The New York Times, June 1, 2010, ran a short article about a law called Kendra's Law. It was written in response to the murder of Kendra Webale, a 32 year old woman who was pushed to her death in front of an on coming subway train. This tragedy occurred eleven years ago. The man who pushed her to her death was an unmedicated man who suffers from paranoid schizophrenia. Essentially, the law requires that those with paranoid schizophrenia who have shown a pattern of violence when unmedicated be medicated whether they want to or not. It also requires that they be followed closely by mental health workers.
During its first five years Kendra's Law was found to be extremely effective in reducing violence on the part of a small segment of the chronic mentally ill. Mostly, they have been violent as a result of auditory hallucinations commanding them to commit these types of acts. In addition, the law successfully reduced homelessness on the part of these individuals. As a result, the law was extended five more years and is now up for reconsideration on a permanent basis. It should be pointed out the 44 other states have similar laws enacted. Unfortunately, in those other states, there is little or no enforcement.
The controversy surrounding Kendra's and similar laws around the country is the question of whether they violate civil rights. In other words, don't all of us have the right to decide whether we want to take certain medications or not? Does the state have the right to force people to take medications? Does the government become too powerful if its empowered to force compliance with medications? Finally, how is it to be determined who among the mentally ill should be required to take medication and who should be exempt?
Those who favor the enactment of this type of legislation insist that some of those who are mentally ill lack the capacity to make a sound and informed decision about medication. The reason for this lack of capacity is that they are too sick to fully understand their needs. Consequently, they end up either in mental hospitals from which they are released when they are medicated and back to some type of functioning. The next step is non compliance with medication, homelessness or prison.
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Of course, one of the questions that we must ask is, even if people with paranoid schizophrenia are not able to make a logical decision when in the throes of a full psychosis, should not their rights be protected as much as anyone else's? First, we are really discussing a tiny percent of a tiny percent of people who fall into the category of the violent or criminally mentally ill. Should we risk our civil rights by endorsing legislation that gives the government the power to medicate people against their will?
So often it seems as though it would be much easier to go the way of dictatorship in solving our problems. That is an illusion and one that is very dangerous. In my opinion, it is wrong to force people to take medications if they are opposed to it.
What is your opinion about Kendra's and similar laws? What is your experience with mental illness in your family or yourself?
Your opinions are strongly encouraged on this important issue.
Allan N. Schwartz, PhD.