Law doesn't improve care for mentally ill (New Haven Register, 4/23/2013)

Law doesn't improve care for mentally ill
by Arjune Rama, MD

Like my fellow Connecticut residents still shaken by the Newtown shootings, I was excited and relieved when Connecticut Senate Bill 1160 (“An Act Concerning Gun Violence Prevention and Children’s Safety”) passed April 3.

The law establishes a dangerous weapons offenders registry and requires a universal background check for all gun purchases. Those wishing to purchase long guns will need an eligibility certificate that requires fingerprints, a firearms safety training course and a national criminal background check.

No firearm may be loaded with greater than 10 bullets except in a person’s home or at a shooting range.

However, as a mental health care provider, I am infuriated by one section in particular:

“Sec. 10. (NEW) (Effective October 1, 2013) Whenever a person is voluntarily admitted to a hospital … for care and treatment of a psychiatric disability … the hospital shall forthwith notify the Commissioner of Mental Health and Addiction Services of such admission and provide identifying information including, but not limited to, name, address, sex, date of birth and the date of admission. The commissioner shall maintain such identifying information on all such admissions.”

In other words, starting this fall, if someone comes to our emergency department asking to be admitted to the hospital for mental health care, our service is obligated to report his or her name, address, sex, date of birth and the date of admission to the state government.

I have to make my patients aware that they are welcome to treatment, but will also become a part of a growing database, even if their illness is completely unrelated to guns or violence. While this may not seem particularly problematic, consider the delicate scenarios in which people are voluntarily admitted to a psychiatric unit.

These are octogenarians for whom the death of a spouse has driven them to the brink of suicide. These are college students with new-onset schizophrenia trying to understand why their roommates have placed tracking devices in their brains. These are people freshly laid-off figuring out how to handle their frustration. These people are entrusting us with their most private pain.

Prior to reading the legislation, I thought that perhaps we were entering a period wherein mental health care would receive higher priority. I thought that we as a society finally realized that mental illness is a cage in which our patients find themselves. Instead, I am realizing that the Connecticut law serves to strengthen the bars of that cage, expand the cage itself and put tracking tags on everyone in it.

While this legislation has some groundbreaking provisions that will undoubtedly save lives, I hope that our lawmakers realize the potential outcomes for some of our most desperate citizens. Those looking for solace to prevent possibly killing themselves may think twice to present to the emergency room to avoid being documented on a government list.

For the same reason, those with bubbling anger may similarly choose to take matters into their own hands rather than to responsibly seek help.

In sum, the mental health provisions in this law do not improve care for the mentally ill. Rather, these provisions improve the containment and tracking of the mentally ill. By attempting to contain and track rather than treat and prevent, we may inadvertently lose more lives as a result.