Schizophrenia and Predicting Future Dangerousness

August 8, 2012

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.


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