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Michaud: Strides forward for treating mental health

"Not only have recent mass killings been linked to people with schizophrenia, but the perpetrators' problems were often known to family, neighbors and counselors. They slipped through holes in our safety net.," writes Anne Michaud. Credit: Mark Weber / Tribune Media Services

For those of us who care about decent care for mental illness, it's been a very good week.

The New York State Legislature bolstered what was already one of the strongest assisted outpatient treatment laws in the country, Kendra's Law. Outpatient treatment is part of the safety net that the United States failed to adequately construct and fund when it began closing psychiatric hospitals in the 1960s -- and many mentally ill people end up homeless, abusing drugs, arrested or committing suicide.

Kendra's Law provided for court-ordered, intensive outpatient supervision, to ensure that mentally ill people continue to take prescribed medication. However, in some cases, court orders lapsed without review, or didn't follow people who moved to a different county. Those problems have been resolved.

The law was named for Kendra Webdale, who in 1999 was pushed off a subway platform into the path of an oncoming train. Two subway pushes last month -- the killings of Ki-Suck Han and Sunando Sen -- reminded New Yorkers of the need to close the holes in Kendra's Law.

Also on Tuesday, the State Legislature placed stronger supports beneath mental health professionals who are treating potentially dangerous patients. A new law directs therapists to report patients they deem a possible threat to themselves or others, and those patients must surrender any guns and permits.

Therapists already had a duty to warn potential victims, in accordance with the 1974 Tarasoff decision, but the threat had to be very specific. Tuesday's vote in Albany may broaden therapists' license to speak up without fear of retribution.

Tatiana Tarasoff was killed by a University of California student in 1969, after the student confessed his murderous wish to a therapist at the campus counseling center. Campus police were notified, but no one told the young woman -- with tragic results. Most states, including New York, have since adopted this ethical standard.

The new laws from Albany were, clearly, a reaction to the Newtown, Conn., school shootings. In recent mass murders, the perpetrators' mental problems were often known to family, neighbors and counselors. Yet they slipped through holes in our safety net.

Likewise in response to Newtown, President Barack Obama yesterday signed 23 executive actions into existence, five of which relate to mental illness. Among them, the president's office will release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement officers.

Three further executive actions relate to funding for mental health care, including finalizing regulations covered under the Affordable Care Act, aka Obamacare. Preventing and treating mental illness on par with physical illness is crucial, and it's the test of a civilized nation. Health insurance companies, take note.

Finally, the president called for a "national dialogue" on mental health, to be led by Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.

Congressional cooperation will be needed for other action recommended by the White House: Obama proposed spending $50 million to train 5,000 mental health professionals to work with young people in communities and schools. The president's plan notes that 75 percent of mental illness appears by age 24.

This funding has the potential to help a great many people who may never be tempted to commit mass murder. It's exciting -- and civilized -- that we are finally ready to grapple with this painful affliction.

Anne Michaud is the interactive editor for Newsday Opinion.


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