Civil Liberties

Is the Lesson of the Aurora Shooting That We Need Better (Or More Compulsory) Mental Health Services in the U.S.?

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Maybe the problem isn't Hollywood, a lack of Christian ethics, guns, Occupy Wall Street, nerds, or the Tea Party. Maybe the problem is crazy people sometimes shoot other people. And maybe what is most surprising is how little people have been pushing the familiar narrative that a better, perhaps more coercive mental health system could have prevented tragedies like the July 20 shooting that killed 12 people who just wanted to see The Dark Knight Rises. But here comes that narrative, and maybe when the blame the Tea Party! I mean Occupy Wall Street! screams have died down, more people will go back to worrying that the mentally ill are all one moment from massacring us all, especially if they're obsessed with Batman.

Though mental illness is certainly less scientifically solid than some experts would like you to believe (check out Jacob Sullum on some of the problems with the holy psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders IV) it also exists in some fashion. In spite of the terror over Sarah Palin and angry rhetoric post-Tuscon shooting, it turns out Jared Loughner was just pretty God damn loony. Norway's monstrous Anders Brevik, on the other hand, had a long-winded manifesto detailing why he had to blow up and then shoot 70-odd countrymen. Still, you could argue that he was loony as well. Aren't people who slaughter other people crazy? What else do you call hunting down children in order to keep your country free from immigrants? The debate about James Holmes, the suspect behind the Aurora, Colorado massacre is now beginning; is he crazy or a cold, calculating terrorist? What's the difference? Can he be both, much like Columbine killer Eric Harris turns out to have been a probable psychopath who also had ambitions to change the world with violence?

Over at Pajamas Media, Clayton E. Cramer has posited a variation on this familiar, anti-libertarian theme. Cramer writes that the origins of some America's recent, nastiest shootings stem from that period of deinstitutionalization of the mentally ill that happened in the 1960s-1980s. Back in the day, it seems, you didn't tend to see homeless, mentally ill folks on every other street corner, because they were locked up. Cramer doesn't exactly go out and say that the standards for committing folks should be lowered, but he strongly implies just that. He points to the supposed dangers of Addington vs. Texas (1979) which established that long-term involuntary commitment was kind of a serious thing. So that decision "raised the burden of proof required to commit persons from the usual civil burden of proof of 'preponderance of the evidence' to 'clear and convincing' evidence." However,  "there was no reduction in the rates of commitment as a result of the decision."

Basically, the old standby "beyond a reasonable doubt" was an unfair burden on the state, due to the tricky nature of mental illness. So they decided that the standard for commitment was somewhere in the middle of standards of higher standard of proof for criminal cases versus less for civil ones. 

Cramer is clearly not keen on this, and he points to several studies that point to the high number of prison inmates who seem to be suffering from mental illness. He links to to a 2005 Department of Justice study which reports that 65 percent of local inmates, 56 percent of state inmates, and 45 percent of federal inmates have some kind of mental health issues. But of course, huge percentages of the 2 million people in prison are there for drug-related crimes, not exactly obvious signs that they are would-be Loughners, Mansons, or Dahmers. 

In two pages, Cramer is rather squirrelly as he avoids saying exactly what he wishes the standards of commitment might be, only that they are not what they should be (and that they are not what they once were). He concludes: 

When you watch a relative spiral down into severe mental illness, you know that there is something terribly wrong, but our legal system has made it nearly impossible to provide help to those who are insane. 

[…]

The mainstream media, of course, are using this tragedy in Aurora as an argument for restrictive gun control. But the core problem — the deinstitutionalization of the mentally ill — is simply being ignored.

Over at Fox News, psychiatrist Keith Ablow is also sure that there is a similar lesson to be gleaned from Aurora:

Because, in the end, it will become clear that more than one person—and probably several, including family, friends, neighbors, classmates, health care personnel or educators—knew or should have known that James Holmes was confused, losing sight of reality, experiencing severe mood swings, withdrawing from the world around him, experiencing violent fantasies or all of the above.

He goes on to worry that many people don't know they can get help if a loved one is acting strangely:

They don't know that they can call 911 or that they can call their local police. They don't know that they can petition a district court to commit a loved one to a psychiatric facility. Many have no idea that their communities are covered by mental health centers with crisis teams that are duty bound to respond to such matters by at least considering the possible risks or evaluating the individual in question.

Perhaps so, but Reason readers might recall the dangers of calling police when someone is in emotional distress, chronic or acute. Even in the last two years, Kelly Thomas, Kyle Miller, and Nick Christie — all mentally ill in some fashion — died at the hands of police. Brian Aitken, who nearly went to jail for seven years thanks to New Jersey's convoluted gun laws, found himself in police hands after his mother called them, concerned about her son's mental state.

The state's ease of commitment was also chipped away at in the 1975 case O'Connor vs. Donaldson which held that "A State cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom by themselves or with the help of willing and responsible family members or friends" in response to a man who had been held for 15 years in a mental institution without treatment and without any proof that he was a danger to others, besides a few expressions of paranoia delusions pre-commitment. Fifteen years is a very long time to violate a man's rights just because he displayed some seemingly baseless paranoia.

As Jacob Sullum wrote in April 2011 in Reason's special issue on the Tuscon shooting, when this more commitment idea was being bandied about as a could-have-stopped it thesis:

On The New Republic's website, University of Maryland political scientist William Galston warned that "the rights-based hyper-individualism of our laws governing mental illness is endangering the security of our community and the functioning of our democracy."

These and many other critics argue that innocent people could be saved if it were easier to imprison dangerous lunatics like Jared Lee Loughner before they commit crimes. But the champions of involuntary psychiatric treatment rarely consider the innocent people who would be stripped of their freedom and forced to take antipsychotic drugs if the government were allowed to lock up potential Loughners based on little more than their wacky beliefs and off-putting behavior.

