Schizophrenia and Predicting Future Dangerousness

thejbmission asked an excellent question about schizophrenics and why our legal and mental health systems wait until after a tragic event occurs before doing anything to prevent it.

The short answer is mental health experts cannot accurately and reliably predict future dangerousness by schizophrenics. They are as likely to be right as they would be if they flipped a coin.

Most people afflicted by schizophrenia are not violent and, since they are not a danger to themselves or to others, they cannot be involuntarily committed to a secure mental health treatment facility. Without medication they are often delusional and when they are delusional, they cannot hold a job. The antipsychotic medication that keeps the delusions at bay has unpleasant side effects, however, that leave them feeling deadened like zombies. Families can do little to help them and they are often homeless wandering aimlessly about our cities talking to the voices no one else can hear. They occasionally commit petty crimes to survive and when they do, they are likely to be arrested and taken to jail. They plead guilty, are sentenced to time served, and released to the streets to begin the endless cycle anew.

Our mental health laws prohibit involuntary commitments unless a mental health professional, who typically is a screener at a hospital ER, finds probable cause that the person is dangerous to himself or to others. Such a finding usually results after an attempt to commit suicide.

The involuntary commitment is limited to 72 hours and cannot be extended unless approved by a judge following a hearing. The patient has a right to be present at the hearing and represented by counsel. If the judge finds probable cause to believe that the patient is a danger to himself or to others, the involuntary commitment will be extended for a period of 30 days and, upon review, may be extended for another 30 day period, etc.

Most people are released after the 72 hour period.

Predictions by mental health experts regarding who will commit acts of future violence are about as likely to be accurate as a coin flip. Therefore, there is no factual, medical or legal justification for singling out anyone, whether schizophrenic or not, and confining them for any reason for any length of time unless, due to a recent event, they are a danger to themselves or to others. That danger must be fact-based and immediate.

13 Responses to Schizophrenia and Predicting Future Dangerousness

  1. Digger says:

    An eight year old girl, who had a slight ADHD however did have
    ADD, was one of the children I spoke of along with several who were thrown into the drug WITHOUT proper guidance and only from an unqualified teacher advise did parents go with it. The results were a disaster even though the family attending physician gave the drug on the analysis of a teacher. This one girl I followed was in a stupor for 8 years and got nowhere until her parents examined the facts. I would never claim that all are in the same category but as soon as the girl was in a class without pressure she began to blossom and the drug was gradually taken away. While on it she was a zombie, walked the house all night long only to be put on another dose to get through another day. Thank God this family did not listen to “authority”. The girl “grew” and “grew out of” many of her symptoms. Was for awhile about 2 years behind in what others her age had accomplished. However, with close watch by the parents, she managed herself through grade, high college, cosmetic schooling and got her license to practice in three different state exams. The fact is when reaching a “mature” age this can level off and a child can be as responsible and worthy as any other, but it takes closely dedicated parents. Also interesting fact is that in the slow learning part, it was proven that a child with such personality is wrongly pressured to do written scholastic accomplishments and can fail but IF ALLOWED to express the same answers and theory required ORALLY they have every bit the intelligence as others. Something that was found out by chance because the parent went to great lengths in requesting the school system to at least allow these students to perform orally as others do written. Not basing any of this as a general cure but at least should be tried before dosing with drugs to benefit the adults with desired “peace and quiet”. Now 23, leading a good and healthy life, responsible, compassionate, calm. A genuine asset to society.

  2. ajamazin says:

    The family, friends or anyone who has knowledge that the person meets the standards for inpatient commitment may file a petition with the court.

    This will involve signing an affidavit stating the facts that indicate the presence of mental illness and danger to self or others.

    If the court determines there are reasonable grounds for inpatient commitment, a custody order will be issued, and a law enforcement officer will pick up and transport the person to a mental health center or hospital where the person can be held up to 72 hours.

    Most people are released after the 72 hour period for one of three reasons:

    1. Failure to meet the criteria;

    2. The fear of being sued;

    3. The person lacks insurance.

    • Number three is incorrect as far as involuntary commitment goes. The local and/or state government picks up the bill if there is no insurance coverage. Medicaid also has specific coverage for this.

      • Correction. The local and/or state government picks up the bill if there is no insurance and the involuntary commitment was made by some legal authority, not family etc.

        • ajamazin says:

          justincaselawgic.

          “The local and/or state government picks up the bill if there is no insurance and the involuntary commitment was made by some legal authority, not family etc.”

          But of course!

          Local and/or state governments have budgeted and have ample funds for the psychiatric care of the uninsured.

      • ajamazin says:

        1.There is a big difference between practice and theory.
        I stand by my answer.

        2. Obviously, Medicaid is insurance.

  3. Digger says:

    Often there is thought that if a crime is committed, the mental health patient has been on medications and then stopped taking them just before the crime. Is there any real truth to this and if so
    isn’t there some responsibility that falls back onto the professional who is treating the patient. There was a period of time about 15 years ago where children with classroom disruptive behavior were
    without good cause and evaluation, put on Ritalin (?) This was done at the advise of the “teachers” who could better handle the class, it made their days job easier. As I remember, until parents began to question and object the use of these drugs had a traumatic and dangerous effect on many of these children who actually had no mental problem except possibly some learning disability. I wonder if there is a possibility that any of these young people who have committed crimes today, are from the groups of that period of misuse of a “controlling” drug when not necessary. All they needed was class where they were given more time to accomplish instead of being pressured by forced medication to keep up with those who were considered excellent students. That is another issue, making the comparisons and instilling in a child that they are not as worthy as some other child. I believe there are now more special need classes available. Not being disrespectful to teachers overall for I do not know how the use of drugs on children came to be at that time, who was responsible for such a suggestion.

    • ajamazin says:

      “Matt. Matt, Matt, you don’t even– you’re glib.
      You don’t even know what Ritalin is.

      No, you see. Here’s the problem. You don’t know the history of psychiatry. I do.”

      TOM CRUISE

      • Digger says:

        Excuse me, are you commenting to me???? If so, I did put
        a question after the Ritalin because I was not sure the name of a correct of drug used. Often a psychiatrist in in need of a credentialed and highly qualified psychiatrist.

        • ajamazin says:

          Some people claim that ADHD doesn’t exist. Some believe that if sugar intake is reduced, artificial additives are removed from food, and TV and computer games are disallowed that symptoms of ADHD will vanish.

          For the people who have to deal with the challenges, who often have few resources available to them, this is like kicking someone when they’re down.

          Many people don’t seek diagnosis or treatment for their children because of the stigma created by some ill informed people.

          Who would tell someone who’s child is a diabetic that insulin should be withheld because diabetes is a phoney condition thought up by the drug companies ?

          While ADHD is sometimes underdiagnosed, overdiagnosed and misdiagnosed, it is a real condition with often severe negative consequences for the person who has it.

          A qualified doctor can make a clinical diagnosis and if ADHD is diagnosed, then a treatment plan, which can include a drug such as Ritalin, will be designed and implemented to improve the quality of the patient’s life.

  4. Two sides to a story says:

    Ack, sorry for all the weird grammar mistakes!

  5. Two sides to a story says:

    I have a relative who has another mental health issue along with a learning disabilities who has a minor criminal / civil record a mile long – usually for “extreme panhandling” or trespassing – i.e. going into businesses that he’s been banned from, and both despite medication. It’s distressing to watch and we try to keep him busy doing other things, but people with these conditions tend to stubbornly live as they choose and have the right to do so.

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