I applaud Maryland's initiative to create a new center to identify and treat people with psychotic symptoms early in their illness ("Mental illness and guns," Oct. 23).
However, the current commitment laws in Maryland remain an impediment for a number of reasons.
Some individuals with severe psychosis, for example, have a brain condition called anosognosia, which renders them unable to understand that they are ill and thus that they need treatment. That is why they often refuse treatment.
Moreover, Maryland's current law for emergency evaluation and involuntary hospitalization requires "danger to self or to others." This is often interpreted by police, judges and medical providers as "imminent" danger of "physical" harm. This is a high barrier to early intervention. The laws need to be clarified to include a reasonable expectation of dangerousness, which should also include the inability to meet one's essential needs.
In 2009, my young adult son stopped taking his medicine for psychosis and refused treatment. He became delusional, threatening to kill an imaginary man named Roger. I worried that he might mistake a real person for the Roger of his delusion.
However, Circuit Court judge Robert A. Greenberg denied my petition for an emergency evaluation on the basis of "immediacy," indicating he felt no danger was imminent. Fortunately, there was no tragedy, but my son's brain was without the neuro-protective effects of an antipsychotic for far too long before finally getting hospital treatment.
This year, when he relapsed his outpatient doctor again did not believe the psychosis met the "danger" standard for involuntary hospitalization. The doctor refused to petition for emergency evaluation until after it was necessary to call the police to my son's home.
After one week of involuntary hospitalization and after be prescribed a new medication, he was doing much better, but he will never be whole. Each extended psychotic period, due to our legal barriers to treatment, has reduced recovery of function. Our laws need to facilitate medical treatment for those with anosognosia, not delay it.
Marilyn Martin, Chesapeake Beach