Dangerousness: a foolish criteria

A front page story in The Washington Post yesterday was published under the headline: “Hinckley: Man on the mend or a danger?”

According to the story, a federal judge will decide the fate of would-be assasin John W. Hinckley Jr., this week after listening to five days of testimony.  Hinckley’s family members, as well as his doctors and case manager, claim the now 56-year old Hinckley does not present a danger either to himself or to the community. The depression and unspecified mental disorder that drove him — along with his narcissistic personality disorder — to nearly kill President Ronald Reagan in 1981 are now all under control.

That’s not so, prosecutors claim. They insist that  Hinckley, who has spent the past three decades in mental facilities,  is deceptive, lazy, and can’t be trusted. The Post quoted Assistant U.S. Attorney Sarah Chasson stating, “Mr. Hinckley has not been a good risk in the past and, therefore, is not going to be a good risk in the future.”

The judge is being asked to determine if Hinckley is “dangerous.”  If he is, the judge will not grant him more freedom than the ten day visits that he currently is allowed periodically with his mother — while being monitored by the U.S. Secret Service.

I often am asked how “dangerous”  became the criteria that is used  to decide if someone is so mentally ill that he/she can be involuntarily held and forced to undergo treatment. The question is an important one, especially for those of us who have loved ones with mental disorders.

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When do we release Andrea Yates and John Hinckley?

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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