Your tax dollars at work
The WSJ reports on the unintended consequences of a government program (but is this in any way an appropriate job for the federal government?):
Congress created the national Protection and Advocacy for Individuals with Mental Illness program, or PAIMI, in 1986 to curb abuse and neglect of the mentally ill, primarily in institutions. In the 1960s and 1970s, many abuses were uncovered at hospitals, where patients were physically restrained, neglected or overmedicated. The PAIMI program, operated by the Substance Abuse and Mental Health Services Administration with a 2008 budget of $34.8 million a year, funds protection-and-advocacy agencies in each state…
On June 20, 2006, William Bruce approached his mother as she worked at her desk at home and struck killing blows to her head with a hatchet. Two months earlier, William, a 24-year-old schizophrenic, had been released from Riverview Psychiatric Center in Augusta, Maine, against the recommendations of his doctors. “Very dangerous indeed for release to the community,” wrote one…
A few weeks after William Bruce’s admission, psychiatrist Jeffrey Fliesser wrote that William was hostile, paranoid and “dangerous to others without additional observation and active attempts to treat him,” an opinion he reiterated over the next five weeks. The doctor also wrote that he urged William, now diagnosed with paranoid schizophrenia, to take medication, but William refused…
the doctor’s notes also show that William’s release was backed by government-funded patient advocates. According to medical records, the advocates — none of them physicians — appear to have fought for his right to refuse treatment, to have coached him on how to answer doctors’ questions and to have resisted the medical staff’s efforts to contact his parents. As one doctor wrote, William told him his advocates believed he is “not a danger, and should be released.”…
Helen Bailey, one of William’s advocates, declined to discuss the details of his case but says the handling of it was consistent with her professional duties. “My job is to get the patient’s voice into the mix where decisions are made,” says Ms. Bailey, an attorney with Maine’s Disability Rights Center in Augusta. “No matter how psychotic, that voice is still worthy of being heard.”…
Ms. Bailey…doesn’t believe the advocates prevented William from getting medical care. “There is nothing in the William Bruce case that is contrary to the way we do business,” she says, adding that it is the hospital’s responsibility to try to have a patient committed or forcibly medicated. More generally, Ms. Bailey says it isn’t a given that families of the mentally ill should be involved in decisions involving their care. “There are some God damn nasty families out there,” she says…
There are, we suppose, always two sides to a story, but it’s hard to suspend judgment in this case. After William Bruce was arrested for killing his 47 year old mother, he “told a psychologist that the Pope told him to kill his mother because she was involved with al Qaeda and Saddam Hussein.”