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.
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 courts to order those with serious mental illness and a history of violence kept in treatment, which almost always includes medication, as a condition of living in the community. AOT has been proven to reduce hospitalization, incarceration, arrests, and violence by around 70 percent. It could have kept Bonds in his “serene” state rather than his “wild” one.
Assisted Outpatient Treatment laws exist in 46 states, but are rarely used because state officials have sided with mental-health trade associations that believe psychosis is a right to be protected, rather than an illness to be treated. Last month New York considered a bill that would have required mandatory evaluation of patients who were being released from involuntary commitment, but Governor Andrew Cuomo and Assistant Assembly Speaker Felix Ortiz caved in to the mental-health industry and scrapped the idea. Massachusetts is currently considering an AOT bill. The state Department of Mental Health is funding Western Mass Recovery Learning Community, which is lobbying against it. In California, government mental-health funds intended to help those with serious mental illness are regularly diverted to groups that oppose the state’s AOT law.
Government should stop focusing its mental-health spending on pop-psychology programs that fail to make a whit of difference to the seriously ill.
Finally, government should stop focusing its mental-health spending on pop-psychology programs that fail to make a whit of difference to the seriously ill. Today, you can simply claim you have trauma, bad grades, are getting divorced, are sad, or were bullied, and you’ll gain access to mental-health funds. This leaves fewer dollars to treat the seriously ill. Mayor Bill de Blasio’s ThriveNYC plan, which his wife Chirlane McCray is trying to expand to other states, is the most brazen example of this eye-off-the-prize strategy, but California’s Mental Health Services Act is an even worse offender.
To fix this problem, President Trump announced that he will appoint Dr. Elinore McCance-Katz as first assistant secretary of mental health and substance use disorders. As she wrote late last year in National Review, McCance-Katz is a strong champion of focusing resources on the elephant in the room: treatment of the most seriously ill patients. Her confirmation hearing, like many of this administration’s, appears to be on the back burner, and it needs to be moved to the front. We must change direction now before someone else dies.
I have someone with serious mental illness in my family. I don’t want her to become a poster-child like Alexander Bonds. It is the seriously ill like her who need help the most. By spending money on serious mental illness rather than diverting it elsewhere, we can avoid more tragic deaths and grieving families in the future.
— D. J. Jaffe is the author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill and the executive director of Mental Illness Policy Org.