that Kendra's Law reduced "harm to others" by one-half. Example 2: Totally ignored is the program's disappointing rates of success in reducing alcohol and substance use among people who have combination diagnoses. Considering that such problems reportedly affect 50% of Kendra's Law participants and puts them at high risk for violent behavior, this lack of candor is troubling. Example 3: The state's report of 2005 (the latest available) indicates a shortage of case management services. Case management was to be a keystone of the Kendra's Law program. An apparent over-reliance on meds alone and the shortchanging of other community supports boosts critics' claims that access to appropriate high quality programs, not forced meds, turns lives around best.
I think your list of suggestions is extremely useful and only wish that you had ready access to the law to put them into effect. At the very least they whould be a part of every major city's health dept law.. -
ReplyDelete