“Lack of Insight”: The Phrase Sucks But the Problem Is Real
Because I’m still in shock over the election of Barack Hussein Obama as the 44th president of what I can now say is the TREMENDOUSLY AWESOME United States of America, I asked TTWS readers what we should talk about now. Kay wrote the following, and I think it highlights many challenges mental health advocates have to face. There are no easy answers here, but I share the frustration of those involved in this case.
I’m always a fan of talking about compelling mentally ill people to get help. I’m on my uni’s debate society, and have close relationships with debaters from other schools. One unversity’s club had a girl that the other members were really concerned about, because she would follow people home and call them at all hours, they found notes implying she wanted to hurt herself and others, and a lot of other major concerns. They tried to talk her but she would literally walk away and refuse to listen. So as a group they went to Student Counselling and expressed their concern that she would hurt herself or someone else, and they were told that the university couldn’t do anything unless she came in herself.
A few months later, this girl went to a bus stop, stabbed a stranger, then got on a bus. My friends expressed relief that it wasn’t any worse (the victim did not suffer any permanent physical damage and is now fine) and that she is now getting the help she needs (she is in a psychiactric hospital), but it could have been so much worse. It could have been another Virginia Tech.
Should the university have intervened even if this girl showed no interest in getting help? Are they responsible to any degree?
I think Kay’s final question here is important, but embedded within the story are questions that make advocates nervous on the score of empowerment, emancipation and involuntary commitment.
Discuss.
liz | 11:33 AM | Uncategorized
Liz,
This is such a difficult call.
My initial thought is when a group of people – as opposed to say one or two -calls for an intervention, it should be seriously considered. Thank God the person who was stabbed has recovered, but I agree with Kay this easily could have become far worse.
The rights of a sick individual in instances such as these are trumped by the need to protect society as well as themselves. It is tough love taken to the most extreme.
Dennis
Most likely, this girl will have a very short hospital stay and, even if she is taking medications that help her symptoms while in the hospital, when she is discharged, she very likely will not have any follow-up treatment, especially if she decides she doesn’t need it. Then, as so often happens, she may just continue to cycle in and out of hospitals, waiting each time until she shows that she is a “clear and present danger to herself or others” before she can be committed into treatment again. That is what our current law in Pennsylvania, the Mental Health Procedures Act of 1976, requires. So, under this law, the university cannot intervene. When family and friends try to help someone they care about with a severe mental illness and lack of insight, this law requires that they first prove dangerousness, and only a previous 30-day history can be used for proof that someone fits the criteria of “clear and present danger.” We need to change our laws if we want to help individuals who lack insight that they have a treatable mental illness. An effective outpatient treatment law such as SB 226 would benefit someone like this girl because a provider agency would also be required to ensure that she continued to receive treatment in the community. (http://www.treatmentadvocacycenter.org/index.php?option=com_content&task=view&id=234&Itemid=169)
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