More treatment, less prison

By The Gazette Editorial Board

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Even the prosecuting attorney agreed that Jesse Fierstine was only trying to help when he cut out the pacemaker in his father's chest on April 25, 2009. The judge said the case weighed heavily on her. Fierstine's relatives insist prison is not the remedy for his mental illness.

Nonetheless, Judge Monica Ackley on Monday sentenced the 34-year-old Manchester man to the maximum 20 years after he pleaded guilty to willful injury, going armed with intent and two counts of assault causing serious injury - reduced from the original charges of attempted murder and willful injury that could have carried even longer sentences.

Consider the circumstances of this case. Then ask: Does a lengthy prison term serve justice, protect the public or help Fierstine, who has no criminal history, get well?

Five times from 1999 to 2005, the courts issued mental health commitments for Fierstine. Five times, he did not receive the intense treatment his family said he needed - even though medical records showed his illness involved auditory hallucinations, suicidal tendencies and psychotic behavior.

Fierstine's father suffered from chronic congestive heart failure that was worsening. The son, who wasn't taking his medication at the time, believed his father's pacemaker wasn't working properly and he could help by taking it out, a doctor said.

The father recovered from his son's action, but died several months later. His death was not linked to the pacemaker attack.

Judge Ackley said she did not suspend the sentence because Fierstine has not taken responsibility for substance abuse, a factor in not staying on his medication.

Donna Fierstine, Jesse's mother, believes the system failed her son, and it's hard to disagree. Though Iowa has many dedicated, competent people working in the mental health system, overall resources simply don't match the demand.

Prisons have become our mental hospitals. One of every six inmates in the Iowa prison system is seriously mentally ill; 40 percent have some level of psychiatric illness. Nationally, the prison population with serious mental illness has tripled in 30 years. Many of them also have substance abuse problems. And Iowa prisons' treatment programs for addictions and mental illness are overmatched.

Pending state legislation would launch major reform in delivery of mental health services, expected to take several years to complete. That won't help Jesse Fierstine.

But treatment sooner instead of costly imprisonment later should be the goal moving our mental health system forward.

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