Congress Looks to Revamp Mental Health System

Soon, Congress will hear testimony concerning the Helping Families in Mental Health Crisis Act. Republican representative, Tim Murphy, from Pennsylvania, sponsored the bill, and, though many agree that the mental health care system requires revamping, some provisions in the bill have sparked controversy. Among the more controversial provisions is one that supports the increased use of involuntary outpatient treatment—via court-ordered therapy for “certain mentally ill people with a history of legal or other problems.” Detractors of this provision claim that it will erode trust in doctor-patient relationships, and that it presents a civil rights issue. However, 45 states have compelled treatment programs already, one of which is New York.

New York’s compelled treatment program, Kendra’s Law, was passed in 1999. Since the implementation of Kendra’s Law, studies show that the percentage of patients returning to the hospital or getting arrested has greatly decreased. The statistic is significant, as “about 350,000 Americans with a diagnosis of severe mental illness…are in state jails and prisons” and the availability of psychiatric beds meets only 10 percent of that need. 

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Potentially Dangerous Precedent Possible in Mississippi

Anti-fetal homicide laws were enacted originally to protect mothers of unborn children against violent acts. Yet, in reality, “they’ve led to disproportionate prosecution against African American women who suffer miscarriages.” An ongoing case in Mississippi could set a dangerous precedent with regard to the criminalization of pregnant women for their purportedly reckless acts.  Rennie Gibbs was charged with the murder of her unborn child after it was stillborn when she was 16 years old. Gibbs is being prosecuted for “depraved heart murder” because the autopsy showed that Gibbs had used cocaine during her pregnancy—but the cause of death was originally attributed to the umbilical cord being wrapped around the infant’s neck. That cause of death was never ruled out.

Read more here and here.

Iowa Reconsiders HIV-Specific Laws; Growing National Trend

In 1990, Congress approved the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act funds support and medical treatment for individuals with HIV. However, under the Act every state had to certify that it had criminal laws that would prosecute individuals with HIV who knowingly exposed others to the disease, even if those exposed did not contract HIV. Individuals who are successfully prosecuted under these laws are listed as sex offenders. In one case in Iowa, a woman was prosecuted successfully even though she claimed that she informed the man that she was HIV positive. He claimed she did not tell him; however, two weeks prior to filing his complaint against her, he was convicted of domestic abuse for hitting her. She is now listed as a sex offender.

Currently, the federal government and advocates consider these HIV-specific laws to be draconian in light of modern scientific knowledge regarding HIV, which is “no longer the death sentence it once was.” Many of these HIV-specific laws do not require exposure in the form of sexual contact, and some even include exposure in the form of something as innocuous as spitting. HIV cannot be transmitted through saliva. Some states, including Iowa, are reconsidering and changing their HIV-specific laws in response to this change in public opinion.

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Supreme Court to Address Standards for Intellectual Competence

The Supreme Court of the United States barred the execution of intellectually disabled individuals in 2002. Soon the Court will address the standard that a State should use to determine whether an individual is intellectually disabled. There are ten states that use IQ scores to assess the intellectual competence of convicts, including Florida. Typically, in these states, a person with an IQ of 70 or higher is considered intellectually competent. Some psychologists maintain that using such a bright-line standard is scientifically outdated, and that IQ tests are not precise enough to make such a determination. The Court will hear arguments on the issue in Hall v. Florida, on March 3, 2014.

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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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Assisted Suicide Case Dismissed: Pennsylvania v. Mancini

A nurse named Barbara Mancini was accused of homicide in 2013. Allegedly, she handed her father a bottle of morphine with the intent to assist in his suicide. Her father, Joseph Yourshaw, 93 years old, suffered from end stage renal disease and was in home hospice.  However, the case has been dismissed. Judge Jacqueline Russell stated in her decision that the Pennsylvania Attorney General did not prove that Ms. Mancini gave Mr. Yourshaw the morphine with the intent to assist in his suicide, and that Ms. Mancini could have intended solely to alleviate his suffering. Some believe that though assisted suicide is legal in five states only, this decision “is the latest in a series of recent developments signaling the reluctance of courts” and legislatures to criminalize medical treatment that “may hasten death.”

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UPDATE: Man Forced to Undergo 3 Enemas and Colonoscopy by Police

David Eckert, from Hidalgo County, New Mexico, was subjected to numerous, highly invasive procedures, because police suspected him of hiding drugs in his rectum. Mr. Eckert had been convicted of methamphetamine possession in 2008, and the police suspected his continued involvement with drugs. However, the officers who searched both Mr. Eckert’s person and his vehicle, after pulling him over for a traffic violation, found neither drugs, nor weapons. One officer indicated that Mr. Eckert held himself in an “erect” position, and “kept his legs together,” which led the officers to assume that Mr. Eckert held drugs within him.

 After a local hospital refused forcibly to search Mr. Eckert, he was transported to the Gila Regional Medical Center (GRMC), 50 miles away. At GRMC, Mr. Eckert was subjected to two rectal exams, three enemas, forced bowel movements in front of officers and nurses, x-rays, and a colonoscopy performed under anesthesia. However, each search was fruitless. Mr. Eckert received a bill from the hospital for $6,000. Mr. Eckert filed suit against the hospital, and the parties settled for $1.6 million.

Read more here.

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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Turkish Police Potentially Violated Geneva Protocol with Overuse of Tear Gas

Turkish police forces may have violated the Geneva protocol by overusing tear gas against citizens and health care workers, some of whom were engaged in a protest against the government. The conflict began in May of 2013, when environmentalists gathered in Istanbul to protest the government’s intended destruction of Gezi Park. According to a letter of protest, signed by 25 scientists and 4 Nobel laureates, over the last two months the overuse of tear gas in confined spaces has resulted in 8,000 hospital admissions and 61 life-threatening injuries. Also, tear gas has been thrown directly into hospitals that have tried to treat injured protesters, purportedly to intimidate nurses and doctors. The Geneva protocol is strict regarding the use of asphyxiating substances during such conflicts.

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AMA Declares Force-Feeding Detainees Violates Medical Ethics

Doctor’s groups, such as the American Medical Association, have urged the U.S. military to end the practice of force-feeding detainees in Guantanamo who have engaged in a hunger strike. Force-feeding requires that doctors and nurses strap the detainee to a chair, gag the detainee’s mouth, and then insert a nasogastric tube. The insertion of a nasogastric tube is uncomfortable in the extreme, even for a willing patient. Detainees resisting tube insertion may gag, have trouble breathing, or vomit. A motion filed in federal court to end the practice was rejected by U.S. District Judge Rosemary M. Collyer. Judge Collyer stated that the Court did not have jurisdiction, and if it did she would still reject the complaint. She claims that the “real complaint” is that the U.S. Government refuses to allow the detainees to starve themselves to death.

For more on this issue, click here and here.