Behind New York's change in mental health, a lonely quest

Psychiatrist E. Fuller Torrey has been advocating for stricter policies on involuntary psychiatric treatment for 40 years. Now it's paying off.

BETHESDA, Maryland — Psychiatrist E. Fuller Torrey, 85, has Parkinson's disease, the tremors sometimes so strong that his hand beats like a drum on the table.

Yet every morning when he reads the newspapers, he looks for stories of violent behavior by people with serious mental illness, to add to an archive he has kept since the 1980s.

His files include reports of people who, in the grip of psychosis, assaulted political figures or pushed strangers into the path of subway trains; parents who, while delusional, killed their children by suffocating, drowning or beating them; adult children who, while not on medication, killed their parents with swords, axes or hammers.

Dr. Torrey, who did pioneering research into the biological basis of schizophrenia, used these stories in the service of an argument: that it was a mistake for the United States to close its public psychiatric hospitals without adequate follow-up care. And that to remedy this, the government should create systems to compel seriously mentally ill people in the community to seek treatment.

For much of his career , Dr. Torrey has been a lone voice on this issue, disavowed by patient advocacy groups and organized psychiatry. But his ideas are now sparking major policy changes, including New York City Mayor Eric Adams' announcement last month that city officials would send people with untreated mental illnesses to hospitals, even if they posed no threat to the others.

"This is the biggest attempt to change the thing we said we wanted to change," Dr. Torrey said.

"I think the stakes are high," he added. "Because if it fails, if you don't have any improvement, I think people give up for another decade, just live with it for another decade before someone else comes up with a new idea."

Dr. L Torrey's influence on New York politics is profound. The mayor's adviser on this issue is Brian Stettin, who has been plon ge into mental health politics in 1999 when, as an attorney in New York's Attorney General Eliot Spitzer's office, he was asked to write Kendra's Law, named after a woman who was pushed in front of an oar subway by a man with schizophrenia. The law allows a court to order a person with mental illness to comply with an outpatient treatment plan, risking involuntary commitment if the person refuses.

At the time, Mr Stettin turned to Dr Torrey's organization, the Treatment Advocacy Center, for advice and became so convinced that after leaving state government he spent more a decade as group policy director. In an interview, Mr. Stettin described Dr. Torrey as "the biggest influence on my thinking about the role of law and politics in providing medical treatment for serious mental illness".

Ira A. Burnim, legal director of the Bazelon Center for Mental Health Law, said that in the course of defending his ideas, Dr. Torrey exaggerated the dangerousness of people with serious mental illness, changing their way of being consulted.

"Whenever there was a sensational crime involving someone with mental illness, Fuller Torrey would be there, saying that that's what happens when you have our current civil recognizance laws," he said. "Among the...