While I appreciated the candid Sept. 6 editorial "More needless carnage," the editorial made only passing mention of an important contributor to preventable violence: the lack of pragmatic commitment laws in many states, including Massachusetts, for patients with treatable psychotic illnesses such as schizophrenia.
Our current law allows for involuntary emergency and inpatient treatment but cannot mandate long-term outpatient treatment for patients with psychotic illnesses. These patients often have little to no insight into their illness and will not consistently take medications, to their own and society's detriment. Unfortunately, some (not all) are also dangerous when untreated and psychotic.
Without a legal framework that acknowledges this clinical reality, even the most comprehensive and integrated mental healthcare system cannot function. Without legal reform leading toward mechanisms for longer-term assisted treatments (for example, court-mandated outpatient treatment), the Commonwealth will continue to abandon those members of our community who need our protection and care the most. Untreated psychosis is a preventable cause of human suffering and societal tragedy.
Dr. Oliver Freudenreich
The writer is a psychiatrist in the schizophrenia program at Massachusetts General Hospital.
Psychotic Disorders: A Practical Guide