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As we approach the new trial of Andrew Goldstein, serious thought should be given to the predicament in which Mr. Goldstein finds himself. The declaration of a mistrial verdict in the subway pushing of Kendra Webdale by Andrew Goldstein says much about the beginning of the public's understanding of mental illness in our community. Unfortunately the two hold-out jurors, people who had had direct professional contact with people experiencing psychotic episodes, were unable to convince their fellow jurors of the merit of their viewpoints.

For purposes of clarification, the public should be made aware of the severe shortcomings of this trial. Many of the inflammatory ideas presented by the Prosecution were simply wrong, starting with the concept of the "schizophrengenic mother", a notion which was abandoned by the psychiatric community in the late 1970s and early 1980s. At that time, it became indisputably clear that schizophrenia as well as many other mental illnesses were neurobiological brain disorders and not psychological states of mind caused by uncaring mothers or family members. These diseases, although not curable at this time, respond well to individualized, carefully monitored pharmacological treatment and psychosocial rehabilitation, neither of which were available to Mr. Goldstein.

If Andrew Goldstein had been going into an insulin coma as a result of a diabetic condition at the time of the unfortunate subway occurrence, there would have been no question of his inability to formulate the necessary intent to warrant conviction for murder. Our society, however, still reels from the stigma of mental illness. People are reluctant to speak of it and therefore have little understanding of its chemical underpinnings. As a result, jails have become the primary repositories of the mentally ill. At any given time, fifteen to twenty percent of the city jail inmates are mentally ill, while 7 to 8% of state prisoners are similarly afflicted. The penal system is overwhelmed by this population and ill equipped to deal with its special needs.

When state mental institutions were downsized and the severely mentally ill thrust upon communities, specific target funding was supposed to follow so that this needy population would receive appropriate housing and medical care enabling them to be mainstreamed into society. This noble plan was never effectuated. Alternatives to long term hospitalization do however exist. The severely mentally ill can be well served by ACT Teams, which create what is a seamless delivery of services via a "hospital without walls." Members of the ACT Teams are comprised of a psychiatrist, social worker and mental health worker. It is their job to physically visit the patient in their home environment to make sure that they are properly dosed with appropriate medication and that they receive the social supports to which they are entitled. Unfortunately the funding for this proven treatment is grossly inadequate, although this system of care delivery costs but a fraction of what hospital treatment costs. As a result, many of the severely ill who would especially benefit from this system fall between the cracks. Andrew Goldstein was one such patient who realized that his disease was reoccurring and sought help, not once, but at a number of hospital emergency rooms. In each instance he was turned away.

The Webdale family is to be commended for the lawsuits that they are bringing against the hospitals which denied Mr. Goldstein care. It is time that the system which fails to deliver care be held accountable for the subsequent tragedies which occur. It is also time to stop judging the accused's guilt or innocence by whether or not his family is involved in his defense. Our society is literally littered with emotionally and financially burned out family members of the severely mentally ill. These people, like their ill relatives, receive little or no support from the system. It is a fallacy to judge the capability of the accused to form intent to commit a crime based upon the presence or absence of family members at his trial.

The only appropriate action to be taken toward Andrew Goldstein is to "sentence" him to long term care in an appropriate psychiatric hospital. It is the social care delivery system which has erred, not Andrew Goldstein or his family. It is the care delivery system which must be re-evaluated. Hopefully Kendra Webdale's tragic death will serve to remind our society that it has not fulfilled its responsibility toward the untreated mentally ill and their potential victims.