Fuller Torrey Is Dangerous

I was attempting to write an op-ed tonight. It is a response to an op-ed in the May 12 Washington Post by Pete Earley, who seems to be the front man for those who argue that the mentally-ill should be forcibly medicated in outpatient settings with very little due process, acknowledgement of just how poorly meds work or regard for their human rights. Basically, I am still trying to figure out how to respond to Earley because the WaPo limits op-eds to 800 words and Earley did so much damage in his copy that it would take 3 times the space just to answer him.

Anyway, I was trying to settle my mind about one of the points Earley makes in his piece--that the mentally ill shoot police 5 times more than the general population does (whatever the general population that shoots police is) and that kinda made me do the old "Huh? What?" I've been reporting on cops for 7 years and mental illness for much of that time as well, and I have never run into that number nor have I ever had a cop mention it to me. So it made me skeptical. Where did that number come from? What's the supporting dataset? Earley had mentioned that the number came from the Treatment Advocacy Center.

TAC is Fuller Torrey's non-profit that goes around demonizing all mentally-ill Americans on the basis of the violent behavior of a few. Torrey is a controversial figure in psychiatry. He believes that a virus present in cat shit is the source of schizophrenia. I am not kidding. He has also spent much of his career accusing schizophrenics and bipolars of being John Hinkleys-in-waiting. He is also the author of the best-selling Surviving Schizophrenia. He is quoted in the press probably more than any other single expert on mental illness. He and his colleagues are powerful and argue for outpatient commitment laws before public bodies.

So I went to TAC's website looking for the data. I couldn't find it, but I ran into this press release: "NEW STUDY LINKS VIOLENCE AND SCHIZOPHRENIA." That was news to me since I am fairly up to speed on the psych journals, especially in regards to the CATIE study on schizophrenia. In the press release, Torrey asserts that violence is common among some schizophrenics, that the reason is because they weren't taking their meds, and that they must be legally forced into "treatment" compliance.

Then I went to the abstract of the study he cited. (I'll get the full paper in a day or two.) It is something of a sub-study of the full 4,000 patent CATIE study. Here the sub-group is 1,400 patients. Of those, the study authors found that 19 percent had committed a violent act of some kind in the previous 6 months. That much of the data Torrey reports before going off on his usual tirade for forced treatment. That works out to about 266 people from the 1,400.

Here's what Torrey fails to mention. From the abstract itself: "Violence was classified at 2 severity levels: minor violence, corresponding to simple assault without injury or weapon use; and serious violence, corresponding to assault resulting in injury or involving use of a lethal weapon, threat with a lethal weapon in hand, or sexual assault."

Minor violence was reported in 15.5 percent of the cases or with 217 people. Serious violence was reported in 3.6 percent of the cases or in 49 people of the 1,400 in this study. I don't know about you, but I don't feel like seeing discussions about how we grapple with mental illness in this society being driven by 49 people out of 4,000 people in the entire fucking study.

What's interesting to me is that in his press release Torrey is wound up over the fact that most of the minor violence was directed against family members by patients being dragged off to the hospital. Having seen that dynamic play out before in the lives of patients I know, I can assure you that whatever hit mom or dad took from their son was partly driven by mom or dad screaming in their faces. I've seen this before. I wouldn't hit anyone over it, but I can understand how the supercharged dynamic gets out of hand and a shove turns into an assault turns into a crime turns into a poster child for Torrey. It's interesting to me that Torrey is so stirred up over it. I wonder if he ever had a son or daughter hit him, or if it is a result of his years working on the wards at St. Elizabeth's where John Hinkley is kept. It's interesting to me, too, that Earley seems to be tied in with Torrey--they are both in the DC area and I wouldn't be surprised if Earley leans on TAC for more than just the numbers of mentally ill people shooting cops data. I wonder, too, if Earley's bipolar son ever struck him. Anyone know?

But what's really interesting to me is that more people in the CATIE study weren't connected with violent acts, minor or major. In the original paper published last September, study authors outline the sad demographics of the 4,000 study particpants. I don't have the study with me, but from memory, my feeling was that it was like the study particpants had been plucked from homeless shelters around the country, VA hospitals and the outpatient clinics with the most hardcore populations. Most of the people in the study were unmarried, a huge majority were unemployed and barely educated. The average age was about 40 and most had been schizophrenic for about 20 years. Men outnumbered women. Strangely for a public health study, there was a high percentage of African-American participants (psych studies are most often heavily tilted towards Whites).

My point is that if out of 1,400 long-term, deeply schizophrenic men and women who had endured decades of the streets and the psychological torture of their illness that the most they could find was 49 people who'd committed criminal level assault, then I wouldn't call that quite the stirring indictment of schizophrenics that Torrey thinks it is. I would call it a victory for the other 1,351 patients and a rather stirring testimony to the strength of the human spirit. I don't say shit like that very often. But I am proud of those people.

I was proud of a schizophrenic I know last summer. I cannot go into too many details. But the bottom line is I was around her one day when shit started going bad for her, despite the fact that she is highly med-compliant and very highly medicated. All the same, she was trying very hard to fight back from losing most of her teen years to being hospitalized for very long periods. This day, she was doing poorly and I asked her to step outside and talk to me about it. In short order, she melted down and began stomping her feet on the ground and swinging her fists in the air. I stood there and said nothing for a minute, then began calmly encouraging her that she needed to slow her mind down, breathe deeply and suck it up, because sure having a wicked mental illness sucks like crazy, but it sucks less than losing control and winding up back in the hospital, which could have happened.

So she pulled it together and calmed down. She said she wanted to take the bus home from work, a crosstown ride. I thought that might not be the best idea, given all the weird stimuli available to the minds of schizophrenics on urban buses. Instead, I called her mother who came and took her home. She was back the next day and in fine shape. A few weeks later, I wrote her a letter of recommendation to college. She begins in the fall. While she hates how her meds make her feel, she takes them anyway.

So why does the Fuller Torrey crowd always insist that the story of mental illness in our culture be told through the relative few who've done acts of violence and not through people like this young woman? Or through people like me? What is their beef with the mentally-ill that they cannot get past? Why don't they every so often give some credit to us Ishmaels who have returned?

Whatever it is, it is disrespectful and dangerous in the mouths of people like Fuller Torrey and reporters who lean on his mindset a bit too hard. They are both clearly lining up to drive policy and clinical practice on treating bipolars and schizophrenics. They can say what they want, but they need to stop twisting the facts. What's sad to me is that in some ways Torrey and Earley and I are not that far apart, but those ways are few. I guess I now need to track down that violence against cops data.

I'll return to the WaPost stuff later.

Posted by Philip Dawdy at May 15, 2006 02:15 AM
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