Research shows that brain disorders such as schizophrenia, bipolar disorder and depression are related to abnormalities in brain functioning. What could be more terrifying than to suddenly start to hear voices telling you that you must do something horrible or to believe that your family is trying to poison you?
Mental illnesses may sometimes be “triggered” by something like extreme stress or trauma, but just like any other diseases, they have a biological basis. Think about diabetes or cancer. People may eat too much of the wrong foods, smoke or stay in the sun too much, which may trigger illnesses. The difference for people with brain disorders is that a brain malfunction causes behaviors they sometimes cannot control. One of these things might be punching or kicking someone who is trying to help them especially if they are approached in the wrong way.
The N.C. system of care for people with mental illnesses is broken. Gov. Pat McCrory acknowledged this in his heartfelt address at the signing ceremony for his Executive Order creating the Governor’s Task Force on Mental Health and Substance Use. But things will get worse for people with brain disorders and “the system” when, on Dec. 1, anyone who attacks a hospital worker anywhere on hospital grounds could be charged with a felony.
Hospital workers deserve to be safe at work, but their jobs do have risks. And punishing people who are not able to control their actions because of behaviors resulting from brain disorders is not going to deter them or others from acting out in the future. It is only going to punish them more severely for something they can’t control.
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Think about this scenario: A 16-year-old has his first psychotic break. The scared, out-of-control patient arrives at the ER where health care workers with little, if any, training on how to approach a patient with a brain disorder try to restrain him or give him a shot to calm him down. In the process, he hits and injures a nurse.
Charges are filed by the hospital, and he is now facing a felony. If his family is poor or if his family is not supportive, it is likely that he will not have good legal representation. He goes to jail where everyone 16 and over is considered an adult. His parents have no access to information about his care or medication while he is in jail since “guardianship” is transferred to the jail. Chances are, he will become psychotic again as a result of all the stress. He could become violent, resulting in a transfer from jail to a state prison. Parents may not even know where he is.
If the court has reason to believe he has a mental illness, he will have to face a “competency to proceed” evaluation, and the person will have to wait for trial until he is medicated and determined to be competent. This can take weeks or months while he is still locked up. It is not clear when he will ever be released. When he is, it is likely that he will leave jail with no medication or prescriptions and no medical records for his parents even though he is a minor. He will probably have a felony conviction on his record for the rest of his life, making employment and housing extremely difficult. And his psychosis, which could have been effectively treated had he received the appropriate care at the outset, will probably be a problem for his entire life. It sets him up for failure.
This law will result in putting even more people in jail for the “symptoms” of their brain diseases. It does not help protect hospital workers. Rather, it punishes people for having a brain disorder, puts more pressure on the courts and keeps taxpayer dollars flowing into jails. How does this help anyone? This law is a good example of just how broken the system is.
I applaud McCrory for establishing the cross-agency task force to work on an integrated solution among state agencies, health providers, law enforcement, courts, jails and prisons and other parts of the broken system. My hope is that the focus will be on improving the lives of people living with mental illness, including families, and that their voices will be heard as participants on the task force. Unfortunately, they experience the broken system from all these vantage points as a routine part of their lives.
Ann Akland of Knightdale is on the board of directors of NAMI - Wake County (National Alliance on Mental Illness.)