Are you A-OK with AOT?
There ain't no controversy like the one surrounding Assisted Outpatient Treatment (AOT). Right now Pennsylvania is considering Senate Bill 226, which amends the act of July 9, 1976 (P.L.817, No.143), entitled "An act relating to mental health procedures; providing for the treatment and rights of mentally disabled persons, for voluntary and involuntary examination and treatment and for determinations affecting those charged with crime or under sentence," adding provisions relating to assisted outpatient treatment programs. For the full text of the bill, click here. And please do read the entire text of the bill before making any judgments, pro or con. I think people don't do that enough.
As I've said before, I have concerns about this type of legislation, but on the whole, am in sympathy with its intent, which is to get severely ill people treatment when they desperately need it -- providing enough safeguards so people's rights will not be trampled. I know it's a tall order. Is Senate Bill 226 the answer? I can't say.
Though I'm leaving the Prison Society tomorrow, my support for its mission -- to better the lives of incarcerated people -- remains. That includes making sure they have appropriate access to health care, whether for diabetes or schizophrenia. It also means recognizing that not everyone who's incarcerated needs to be there. Many, many people get caught up in the criminal justice system for years -- decades even -- merely because they did not have access to treatment for their mental illnesses. The conditions within prisons are, I assure you, much more punitive and destructive than those in psych hospitals. I have seen both sides of this, and the ugliness of incarceration -- and the incredible abuse and hostility people face behind bars -- is hard to describe. The isolation, in particular, that mentally ill inmates are forced to endure is horrible. I know I've said this before, but it's worth repeating.
The hearing for SB 226 takes place in Harrisburg on Oct. 2. I can't go -- new job, and all that -- but if you have time and are interested in learning more, it would be worth the trip.
Comments
The good news is, this bill is much less terrible than the Illinois bill that just past, having, as it does, provisions for prosecuting people who swear falsely to file a petition criminally and having fairly specific criteria for AOT.
Predictably, I don't like the bill, but that's because I don't think untreated mental illness is the problem, I think it's lack of jobs, lack of housing, and lack of safety and opporutunity in general. I don't think forced medication will ever work and I also don't think forced testing of people labeled as drug addicts to keep them off of drugs can ever work. Also, forcing meds on people based on unreliable diagnostic procedures and tenous at best research that these drugs help is stupid, immoral, and unconstitutional.
And if we're going to force people labeled mentally ill to subject themselves to lab tests to determine if they are drinking or using illegal drugs, shouldn't we test the entire population?
Posted by: Sally | September 27, 2007 12:11 PM
Congratulations on your new job, Liz. I hope the transition is a smooth one.
That bill is kind of long and hard to read because of all the legalistic language (I guess it's to be expected that a proposed law would be that way). Anyway, I didn't read enough to make any informed judgment about this particular bill, and I can see how psychiatric treatment could be the lesser of evils for someone whose likely alternative would be prison. But generally I think there's a lot of truth in what Sally says about the "lack of jobs, lack of housing, and lack of safety and opportunity" as reasons why many people come to the attention of the mental health system.
For most practical purposes, there is no longer a national social safety net in this country for people who aren't part of mainstream society. Our quarter-century-long war on the poor has pretty much shredded that to pieces (not that it was all that great even before the so-called "Reagan Revolution" - but I think it's much worse now). How can a country that judges everyone almost entirely on how much money they have, and doesn't protect it's citizens' most basic needs if they become poor, even pretend to care about their mental health?
In the town where I live, some teenaged thugs have recently been attacking homeless people while they sleep in public parks and open spaces. Over the Labor Day weekend, they assaulted one man in the park across the street from where I live so badly that he later died. A few others were merely injured - I wonder what it did to their mental health to be attacked that way? It just seems to me that the professed concerns for everyone's mental health seem to ring kind of hollow when it's such an accepted state of affairs that many people go without decent jobs, basic housing, any kind of meaningful opportunity, and can be kicked to death while they sleep by the children of the wealthy and the middle class.
Posted by: Kent | September 27, 2007 08:37 PM