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Sunday, August 19, 2012

Andrew Goldstein Pleads Guilty

Andrew Goldstein Pleads Guilty - Andrew Goldstein has just pleaded guilty to manslaughter for pushing Kendra Webdale to her death in front of a New York City subway train in January 1999. It is expected that he will serve 23 years in prison with five years of supervision after his release (“Nearly 8 Years Later, Guilty Plea in Subway Killing.” New York Times, 10/11/06.)

Unless you have been living on the moon, you know that it is widely acknowledged that this tragedy resulted from Andrew Goldstein’s untreated mental illness. However, it seems to be less well known that Andrew Goldstein desperately sought treatment – often – in the years before his symptoms overwhelmed him and he killed Kendra Webdale. For example, according to a great article by Michael Winerip in The New York Times Magazine (“Bedlam on the Streets,” 5/23/99), Goldstein voluntarily signed himself in for all of his hospitalizations, numbering more than a dozen. And he more than once asked to be hospitalized long-term at Creedmoor State Hospital.

Of course, there would have been a far better alternative to long-term hospitalization. According to another article by Winerip in the Times (“Report Faults Care of Man Who Pushed Woman Onto Tracks,” 11/5/99), Goldstein could have lived in supervised, state-financed housing “with day services, clinic visits and an intensive case manager” – services that might have helped him work toward recovery – for $25,310 a year. This would have been a bargain compared to the $95,075 that taxpayers shelled out in 1998 alone to pay for Goldstein’s care, mostly in Medicaid payments to hospitals.

Reading this gives me terrible cognitive dissonance. What were they thinking?! By the way, Winerip places Governor Pataki and the State of New York at the top of the list of those “who should be held accountable for what happened to Goldstein and Webdale.”

You probably also know that, as a result of this tragic incident, Kendra’s Law was signed into law, despite tireless efforts by the New York advocacy community to prevent its passage. Kendra’s Law provides for requiring individuals with psychiatric diagnoses who are living in the community to accept outpatient mental health treatment (usually involving medication)

At the risk of preaching to the choir, I just want to note that involuntary outpatient commitment is a bad idea.

First, force and coercion have been proven to drive people away from treatment, and are expensive and ineffective. In addition, involuntary outpatient commitment is impossible to enforce and impossible to implement in a manner consistent with due process and human rights.

What happened to Kendra Webdale was tragic. What happened to Andrew Goldstein is also tragic. And Kendra’s Law simply compounds these two tragedies.

I feel compelled to add here that such tragic incidents involving people diagnosed with mental illnesses are extremely rare. People with mental illnesses are far more likely to be the victims than the perpetrators of violent crime and, according to a study by well-known researcher John Monahan, “Clearly, mental health status makes at best a trivial contribution to the overall level of violence in society.”

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