In response to a recent article in The Sun on the Maryland Center for Excellence on Early Intervention for Serious Mental Illness, Rene Muller suggests that murder may be an understandable response to overwhelming anxiety and trauma and efforts to treat these people with medications may be misguided. In the process of putting forth this argument in his commentary, "Mental health profession falls short in stopping violence" (Oct. 28), Mr. Muller reduces the treatment of mental illnesses with psychotic symptoms to the choice between pharmacological and psychosocial intervention and does his readers a further disservice by inaccurately portraying the mission of Maryland's Center for Excellence on Early Intervention for Serious Mental Illness.
We appreciate that many biological and environmental issues may create a psychotic disorder in a vulnerable individual. However, we believe the choice between biological and psychosocial treatments for the treatment of people presenting with psychotic symptoms is a false polemic. Multiple empirical studies have demonstrated that interventions which combine biological and psychosocial treatments are significantly more effective than the use of a single modality.
Our other concern with the op-ed from Mr. Muller is the assertion that the Maryland Center for Excellence on Early Intervention for Serious Mental Illness is designed to reduce the chance that people with mental illness will become "killers." The goal of the center is not about reducing the risk of mass murder. Such violence is extremely rare for persons with psychotic disorders and would be a poor target for this program. Rather, the goals of the newly created center are to create a system in Maryland to identify adolescents and young adults who are at risk for developing a mental disorder with psychosis and initiating interventions which are hoped to change the course of a developing illness. The ultimate goal is to study and learn from diagnostic and intervention paradigms in an effort to improve the recognition and treatment of these often crippling disorders.
Drs. Robert W. Buchanan and Scott T. Aaronson
The writers are, respectively, director for the Maryland Center for Excellence on Early Intervention for Serious Mental Illness and president of the Maryland Psychiatric Society.
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