Statutory regulations for mandatory out-patient services to treat mental disorders and reduce crime need to be brought forward by the individual state legislators to reduce violent crime and high incarceration rates. Where some laws are set to expire, there must be a movement to reassure the communities they will be extended or renewed. A recently published study of homicides reveal that homicides committed by individuals with schizophrenia and bi polar disorder have a history of previously hospitalized placement for a violent episode. This strongest predictor can be used as a tool for future violence and is indicative of the individual’s indicator that there were severe psychotic symptoms present before the crime was committed. The study focused on individuals who killed somebody within six months of their release from a psychiatric hospital.
Also a most important factor in this study was the fact revealed the medication taken or prescribed was not being taken as prescribed. Instead it revealed an abuse of alcohol and street drugs. Together, this profiles the person with schizophrenia and bi-polar disorders as truly dangerous once released from such in patient treatment. On the opposite side of this study revealed that those persons, who are compliant with their medication, avoid street drugs and alcohol, are no more a danger to the public as anyone else in the community. (Torrey EF, The Insanity Offense, New York: W.W. Norton, 2008, pp. 179′”183).
The lead author, Dr. Seena Fazel, associated with the Department of Psychiatry at University of Oxford claims that “between 10-20 percent of homicides perpetrators have psychosis.” American studies reveal a reported 10 per cent plus of homicides are committed by individuals with these disorders or others related. (Matejkowski JC, Cullen SW, Solomon PL, Characteristics of persons with severe mental illness who have been incarcerated for murder, Journal of the American Academy of Psychiatry and the Law 2008;36:74′”86).
The immediate needs to address these results could impact the rate of incarceration and prevention of homicides within the community. The need to identify and implement such prevention procedures is most urgently required in order to address the high rate of mentally ill criminals, the incarceration rate of prisons and the treatment of out-patient who have demonstrated symptoms of psychosis that should require legislative support for more mentally ill regulations, the establishment of a sound monitoring and supervision process (out patient service) of their medication ad living habits to avoid future violent crimes and an awareness to public defenders, prosecutors and judges that these programs are available and should be used more frequently to reduce or prevent future crimes.
Stated within a release of the Columbia University dated February 18, 2010, a team has “determined that mandatory outpatient treatment for New Yorkers with severe mental illnesses has led to a drop in violent criminal behavior, ranging from hitting and choking to rape and murder.” Accordingly, this first assessment of Kendra’s Law shows this law has merits as it mandates treatment for psychotic disorders and other mental illnesses.This law is set to expire this summer.” In 1999, New York State has enacted legislation that provides for court-ordered assisted outpatient treatment (AOT) for certain people with mental illness who, in view of their treatment history and present circumstances, are unlikely to survive safely in the community without supervision.”
The study also stated that “since enactment, the law has met with some opposition. Critics question the method of forcing patients into treatment, fearing elevated stigma, decreased self-esteem and compromised civil freedoms. Focusing on those who have demonstrated violence, the Columbia study team took their control group results that illustrated a reduction equivalent to four times a lesser chance to commit a violent crime than those who participated with the outpatient mandatory treatment programs. It also revealed those in the control group demonstrated “higher social functioning and slightly less stigma.”
The most urgent matter at hand is the information of such programs availability to the courts and families of mental disabled individuals who could benefit from outpatient treatment programs before they commit a violent crime that can be, in some cases , avoided. It is the social responsibility of each state to enact and review such a program within their states to ensure public safety is maintained and the rate of incarceration is addressed. Needless to add is the reduced burden placed on the taxpayers to keep a mental disabled person in prison for many years.
At present, 42 states have laws mandating outpatient care for individuals with severe mental illnesses. Ask your legislator is they are aware of this law and how it can impact their state’s incarceration rates. One can only imagine the savings the states may incur if such a mandatory outpatient program was actively facilitated to treat the disorders and maintain public safety.