Familia’s tragic death should shock us into reevaluating our society’s treatment of those with serious mental illness.
Last Wednesday, a mentally ill man named Alexander Bonds killed New York City police officer Miosotis Familia with a bullet to the head while she sat parked in a police truck. The assassination should be a wake-up call: The government’s mental-health policies are in urgent need of reform. President Trump, HHS Secretary Price, and state officials must work together to fix Medicaid so the hospitalized mentally ill are not discharged while still psychotic, to implement programs that require the dangerous mentally ill to accept treatment when they are in the community, and to encourage all levels of government to focus their existing mental-health funds on treating the most serious cases of mental illness rather than improving “mental wellness” (whatever that is) more broadly.
Alexander Bonds was a poster-child for what’s wrong with our society’s approach to mental illness. According to the New York Times, “Mr. Bonds had been given diagnoses of schizophrenia and bipolar disorder and had been hospitalized on and off for years. When he was taking his medications, [his aunt said], he could be serene and almost never exhibited violent tendencies. But if he stopped taking them or, worse, had a few drinks, he could go wild.” Despite having active mental illness and a criminal record, Bonds was discharged from a psychiatric hospital just a week before the shooting.
None of this is atypical. Prematurely releasing unstable mentally ill patients from psychiatric hospitals is now standard procedure, due to the nation’s being short at least 100,000 psychiatric beds. The average length of stay for the psychotic is now down to seven days, which is not enough time to stabilize them and properly titrate their medications. State governors exacerbate the trend by closing even more hospitals, apparently oblivious to the fact that fewer psychiatric beds lead to more mentally ill prisoners incarcerated. An obscure provision in Medicaid called the “Institutes for Mental Disease (IMD) Exclusion” encourages hospital closings by preventing states from being reimbursed for many mentally ill patients. To compensate, governors simply lock the front door and open the back. Representative Eddie Bernice Johnson has attempted to fix the IMD Exclusion, recent regulations from the Centers for Medicare and Medicaid Services (CMS) slightly ameliorated the provision’s damage, and several senators would like to further chip away at it in the Republican health-care plan. But much more needs to be done.
Familia’s tragic death might also have been avoided if the hospital that released Bonds had petitioned the court to put him in Assisted Outpatient Treatment (AOT) under what is known as “Kendra’s Law” in New York. The law allows....
DJ Jaffe is Executive Director of Mental Illness Policy Org., and author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill.