One Step Forward,Two Steps Back

The more we talk about “mental illness”, the less society understands severe mental illness.  Conscientious journalists and reporters deserve credit for bringing attention to the crisis of criminalization of mental illness, but it is clear from the content of many well-intentioned articles, and opinion pages these days, that there is a lack of understanding of the distinction between “mental health issues” and severe mental illness (i.e. psychotic disorders).

The “frenemies” of individuals with severe mental illness are working relentlessly to infuse media reports with the rhetoric of the anti-stigma movement and the misguided dogmas of the forensic psychiatry establishment.  The frenemies are the self-proclaimed disability rights advocates and ‘defenders of the mentally ill’, the civil rights groups who have fought for the right to be psychotic (opposing the positions of the Treatment Advocacy Center), opposing Assisted Outpatient Treatment legislation, opposing reforms to illogical and unsensible HIPAA laws, engaging in activism that led to the Olmstead Act (which state governments have exploited to shun their responsibilities to provide permanent supported institutional housing).

There is an uptick in media reports of thousands of people with serious mental illness being held for weeks, for months in jails across the country being deprived of their rights – the right to “treatment” as they await transfer to state hospitals for “competency restoration”.  Lost on these well-intentioned journalists is the cruel conundrum underlying this asserted deprivation of rights.  The pathway to injustice begins with the rights that these news reports assert to be trampled upon. Treatment should never be conflated with so-called competency restoration (in and of itself, a gross fallacy and abuse of the good of medical treatment). The right to receive so-called competency restoration is the first step in the preparation of the accused to be prosecuted in an operating environment where the deck is stacked against the mentally ill defendant – in a criminal justice system where no one, the DAs, the prosecutors, the judges, the jurors fundamentally understands the nature of and behavioral consequences of the medical condition of psychosis.