Mental Disorders

Re "Shield the Sick, and Society," editorial, May 28: Congratulations to The Times for supporting AB 1321. As the former supervising judge of the Mental Health Department of the Superior Court and as a judge who heard countless criminal matters involving untreated persons with severe mental illness, I applaud The Times for its support of AB 1421. As your editorial noted, various civil liberties proponents and others have taken an ideological approach that blinds itself to the reality that persons with untreated, persistent mental illness are themselves the victims of our current laws: They wander the streets hungry, homeless and without hope, cycle through our hospitals and are released with no after-care or plan to meet their human needs--and wind up in our prisons and jails not because they are criminals but because there simply is no place for them in our society.

The Supreme Court made it somewhat harder Tuesday for states to lock up sex criminals after they have served their prison time, ruling that states must prove these inmates have both a mental disorder and a "serious difficulty" in controlling their behavior. The 7-2 ruling clarifies the standard for defining who is a "sexual predator."

A Los Angeles County Superior Court judge was kicked off the bench Wednesday by the state judicial commission after it concluded that he repeatedly lied about being a Caltech graduate, a wounded war veteran and a CIA operative in Laos in the 1960s. The Commission on Judicial Performance ordered the removal of Judge Patrick Couwenberg for willful and prejudicial misconduct, noting that he admitted perjuring himself during the state investigation.

A fire raced through a palm-thatched shed housing mentally ill people in southern India, killing 25 patients, many of whom were chained to their beds, police said. At least five other patients were seriously injured in the fire at the Badshah asylum, attached to a Muslim mosque in Erwady, about 350 miles south of Madras, the capital of Tamil Nadu state.

"Pills for What Ails You Socially" (Opinion, July 23) is wrong to assert that "social anxiety disorder" and the antidepressant medicine used to treat it are "largely the innovation" of the drug's manufacturer and its ad agency. Specific criteria for diagnosing social anxiety disorder, also called social phobia, have been described in the American Psychiatric Assn.'s Diagnostic and Statistical Manual of Mental Disorders since 1980. Paxil, an antidepressant, was first approved by the Food and Drug Administration for treatment of depression in 1993 and was not approved for treatment of social anxiety disorder until 1999.

Health and medical writers have a tendency to worry that they've got whatever condition they're researching. When you consider that recently I've written about bowel complaints, bad breath, flatulence, extra body hair and sexual problems, this is not funny. Thus, I was nervous when a colleague handed me a lay medical book titled "Am I Okay?" ("I know I'm not OK, so this book is of absolutely no interest to me," he said.) Turns out that "Am I Okay?"

Americans have long been in love with the idea of psychotherapy. When Sigmund Freud made his first and only visit to the United States in 1909, American intelligentsia flocked to his lectures. Since then, psychotherapy has spread like kudzu, morphing from the medical treatment of specific, diagnosable mental illnesses into a sort of societal support system offered by psychiatrists, psychologists, counselors, therapists, self-help gurus and TV talk show hosts.

As the nation's baby-boomer generation ages and life expectancy grows, the number of Americans with mental disorders--ranging from substance abuse to depression to schizophrenia--likely will rise, "confronting our society with unprecedented challenges," a landmark U.S. surgeon general's report has concluded.

Imagine for a moment that your child has recently been diagnosed with a severe mental illness. You are on an emotional roller coaster. You struggle with the realization that he will face many difficult challenges in his young life while at the same time you are trying to remain strong, informed and well-prepared to manage his health care.