The Madman on the Ferry

By Frank Trippett

Just one day after the Liberty Weekend harbor festival, the ferry Samuel I. Newhouse was carrying some 500 passengers -- including a number of diehard tourists -- on its 8:30 a.m. run from Manhattan to Staten Island. Midway across New York harbor, just past the refurbished Statue of Liberty, a homeless Cuban refugee named Juan Gonzalez, 43, unsheathed a 2-ft. sword he had been carrying. Shouting incoherently, he began slashing and stabbing anybody who stood in his way. Retired New York City Police Officer Edward del Pino, 55, seeing panicky passengers stampeding past him on the ferry's deck, rushed inside in time to see Gonzalez slash a woman to death. Pino, en route home from his job as a security guard, pulled out a .38-cal. pistol and fired a shot into the air. Ordering Gonzalez to hit the deck, he warned him, "You move and you're dead!" But by then two were dead (a 61-year-old Staten Island man and a 71-year-old Manhattan woman) and nine wounded (including a touring couple from Kansas).

As the ferry docked, police seized Gonzalez and charged him with murder, assault and criminal possession of a weapon (which had legally been sold to him for $22 by a Times Square souvenir shop). At the Staten Island police station the prisoner, who fled from Cuba in 1977 aboard a small boat, shouted, "The Father, the Son and the Holy Spirit made me do it!" Authorities sent him to Kings County Hospital in Brooklyn for psychiatric evaluation.

Only a few days earlier Gonzalez had undergone another psychiatric evaluation. After being observed on a street making wild threats ("I'm going to kill! God told me so!"), he had been taken to Manhattan's Presbyterian Hospital. Physicians concluded he had a "psychotic paranoid disorder," but released him after two days.

In the aftermath of the ferry carnage, the decision to put such a violence- prone person back on the streets outraged observers, officials and doctors alike. New York City Mayor Ed Koch ordered his mental-health commissioner to investigate the procedures that were followed from the time Gonzalez was taken to Presbyterian to the time he was arrested.

To no one's surprise, the investigation determined that Gonzalez's release had been "premature," and the hospital's city contracts were put under review. In fact, doctors had considered further hospitalization but could find no space for Gonzalez at the facility. In any case, the hospital said, he had responded well to treatment and had been issued antipsychotic drugs to take with him upon release. Moreover, Gonzalez had agreed to report as an outpatient to another hospital. He never did. The next time he attracted official notice was on the ferry.

That left the public grappling with a question that has been coming up again and again: Why are dangerously deranged people allowed to roam at large? Koch himself expressed the common perplexity. "If someone is irrational, particularly with thoughts of killing expressed," said the mayor, "one would say, as a lay person, that the fact he says the next day 'I'm feeling O.K. now' doesn't necessarily mean he's O.K."

Actually, Presbyterian Hospital's decisions flowed from the pressures and imperatives arising from 30 years of social, medical and legal policies specifically designed to liberate patients from forced confinement. The development of effective drugs prompted states to begin the wholesale release of patients from hospitals. At the same time patient advocacy movements, citing stories of people left to languish for years in "snake pits," established an individual's right to refuse involuntary commitment or treatment.

While benefiting thousands of people, these policies have led to drastically scarce bed space for mental patients, swollen numbers of disturbed homeless people roaming the streets of America's cities, and forbidding legal constraints against forced institutionalization. In Onalaska, Wis., last year, a 30-year-old man shot to death a priest, a lay minister and a church custodian during a mass. He had been released from a Michigan mental-health institution, where he had been committed after several prior assaults. But Wisconsin's laws and those of many other states would not allow him to be involuntarily committed.

In Los Angeles, which has been called the homeless capital of the U.S., a third of some 50,000 homeless are believed to be mentally ill, and fear of violence from the deinstitutionalized is common. But the director of the local mental-health association, Richard Van Horn, says "deinstitutionalization itself is not at fault. Adequate treatment dollars did not follow the population into the community." While the Federal Government initially planned to establish 2,000 community mental-health centers for released patients, no more than 800 were ever opened. Dwindling federal revenues have left communities without the means to treat the homeless mentally ill. New York State, for example, maintained 46,000 in-patient beds for the mentally ill in 1970; today the number is less than 6,000. Says Dr. Henry Storper, medical director of Community Health Incorporated in Miami: "We did not deinstitutionalize mental-health hospitals. We depopulated them."

Violence resulting from such situations is almost inevitable. Dr. Darold Treffert, chairman of the board of the Wisconsin State Medical Society, has collected several hundred cases from all over the U.S. of deinstitutionalized patients who, lacking treatment, became involved in violence. Says Treffert: "Most states ended up with three standards for civil commitment: danger to self, danger to others and gravely disabled. We need a fourth standard, for that patient who is obviously ill but not yet deteriorated to the point of being dangerous." The tragic history of the New York ferry slashing underscores just how serious that danger can be.

With reporting by Joseph N. Boyce/New York, with other bureaus.