Tighter controls on the seriously mentally ill urged

A prominent psychiatrist called yesterday for more stringent controls over seriously mentally ill patients to minimize the risks of violence.

In a lecture before the American Psychiatric Association, which concluded five days of meetings in Baltimore yesterday, E. Fuller Torrey, a psychiatric researcher at St. Elizabeth's Hospital in Washington, acknowledged that his views were not "professionally or politically correct."


For too long, he said, psychiatry has bowed to the "civil libertarians," opening the way to avoidable acts of violence committed by a small portion of the mentally ill.

"The public stereotype that links mental illness to violence is based on reality and not merely on a stigma," said Dr. Torrey, a clinician and researcher. "As such, our present attempts to combat this stereotype by campaigns of public education will fail until the problems of violence are addressed."


Dr. Torrey, long considered an iconoclast in psychiatric circles, said he would partly reverse 30 years of giving psychiatric patients more autonomy.

Dr. Torrey stressed the need to ensure that the most disturbed patients in the community take their medication.

He also said hospitals should automatically be allowed to medicate patients who are involuntarily committed.

Many others within psychiatry also view Dr. Torrey with suspicion.

"Our role in mental health is to help people regain their autonomy, and he would have us control their autonomy," said Jonas Rappeport, the retired medical director of the Baltimore Circuit Court and one of the nation's best-known forensic psychiatrists. "He wants to turn back the clock."

Stuart Silver, director of Maryland's Mental Hygiene Administration, agreed that Dr. Torrey's approach would be overkill.