New York City Stabbing Reveals How the Mentally Ill Slip Through Cracks After Released From Prison

A few days after Daniel St. Hubert was released from prison, he allegedly went on a stabbing spree resulting in the death of a 6-year-old boy.   Hubert’s past is checkered with violence. In fact just before his release, he had been incarcerated for five years for choking his mother with an electrical cord. Moreover, Hubert’s time in prison was filled with violence against inmates and correctional workers. The correctional system would seem to have been aware of Hubert’s propensity for violence. Indeed, it took three years before he was deemed psychologically fit to stand trial for the assault on his mother.

While in prison, Hubert underwent years of therapy that resulted in improvement in his behavior including six months without any citations for violence.  On May 23, 2014, after a psychiatric evaluation, Hubert was released without a structure in place to ensure the safety of Hubert and the public.

Currently, the criminal justice system focuses on ensuring that the mentally ill are competent to stand trial, but little has been done to combat mental illness once mentally ill prisoners are released. New York’s “Kendra’s law” gives the state the authority to order outpatient treatment for individuals who have had a violent past and have refused treatment. However, this law does not ensure thatmentally ill people released from prison will receive needed treatment. Hubert’s case forces us to ask whether or not six months without a citation for violence is enough time to deem a prisoner stable enough to re-enter society. Further, is there a better way to keep tabs on released prisoners with mental illnesses?  Whatever the solution, there are civil liberty issues that must be balanced with public safety.

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Philadelphia Police Department Directed to Respect Transgender Population

The Philadelphia Police Department implemented an “unprecedented” policy change last December.  Directive 152 is intended to guide police officers’ interactions with transgender Philadelphians. Local activists state that Philadelphia police were often antagonistic and discriminatory when interacting with transgender individuals. Directive 152 seeks to address this problem by advising officers to use the proper pronouns when referring to transgender individuals. For example, the Directive indicates that in the event of a transgender individuals’ death, officers should “use pronouns and titles of respect appropriate to the individual’s gender identity as expressed by the individual.” In addition, the Directive addresses more difficult issues, such as housing and processing for transgender inmates; officers are to separate transgender inmates from the general population in separate holding cells in order to protect them from physical and sexual abuse.

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Vermont Lawmakers Consider Rights of Patients Committed Involuntarily

Recently, Vermont Senate committees conducted hearings regarding the involuntary administration of psychiatric medication for some psychiatric patients who pose a danger of harm to health care providers. Proposed legislation would “streamline the process” of involuntary commitment and would allow the state simultaneously to request authority to require a patient to take psychotropic medications against his or her will.

On January 22, during the hearings, Dr. Gordon Frankie, Chief of Psychiatry at the Rutland Regional Medical Center, offered anecdotal evidence regarding a patient who assaulted two of the Center’s staff members—leaving one member brain damaged. Dr. Frankie indicated that the staff awaited a court order before it could medicate the patient. The lawyer who directs Vermont’s Legal Aid’s Mental Health Law Project, Jack McCullough, claims that the commitment process operates appropriately and requires no intervention.

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NAMI Forum Focused on Separating Violence from Mental Health Issues

On October 18, 2013, the National Alliance on Mental Illness (NAMI) hosted a forum at Fort Hays State University (FHSU) regarding the mass shootings at Columbine, Virginia Tech, Newtown and Aurora. The forum is part of NAMI’s effort to disentangle the public’s conception of the mentally ill from the violence of the tragedies. The executive director of NAMI Kansas, Rick Cagan, stated that though the perpetrators of those tragedies were mentally ill, other factors contributed to their rage. Professor of psychology at FSHU, Dr. Patrick, said that the men responsible for the mass shootings had exhibited signs of their potential for violence, and that those signs were unheeded.

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Mississippi Implements Novel Law to “Chip Away” at Teen Pregnancy

Mississippi has one of the highest teen pregnancy rates in the United States.  A new law requires that any female who refuses to name the father of her child, and is under the age of 16, must submit to a DNA test conducted by authorities using blood from the umbilical cord. The DNA tests will be used to prosecute statutory rape cases by proving the father’s paternity. Supporters of the law claim it will help drive down the number of teen pregnancies in the State. However, detractors believe that the law may interfere unduly with privacy rights.  Read more here.

Bullying in Health Care Settings

Bullying in health care settings has been recognized as a serious problem.  A recent article in USA Today considers the problem.  The report refers to an episode in Indiana in which a cardiac surgeon angrily threatened a perfusionist (someone who operates a heart and lung machine).  The perfusionist brought suit, and in 2008, the Indiana Supreme Court affirmed a $ 325,000 jury verdict for the plaintiff. Raess v. Doescher, No. 49S02-0710-CV-424 (Indiana SC, Apr. 8, 2008).

In addition, a 2008 report by the Joint Commission (the hospital accrediting group), Behaviors That Undermine a Culture of Safety, referred to a history of “tolerance” for “intimidating and disruptive behaviors in health care.” Bullying and other intimidating behaviors in healthcare settings are especially worrisome because of the possibility that patients could be harmed as a result.  One survey found that more than three-quarters of healthcare workers were aware of “disruptive behavior” by physicians, and almost two-thirds were aware of such behavior by nurses.

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