We Need Lunatic Control
December 17, 2012
RUSH: We are gonna start somewhere in Florida with Patrice. Patrice, thank you for calling and waiting. Great to have out EIB Network. Hello.
CALLER: Hi, Rush. I was gonna comment on a couple things that I've heard lately. I am a psychiatrist. I do work in Florida. I worked with chronically mentally ill patients for over 20 years. Although I do want to say that, you know, the majority of patients who have severe psychiatric illness are not violent. What I have found in my work, clinically, is it is very difficult to get somebody committed to a state hospital because there are patient rights.
As a psychiatrist, you will have patients that may be placed on a 72-hour hold which is a BA-52. They may have done something proceeding their coming into the hospital which could be very violent. They could have threatened to kill their parents; they could have destroyed property; they could have assaulted others. They may be picked up by police, taken to jail, and then they come to the mental health unit.
And what happens is, over time -- 72 hours -- two of us psychiatrists will evaluate them. Now, let's say we do feel that they're a danger to others. Then we go to court, and they're placed on what is called the BA-32. And it can take up to four weeks to get these patients in front of a judge. But oftentimes what happens is in that four-week period of time, if you have a patient that is a psychiatric patient that does have a psychiatrist illness or have a drug-induced psychosis, which we often see...
In the inpatient unit you cannot treat them unless they're an imminent danger to themselves or others. So I have patients that are psychotic, they're agitated, they're irritable. I can't force them to take medication. I have to wait until they actually do something or are threatening or behave in such a way that we can involuntarily medicate them, and then the public defender can continue these cases for up to four weeks. So what happens is when you go to court --
RUSH: Are you saying that mental illness has become a right that people have? You have a right to be mentally ill? My next question is: Even if these obstacles that you've described weren't in your way, and even if you could commit people who you thought needed to be, where would you put them?
CALLER: Again, a couple of issues. They closed down G. Pierce Wood's, which is a state facility in Florida. So many severely psychiatrically ill patients were placed on the street. They went into group homes. They went into society.
RUSH: Isn't that how the homeless became homeless? They used to be institutionalized and a bunch of liberals came along and said, "They have rights! You can't keep them there"?
CALLER: About a third, they say, of homeless patients are mentally ill. But they're not necessarily violent. What I'm trying to say is I can tell you that in my experience you can have a patient who's violent, you can have a patient who is mentally ill -- and I don't know the thought processes of this person who did this terrible thing. I'm saying it's very difficult to not only get 'em committed, because, you're right, there's very few mental health resources. There's not a hospital to put 'em in, and you can't make them take medication. And they will be discharged from the hospital. Even as a psychiatrist, if you say, "I'm concerned. I think this person is a danger to others." The public defender will say, "But they've been on your unit for how many weeks? Have they hurt anybody?" And we can tell them, "Yes, but they're on medication," but this patient is telling me they're not gonna take it when they leave.
RUSH: Well, you're making it sound like there's nothing we can do.
CALLER: I'm telling you that there is, in many instances, as a psychiatrist, nothing that I'm able to do in the system to get treatment for some of these patients who I feel need treatment, but you can't force them to get treatment. You can't. There's laws that protect them. And I understand that, because in the past, you know, I know there was a lot of abuse of patients that were chronically mentally ill, and I don't know what this gentleman, what was going on with his head. But I'm saying, from a reality standpoint, it's very difficult.
RUSH: You know, you ought to read something. I mentioned this in the first hour. We'll link to it at RushLimbaugh.com if you want to find it the easy way, but you can also find it at Gawker.com. It's a piece by a woman named Liza Long, "I am Adam Lanza's Mother." In fact, I might read a couple excerpts of this. But it is written by a woman who has a disturbed child who threatens to kill her. He's 13, threatens to kill himself. She says, look, this kid is going to do what Adam Lanza did if something isn't done. She describes the problems of getting him committed to a hospital, what happens when she tells him that that's what's gonna happen, he throws a fit. She fears for her own safety. I think you'd be fascinated by it. I think everybody would, actually.
CALLER: Well, what I'm saying is you hear people talk, "Well, there needs to be early intervention. These people need to be identified." And, again, even if there is intervention, and even if they are identified, and even if they're in the system, you can't force them to get treatment when they leave. You can't force them to take medication when they leave. You don't have that authority.
RUSH: All right. If you had the authority what would you recommend?
CALLER: In what instance? In a patient who has --
RUSH: Yeah, the situation that you've described.
CALLER: Well, ideally there's a couple of things. If a patient has a severe psychiatric illness, and I'm saying these patients don't often react violently, but let's say you do have a patient who has a history of being violent off his medication, who has a history of assaulting family off of medication who you feel that you can get stabilized and get treated and then when they leave the hospital they refuse to take the medication. I mean, in an ideal world, in a world that you want to protect others, you know, wouldn't it be ideal if the court could order them they have to go every two weeks or every four weeks to get their shot because you know if they don't they're gonna be a danger to others. But that's not how the system is because unless they're imminently a danger to themselves or others, imminently --
CALLER: -- hours away, you cannot commit them.
RUSH: You know what would happen, if you prevailed, if you were able to deal with patients that you properly diagnosed in the way in which you've described, what would happen is some Hollywood producer would come along, hear about it, and make a movie about how one of these people so treated actually came up with the cure for cancer, but nobody was willing to listen because they were insane and that would put pressure on society not to put these people away. It's what we've done with the homeless. Every Christmas season, you have some leftist come along and say, "The homeless are the modern day equivalents of Mary and Joseph. They are wandering around and there's no room at the inn." They try to make this connection. It's a vicious circle. I don't envy you your job. It sounds like a lot of frustration. And it sounds like what we need is lunatic control, and we don't have any.