A draconian alternative?

WASILLA -- Dr. E. Fuller Torrey believes that schizophrenia and other forms of mental illness can trick patients into believing that they are not ill, causing them to stop taking the very medications that enable them to lead normal lives.

A psychiatrist who, according to an August 2002 article by Stephanie Stapleton of the American Medical News, is considered a renegade by many in his profession and extreme by civil libertarians, Torrey advocates for involuntary outpatient treatment of the mentally ill.

Torrey is the director of the Stanley Medical Research Institute as well as president of The Treatment Advocacy Center, a nonprofit organization started four years ago with the announced purpose of eliminating legal and clinical barriers to timely and humane treatment for Americans with severe brain disorders who are not receiving appropriate medical care.

Torrey calls his proposal Assisted Outpatient Treatment. According to Stapleton, he argues for the necessity of community-ordered treatment in some cases; for laws that enable people with the most severe brain disorders to receive assisted treatment and for the assurance that people with such disorders receive adequate psychiatric services and maintain medication compliance upon hospital release.

Stapleton cites Torrey's belief, based on his research, that many of those with schizophrenia and bipolar disorder have brain damage which impairs their ability to recognize their own illnesses.

Others disagree. Stapleton quotes Michael Allen, a senior staff attorney at the Bazelton Center for Mental Health Law in Washington, D.C., as saying that "This is where Fuller Torrey gets slippery" regarding constitutional issues.

The Advocacy Center's Web site at www.psychlaws.org cites many research papers, provides numerous informational resources, and includes the full text of the mental health statutes of every state as well as a model law for assisted treatment.

Alaska Statutes provide for the court to mandate a less restrictive alternative to involuntary residential treatment for respondents when such an alternative is available and respondents have been advised of the alternative but refuse to accept it. Such mandated assisted treatment can only be ordered for a period of 90 days.

Bill Hogan, chief executive officer of LifeQuest Comprehensive Mental Services in Mat-Su, believes that the Alaska mental health system is actively looking for other ways to assist consumers than currently exist.

As of now, however, Alaska consumers do not have access to supervised or court-mandated outpatient treatment programs except on a temporary basis as a condition of probation or early discharge from court-ordered residential treatment.