comments on forced medicating for us with a serious mental illness

I am one of the persons in this country with a serious mental illness.  Rich Lowry, in his January 19th op-ed, quotes E. Fuller Torrey as writing there are 4 million of us, out of whom 1600 commit murders each year. The 1600 seemed high to me (a rate of 40 per 100,000 compared to around 4 or 5 per 100,000 for the general population).  I checked Torrey out at Wikipedia.  The Wikipedia article says Torrey counted the number of murders by those with bipolar or schizophrenic illness in a city of 4 million and extrapolated to the total US population. According to Wikipedia, the estimate came out to 1000 murders per year. Perhaps Lowry was quoting the upper limit of a confidence interval. Using National Institute of Mental Health numbers, there are 5.7 million people with bipolar illness and 2.4 million people with schizophrenia in this country.  Using the National Institute of Mental Health numbers and the Census Bureau estimate of the US population at about 307 million persons, about 2.62% percent of the US population have schizophrenia or bipolar illness.  Dividing Torrey’s estimate of 1000 murders per year by 8.1 million persons gives a rate of 12.3 murders per 100,000 for persons with bipolar or schizophrenic illness.  Dividing 1000 by 307,000,000, the size of the US population, and multiplying by 4,000,000, the size of the population where the murders occurred, we get 13.  So, Lowry observed 13 murders out of 4,000,000 people. A 95% confidence interval for the number of murders committed in the US by bipolar or schizophrenic persons, if we were to assume the 13 observations were from a random sample of size 4,000,000 from the entire US population,  would be (13 / 4,000,000 * 307,000,000) plus and minus 1.96 times 307,000,000 times the square root of ((13 / 4,000,000 * 3,999,987 / 4,000,000) / 4,000,000).  We could be 95% confident that the actual number for the US is between 462 and 1538 murders if the 4,000,000 were a random sample from the US population.  The 95% confidence interval for the rates would be between 5.7 murders per 100,000 and 19.0 murders per 100,000.

As a statistician, the extrapolation makes me cringe.  If I were doing the estimation, I would at least control on the overall numbers of murders in the city compared to the US total number of murders by doing a ratio estimate.

For the city of Fort Dodge, Iowa, in whose newspaper I read Lowry’s op-ed, if Torrey were correct and Torrey’s count for the city of 4 million extrapolates to the whole country, we could use the above numbers, an estimate of the population of Fort Dodge at 25,075 persons, and Torrey’s figures, to get an expectation of .0262 * 25075 * 12.3 / 100000 = .081 murders per year by persons with schizophrenia or bipolar illnesses, or .81 murders in 10 years, in Fort Dodge.   There were 6 murders in Fort Dodge over the ten years from 1999 to 2008.  I do not know if any of the murderers had schizophrenic or bipolar illnesses.

Dr. Torrey, who is a psychiatrist, advocates for better treatment of the seriously mentally ill, but, also, for forcing the mentally ill to take medication.  Certainly, our country’s treatment of the seriously mentally ill is beyond the pale. I believe the reason for the neglect of the mentally ill has to do with the trend toward cutting taxes and government services.  Writing laws about forcing the mentally ill to take medication would not solve the problems we mentally ill have.

I have had an illness in the spectrum of the schizophrenic illnesses for at least 34 years.  My doctors have tried me on 7 different anti-psychotics, lithium, two anti-depressants, and one anti-anxiety medication.  According to Dr. Abram Hoffer, another psychiatrist who has spent his life researching schizophrenia, the anti-psychotic medications lose their effectiveness over time.  Hoffer writes that persons with schizophrenia on anti-psychotics recover about 10% of the time (versus 90% of the time in poorer countries where anti-psychotics are not used).  My experience on anti-psychotics follows Dr. Hoffer’s observations.  I did quite well at first, but, even though I stayed on medication most of the time, I got progressively sicker (to the point of almost constant psychosis).  The reason we try to go off anti-psychotics is that the drugs are horrors.  My experience has been that the drugs cause a deadening of the feeling tone, difficulty with getting out of bed in the morning (I have spent many days not getting up till late afternoon), problems with short term memory, difficulty using the mind, to name a few side effects.  I have tried to go off my medication five times over the last 34 years.  In 2007, I began using nutritional supplements to try to heal myself.  When I started the nutritional approach, I was not working with a doctor who had experience with nutritional approaches and eventually ran into trouble.  Just this last fall, I began working with a clinic that treats mental illness with supplements and diet. I am on a lower dose of anti-psychotics now and have little trouble getting out of bed in the morning and my mental processes are much better.  If I had been forced to take medication, I would not have been able to try the nutritional approach, because the mainstream psychiatric establishment does not believe such approaches are effective.  Believe me, I cherish my right to control my medications.

Dr. Hoffer found that about two-thirds of his patients had food sensitivities causing their illnesses (on page 90 of Healing Schizophrenia, Dr. Hoffer sites that researchers have found at least 50% of those with schizophrenia have cerebral allergies to foods) while most of the rest followed a genotype and had an genetic illness called pyroluria.  Just about all can be treated and recover.  So, I suspect the solution to the types of murders that the psychotic commit is the proper treatment of the illness, using prescribed nutritional supplements and diet  (and psychotropic drugs as needed) under the care of a doctor who has been trained in the use of nutrition and diet to treat mental illness.  Such doctors do exist and my experience with the treatment is encouraging.  The fact that  people suffer with the terrible pain of schizophrenia and, a few of them, do horrible murders, when an effective treatment is out there, is beyond the pale.

Note, Dr. Torrey’s result was for bipolar and schizophrenic persons.  Even if Dr. Torrey’s number were correct, the rate for schizophrenics, who, I believe, are those who commit the crazy murders, like those that happened in Arizona, may be much lower.  I have read that schizophrenics, while disruptive and sometime violent, commit murder at a lower rate than the general population.