Mary Kay Letourneau -- Patients Suffering From Illness

After watching the way Mary Kay Letourneau's problems have been handled by society and the courts, I must express my concern.

I have practiced psychiatry in the Seattle area for 29 years, beginning in the days when the mentally ill were taken to Harborview Hospital for evaluation by two psychiatrists.

The patients were examined and, if found to be sufficiently mentally ill - their judgment and impulse control were not adequate to make decisions about their need for care - they were committed for treatment.

The attorneys became involved and changed the involuntary treatment laws so that only those violently dangerous to self, others or to property now receive care.

Way too often, those in my profession attempt to get help that is often not provided until a dangerous act has been committed. By these means, we have essentially criminalized mental illness. No wonder people have such a hard time admitting impulsive indiscretions, spending money they shouldn't, becoming sexually involved with people they shouldn't.

The problem is especially vexing as psychiatry has made such great strides in the past 20 years in understanding and treating these illnesses. We still need help from the legal system to initiate treatment when the illness is so severe that judgment and impulse control is impaired by irrationality.

Unfortunately, the courts often resort to a punitive approach, which has never helped the mentally ill.

There is no question that Mary Kay Letourneau is mentally ill. There is no question that her illness led to unacceptable behaviors, but her actions were clearly from a deranged mind. Yet, she is sentenced to years in prison rather than to a hospital.

The care at the women's prison will be inadequate as there is no program for her uncontrolled behaviors. Will the state of Washington continue to turn back the clock to the 18th and 19th centuries by treating the mentally ill as criminals rather than as patients suffering from an illness?

Might Mary Kay Letourneau's life had a different course had treatment been mandated at the first signs of severe mental illness under the more compassionate laws of the 1960s? Dr. Raymond E. Vath Seattle