(3-19-18) During the weekend, the Associated Press reported that authorities in Parkland, Florida, sought to involuntarily commit the alleged school shooter there several times more than a year before he opened fire, killing 17 with an assault rifle and wounding 17 more . A commitment under the law would have made it more difficult, if not impossible, for Nikolas Cruz to obtain a gun legally.
A New York Times OP ED by advocate Normal J. Ornstein, whom I greatly admire, specifically discusses what happened in his family in Florida after Ornstein used the Baker Act to hospitalize his son.
Meanwhile, The Washington Post published a front page story entitled, “I’m constantly asking: Why? When mass shootings end, the painful wait for answers begins. Earlier in that same week, D. J. Jaffe, author of Insane Consequences, and no stranger to causing controversy, published an Op Ed in the Post under the title: “Don’t deny the link between serious mental illness and violence.” Jaffe wrote that untreated Americans with serious mental illnesses are, in fact, more dangerous, an unpopular view that others have challenged. He also repeated his call for six changes: 1. more hospital beds, 2. not using dangerousness as the primary criteria for involuntary commitment, 3. adoption and better funding for Assisted Outpatient Treatment, 4. modifying HIPAA so that parents and other caregivers are kept informed by medical providers, 5. using “red flag” orders to remove firearms from persons with mental illnesses, and 6. reining in the federally funded, state administered Protection and Advocacy groups (PAIMI), that often fight to get individuals out of hospitals arguably before they are ready.
How a Bad Law and a Big Mistake Drove My Mentally Ill Son Away
Ever since the school shooting in Parkland, Fla., law enforcement and other officials have been calling for changes in the Baker Act, a Florida law that allows involuntary commitment for 72 hours of people who are an imminent danger to themselves or others. If the Baker Act had been easier to deploy, they think, Nikolas Cruz, the accused shooter, would have been taken and treated before his horrible act.
However this law may be reformed, it will never be able to get people with serious mental illness the treatment they need.
I know something about the Baker Act. About halfway through my son Matthew’s decade-long struggle with serious mental illness, my wife and I invoked the Baker Act against him.
This kind, brilliant, thoughtful young man, who experienced the sudden onset of mental illness at age 24, was living in a small condominium we owned near Sarasota, Fla. One day the manager called us with alarming allegations about his behavior and insisted that Matthew was in immediate danger.
In a panic, we flew to Sarasota, went to the courthouse and filled out the forms to invoke the Baker Act. It was surprisingly easy.
There’s no controversy here. People with psychotic disorders sometimes don’t know they are suffering from a mental illness, and there really is nothing to argue about. And yet, the word “anosognosia”—meaning the patient is unable to see that he is ill—is a charged word.
Why is that? Let me talk a little about the history of this word and the political meaning it has taken on.
Anosognosia is a term that was coined in 1914 by a Hungarian neurologist named Joseph Babinsky. Babinsky noticed that sometimes after a stroke, people are unaware of their deficits. This is presumed to be a result of pathophysiologic changes in the brain, and not the psychological defense mechanism of denial. There is not a precise anatomical finding that predicts anosognosia: you can’t look a patient with anosognosia and say, “ah, the MRI will show a lesion in X area of the brain.” Though certainly, some deficits are more likely to include anosognosia than others.