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Psychiatric Advance Directives Make Sense!

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If you have read my book, this blog, or heard me speak, then you know that the first time my son, Mike, became psychotic, I raced him to a hospital emergency room seeking help. Mike was delusional, but he didn’t believe anything was wrong with him, and he was convinced that all “pills were poison” so he refused treatment. The emergency room doctor told me that he could not intervene until Mike became an “imminent danger” either to himself or others. That was the law. Mike had a right to be “crazy.”  Forty-eight hours later, Mike was arrested after he broke into an unoccupied house to take a bubble bath.
The second time Mike became psychotic, I waited until he became dangerous and what happened?
Our local mobile crisis team refused to come help me, the police were called, and Mike was shot with a Taser.
As a father, those two situations frustrated and enraged me.
What I didn’t know at the time was there was an alternative that could have helped Mike and possibly  prevented what had happened to us. 
It’s called a Psychiatric Advance Directive and this week, I received a wonderful email from my state National Alliance on Mental Illness chapter telling me about how PADs, as they are known, are becoming more common in my home state of Virginia.
A PAD is a legal document that is filled-out by a person with a mental illness while he/she is  well. (One of the biggest myths about persons with mental disorders is that they are always psychotic and, therefore, incapable of rational thought.)
PADs are generally divided into two sections.

Death and Insanity, a Final View

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Much of the information for this blog was taken from an article in the Wall Street Journal which can be read by clicking on the highlighted newspaper link.
I have been writing this week about persons with mental illnesses who have committed murders and how our legal system, the victims, and society deal with these crimes.
This blog is the final one in this week’s series and I want to share it with you because it presents yet another perspective on death and insanity.
Like Wednesday’s blog, today’s is about someone whom I admire. Joe Bruce and I met when I was giving a speech in Maine. You might have seen him on television because his family’s case has received a lot of attention.
Joe and his wife, Amy, lived in Caratunk, a picturesque town of about 110 residents nestled in the state’s northern hills.  Joe is a rugged, friendly man, who worked as a senior technician for the Maine Department of Transportation before retiring several years ago. Amy, served as the town’s treasurer. Their son, William – known as Willy – is the oldest of three boys. The family lived in a 100-year-old farmhouse that sits near the banks of a winding, rock-strewn stream.
To outsiders, their lives may have seemed picturesque, but something was wrong with Willy.

A Different View of Executing the ‘Insane’

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Nick and Amanda Wilcox’s daughter, Laura, was nineteen, beautiful and talented. She was a sophomore at Haverford College, a Quaker school in Pennsylvania, and in the midst of a campaign for the student body presidency when she came home for Christmas Break in 2000.

Laura had worked during the summer as a receptionist at the Behavior Health Department in her hometown of Nevada City, California, which lies between  Sacramento and Reno. When her boss called and asked if she could fill-in for a few days over the holiday season, she immediately agreed.

Her mother, Amanda, would describe her daughter to me this way when we first met last summer.

“Laura had extraordinary capabilities, kindness and spirit. She was an outstanding student, graduating as high school valedictorian and was attending a highly regarded college. She was extremely organized, disciplined and motivated; she had boundless energy. She lived life fully as she danced through her days, easily juggling academics, service work, clubs and student council, piano, ballet, and exercise. Laura touched and inspired everyone she met, she had a big circle of close friends; her teachers adored her. My daughter was beautiful, but her inner beauty was even greater. Her strong sense of compassion, respect, justice, and truth were beyond her years. All of that changed when she crossed paths with Scott Thorpe.”

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How do we define insanity?

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Kelsey Patterson spent much of the 1980s in-and-out of mental hospitals in Texas. No one questioned that he had a severe mental illness –paranoid schizophrenia – that often caused him to become violent. 
In 1980, he shot and seriously wounded a co-worker. Patterson believed his food was being poisoned by the man even though they’d only met that morning.
Three years later, Patterson wounded another man during a delusional assault.
In 1986, Patterson assaulted yet a third victim.
Finally, on September 25, 1992, just days after his brother had tried unsuccessfully to get him committed to a psychiatric facility, Patterson fatally shot a businessman and his secretary.
He then put his gun down, stripped to his socks, and paced, shouting incomprehensibly until the police arrived.
There was no doubt that Patterson had committed two murders.
There was no doubt that he had a severe mental illness and was delusional at the time of the murders.
Did that mean he couldn’t be held accountable for his actions because he was legally “insane?”

Everyday Heroes Make A Difference

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 My wife, Patti, knows how to focus on the good things in life, even during the worst of times.
Perhaps she is resilient because life has been so tough on her. (And I am not talking about the fact that she is married to me.)
Her first husband died of cancer, leaving her a widow in her thirties with four young children. Both of her younger sisters have died recently of lung cancer, creating, as she puts it, ‘a hole in my heart.’
Yet, she has refused to let these tragedies consume her or make her bitter.

When do we release Andrea Yates and John Hinckley?

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An editorial published in The Wall Street Journal recently by D.J. Jaffe, one of the founders of the Treatment Advocacy Center (TAC), caught my interest. You can read the article here.

I write about TAC and assisted outpatient treatment laws, commonly called AOT laws, in my book.  Put simply, AOT laws require a person with a history of mental illness to take their medication regardless of whether or not they want to take it.   

D. J. Jaffe

Most states that have passed AOT laws have very stringent criteria about when a person can be ordered by a judge to take medication. First, there has to be evidence that medication actually helps control a person’s symptoms. In addition, the person also has to have a history of either going off their medication several times or of violence.

AOT laws, such as Kendra’s Law, in New York, have proven to be highly effective at helping persons who have chronic illnesses and often end up in our jails, prisons or are homeless.  

Of course, ordering a person to take medication when they don’t want to take it is controversial and if you want to start a heated discussion in mental health circles — just mention AOT.  Both sides feel passionately about the issue.

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