My Crystal Ball Was Right

It's discouraging that only 6 hours ago I posted to my blog, alluding to the possibility that the murder of Wayne Fenton would be used by some in the mental health world to bang the drum for forced medication and would also present the Washington Post with yet another opportunity to screw things up. I shouldn't have written of it as a possibility—both events have already come to pass.

This morning's Post carries an article in which Fuller Torrey—the head of the Treatment Advocacy Center, the prime mover for outpatient commitment laws/forced medication—says that outpatient commitment of the alleged murderer would've prevented this tragedy. In addition, the paper once again trots out the notion that the mentally ill are violent by citing Torrey's claim that 750 murders a year are committed by the mentally ill. That works out to about 5 percent of all murders in the country. I look forward to poking into TAC's database, which I've found to be error-riddled in the past, to assess that claim. I also look forward to having the time to do so, given my current work demands.

Here's part of what the paper attributes to Torrey:

"Each year, people with serious mental illness commit about 750 murders, or five percent of homicides, in the United States, said Torrey, who just completed a manuscript about the consequences of untreated mental illness. In most of those cases, the victim is a family member. Police, mental-health providers, public figures, priests and strangers make up the rest, he said."

A reporter citing a source's unpublsihed manuscript? Um, if it's not published anywhere, much less in a peer-reviewed journal, why would the reporter cite it? Why would an editor let them? As a reporter myself, I find that incredible. I'd never cite an unpublished study and I've generally found that researchers are loathe to discuss the details of their work until its published.

And then:

"Maryland is one of eight states that lack an outpatient commitment law, which would require a person with a mental disorder to take medication or receive therapy for an illness or else face court-ordered involuntary hospitalization. "So what options did the family have to force him to take the medicine?" asked Torrey, president of the Treatment Advocacy Center in Arlington, which is lobbying for commitment laws across the country. Virginia and the District of Columbia have such laws."

Since my first post, it has become clear that the alleged murderer has bipolar disorder. What's less clear is whether he was on meds at the time of the crime, had recently gone off meds (in which case, he could well have had residual meds in his system), was undergoing a med switch, had blown off meds for ages or had been having a bad reaction to meds (a sadly too common circumstance with meds for bipolar disorder). I hope further details become available soon.

Why are these points important? One, Fuller Torrey is a deeply biased source and reporters and their editors should be deeply skeptical of his opinions and data, given his track record for misstating reality. (They should also be deeply skeptical of sources and experts who are willing to come to the phone on the Labor Day holiday and of the PR people who are willing to hook them up on a holiday.)

Two, in its database of violent acts committed by the mentally ill, Torrey's TAC fails to account for whether the people who were violent were in fact on meds at the time of their alleged crimes. That's not a minor point, since Torrey/TAC's rhetoric depends upon accepting the premise that people not taking meds leads to violence and that meds are a buffer against violence, but there are many examples of people committing violent acts who were on meds at the time of said acts. It's a point you'd think Torrey would want to be very careful with, at least for the purposes of intellectual honesty, especially given that he will likely be waving that unpublished manuscript under the noses of the both the Maryland and Virginia legislatures in coming months.

Three, the state of the art in mental health treatment is sadly lacking in broad efficacy and effectiveness—not to mention bang for the buck—and that's not a point I need to belabor, since it has recently been hammered home with the results of the CATIE, STEP-BD and STAR*D studies. Ironically, all of those studies were funded by NIMH and Fenton would have been intimately familiar with their results. (I'm sure the Post is, too, given that the paper's medical writers have written about the CATIE study. So why doesn't the knowledge that is known to the paper's medical writers make its way over to the metro desk?)

But if anyone needs an example of meds going bad on patients and, in some cases, making them do unusual things, look no further than the recent case of former MLB pitcher Jeff Reardon. Due to my lengthy summer hiatus from blogging, I haven't touched upon his case yet. Suffice to say, the poor fellow was doped on anti-depressants, went out and robbed a jewelry store (a man with no money problems) and a court found that he'd been temporarily insane due to the meds not his illness. I wonder what Fuller Torrey would make of that.

That's enough for the moment, except it's obvious that the implications of Fenton's murder are going to be far-reaching. More than I had feared.