Mental health system still lets them roam
By Dr. E Fuller Torrey
Tarloff: Authorities failed to use their power to stop alleged killer.
'KILLER Ranting and Raving Mad": Did you have the feeling that you'd already read the story?
Perhaps you were recalling the one about Colin Ferguson on the LIRR. Or maybe Andrew Goldstein in the subway, Juan Gonzalez on the Staten Island Ferry, Kevin McKiever in Central Park, Michael Vernon in the Bronx shoe store, Van Hull at the New York Technical College, Jorge Delgado at St. Patrick's Cathedral . . .
The list is endless, and the essentials are virtually identical.
David Tarloff, accused of killing psychologist Kathryn Faughey and trying to kill psychiatrist Kent Shinbach, was known by his neighbors as "the crazy guy." He'd been "in and out of mental hospitals more than 20 times," says his brother, but "they kept releasing him." He did reasonably well when maintaining treatment, but he "frequently went off his medication."
Off medication, in these stories, is when the trouble usually starts.
Like most of the men listed above, Tarloff was well known to the mental-health system and had demonstrated his capacity to be dangerous when not on medication: He'd assaulted a security guard and threatened to kill employees of the Queens nursing home where his mother resides.
People like this need to be on outpatient commitment - obliged to comply with a treatment plan, including taking medication when needed, as a condition for living in the community. New York state has a law that allows such compulsion - and Kendra's Law has been proven to dramatically decrease rehospitalization and to reduce by half violent episodes by mentally ill persons.
But Tarloff apparently wasn't being monitored under Kendra's Law at the time of this incident. Why not?
Critics of Kendra's Law argue that it interferes with a person's civil rights. Yet Tarloff was living by himself, free to take his medication or not, free to act on his delusions, free to carry out the orders of the voices in his head - his civil rights were all too intact.
Not so the civil rights of Kathryn Faughey. She's been denied the most basic civil right of all - the right to life.
Little is surprising about Faughey's killing, except perhaps the extent of its brutality. The Web site of the Treatment Advocacy Center lists hundreds of similar cases - all categorized as "preventable tragedies."
Individuals with severe mental illnesses are responsible for at least 5 percent of all homicides in the United States. The killer is rarely receiving treatment at the time. Family members, especially mothers and children, are the most common targets - with law-enforcement officials, religious figures and mental-health professionals such as Faughey also high on the list.
Psychiatrists are the victims of violent crime more than four times as often as other physicians, according to Justice Department data.
Equally as predictable as the details of the Tarloff story has been the reaction of hospital and mental-health authorities. Tarloff was apparently hospitalized overnight and released 10 days before the homicide - almost certainly another example of how NY law makes it overly hard to involuntarily hospitalize mental patients.
As always, "a hospital spokesman did not return calls" or "invoked confidentiality laws." Invocations of confidentiality in such a case have little to do with anyone's privacy - and much to do with covering the rear ends of everyone who should be held responsible.
And, of course, there will be "an investigation" by city and state officials. The results of such investigations are usually reported weeks later as a small item on page 16 - with the news usually having been overtaken by yet another preventable tragedy, requiring yet another investigation of its own.
Violence committed by seriously mentally-ill individuals who are not being treated are merely one manifestation of our egregiously failed mental-health-treatment system:
- * Untreated patients who are homeless have become part of the decor of inner cities, like abandoned cars.
- * Untreated patients who commit crimes, usually related to their illness, increasingly fill the nation's jails.
- * Public parks, libraries and hospital emergency rooms have all been overrun by the failures of the mental-health treatment system.
And there is abundant evidence that all of these problems are getting worse.
We know what to do, of course. Most individuals like Tarloff do very well if they are properly followed up and treated. Kathryn Faughey's killing is a failure not only of the treatment system but also of every New Yorker for not demanding a system that works - first and foremost, by holding hospital and mental-health accountable.
Until we start doing that, each mind-numbing tragedy will keep on being followed by another.
Dr. E. Fuller Torrey is president of the Treatment Advocacy Center. His next book, "The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens," is due out this spring.
New York Post
February 22 , 2008