The Kendra Webdale-Andrew Goldstein Tragedy: One More Failure In America’s Mental Healthcare System

Posted on January 7, 1999

Arlington, VA - We cannot help but share the grief of the family and friends of Kendra Webdale, 32, who was buried today in Pomfret, New York, after having been pushed in front of a subway train in New York City.

We mourn the loss of a creative young woman who had such a promising future. We also honor the Webdale family's compassion and courage in seeking to turn the nightmare of her death into hope for mental healthcare reform.

We also grieve for Daniel Goldstein, 29, whose promise was stolen by schizophrenia over a decade ago. We share the outrage of many New Yorkers over a mental healthcare system that allows too many people like Mr. Goldstein to fall through the cracks with little, if any, continuity of treatment or case supervision.

It is important to remember that schizophrenia is a cruel, chronic and disabling brain disorder that affects approximately two million Americans each year. It impairs an individual's ability to think clearly, control emotions, make decisions, or relate to other people, including family members. Loss of the ability to control impulses, as reflected perhaps in Mr. Goldstein's claim that "an overwhelming force took over him," also is a symptom. At the same time, studies have shown that individuals who receive appropriate treatment for schizophrenia are no more prone to violence than the rest of the population. With appropriate medication and support services, the treatment success rate for schizophrenia is 60 percent, higher than the treatment success rate for heart disease.

Unfortunately, a recent national study has documented that fewer than 50 percent of individuals who struggle with schizophrenia receive the care that science has proven to work. The experience of NAMI families---who often have had to fight to get loved ones the kind of treatment they need---has taught us that four critical elements must be in place to help those with the illness:

1. community-based care including ongoing medical treatment, housing, rehabilitation and other supports for those who are able to recognize the need for care and manage their own illness.
2. assertive community treatment programs that provide 24-hour-a-day outreach and crisis support for those who are less able to maintain their treatment requirements.
3. outpatient treatment orders that require participation in treatment as a condition for living in the community for those who do not respond to outreach and resist treatment.
4. involuntary inpatient commitment that provides short-term hospitalization to treat and stabilize acute psychiatric symptoms for those who are unable to recognize the need for treatment due to the symptoms of their illness.

According to his court-appointed attorney and news reports, Mr. Goldstein was involved in six unrelated treatment programs in six years. He also had stopped taking medication. Patients with schizophrenia who are not regularly monitored sometimes go off medication because of harsh side-effects and then, because of the nature of their illness, don't realize when their condition worsens. Continuous outreach, support, and monitoring is essential.

The tragic consequences of lack of care are evident throughout American society. People with schizophrenia and severe mental illnesses constitute one-third of America's homeless population: 210,000 individuals. Three times as many people with severe mental illnesses are in jails or prisons as in hospitals. Approximately 15 percent of Americans with severe mental illness commit suicide, frequently due to lack of treatment.

The Webdale-Goldstein tragedy is the latest in a series of high-profile cases in which Americans are learning about schizophrenia and the inadequacies of America's mental healthcare system in the worst possible way. We join the Webdale family in prayers that as a society we will embrace a better way.