Reason contributor and editor in chief of The Freeman Sheldon Richman also wrote in a 2004 essay in Freedom Daily that even libertarians are guilty of forgetting about the inherent civil liberties violations that involuntary commitment entails:

A person diagnosed as mentally ill and judged to be a danger to himself or others has practically none of the rights enjoyed by the rest of us. Notice the failure to distinguish between harm to oneself and to others — a basic distinction in libertarianism. Such a person can be committed to a hospital and forcibly administered drugs and other brutal psychiatric interventions. Or he can be subjected to "outpatient commitment," according to which he will be compelled to take drugs. If he refuses, he can be hospitalized, that is, locked up. It is estimated that some two million people are committed against their will in the United States each year.

It's true. Even if you are unconvinced of Thomas Szasz's thesis of The Myth of Mental Illness, it is undeniable that to lock someone up for mental illness can be worse than a jail sentence in that it can be done for literally nothing except strange behavior. And it can be indefinite.

It's been a handful of decades since the U.S. forcibly sterilized scores of thousands of the "feeble-minded" and disabled. Around that time they also spent years violating all medical ethics by neglecting to tell 400 black males that their syphilis was not being treated. Doctors, even those of mental health, know a lot, but they don't know everything. Hopefully in a few years people will look at involuntary commitment of individuals with as much shame as we now look at eugenics, the Tuskegee Experiment, or even the Japanese internment.

Meanwhile, shootings will still happen every once in a while, because that's just what happens. As someone who had every right to be irrationally angry, screaming for blood, or laws or anything to fix what happened, once said, "in a free society, we're going to be subject to people like this. I prefer this to the alternative." That was the father of Jared Loughner's youngest victim, nine-year-old Christina Green, just one day after she died.

Reason has reported on mental illness questions in the past, most notably Jacob Sullum's fascinating 2000 interview with Thomas Szasz. Also check out, "Mad Enough to Lead," my May look at two different books exploring the link between mental illness and power. 

NEXT: Ed Krayewski on Life After the Aurora Shooting

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  1. Read Thomas Szasz Lucy.

    1. Oh, you do acknowledge him. I didn’t read that far.

      1. Yeah, but I haven’t really read him directly, and clearly I need to.

        1. Sullum’s interview with Szasz is an excellent introduction. I started with Ceremonial Chemistry and The Manufacture of Madness.

  2. Even in the last two years, Kelly Thomas, Kyle Miller, and Nick Christie all mentally ill in some fashion, died at the hands of police. Brian Aitken, who nearly went to jail for seven years thanks to New Jersey’s convoluted gun laws, found himself in police hands after his mother called them, concerned about her son’s mental state.

    none of them wound up shooting anyone. you’re making cramer’s point for him.

    1. Really? Cramer’s point is that these people should be murdered by the police?!?!

  3. Trying to get mentally ill people to get help is as difficult as trying to get drug addicts to get help: you can only convince and not force them. No one should want to live in a society where a neighbor can have you forcibly sent to the funny farm if you they call the state mental health board accusing you of being unbalanced.

    What drives the gun control crowd (and statists in general) crazy is the fact that we live in a very flawed world surrounded by very flawed people and there is simply no way we can control them without going full authoritarian. And to many that is an acceptable trade-off.

    1. Exactly. The instant they start allowing easier forcible commitment, the abuse of it will begin that day.

      It’s just another way statists see of handing the government more power to control behavior. And it’s a particularly Orwellian one at that.

      1. Does the Patriot Act allow POTUS to declare people mentally unfit in the name of national security?

        I doubt if it does so directly but if one can kill American citizens surely just locking them up is so much more humane.

        Many authoritarian countries have done it and the CIA is portrayed in movies and TV episodes of Mission Impossible as being able to do it. Not sure if there are any documented cases in the US of it actually happening though.

    2. Adding to the fact that psychologist have a better chance in guessing who will be violent by flipping a coin then through any sort of test, you have a huge probability that an innocent person will be lock up against their will for no reason.

      1. Unless you believe in pre-crime, involuntary commitment always locks up an innocent person against their will. If they weren’t innocent they would be sent through the CJ system.

        If you disavow IC entirely there’s near certainty that someone will get killed by violent mentally ill people. The fact that the coercion came at the hands of an individual rather than the state does not make it any better.

        1. What I mean by innocent isn’t in the way CJ defines innocent. I am saying that if you give broader discretion to mental health workers to involuntarily lock people up, many of those people would have never committed a crime or harm another person to begin with so there would have been no reason to have placed them involuntarily into a mental facility to begin with.

          1. Yes, of course. But you don’t know who those people are in advance.

            1. I also don’t know in advance which SANE people will commit crimes.

              But I absolutely know that if I don’t lock up all sane people, some of those people will kill someone. Exactly the same earth-shattering knowledge you cite in your 8:28 post.

              1. ” 65 percent of local inmates, 56 percent of state inmates, and 45 percent of federal inmates have some kind of mental health issues.”

                Which of course means 35% of local inmates, 44% of state inmates, and 55% of federal inmates are perfectly sane whatever that means.

                1. some kind of mental health issues.”

                  These statistics bug the shit out of me. “Some kind” of mental health issue. Co-dependency is considered a type of “Mental health issue”.

                  The whole thing is essentially meaningless. What’s that statistic supposed to do? Get mental health professionals narrowing their eyes and scratching their chins about why a particular inmate is incarcerated because she may sometimes exhibit unusually manipulative behavior?

                  1. Exactly. What percentage suffer from the types of mental illnesses generally associated with these violent actions?

                    And even then, it’s a useless statistic. The lifetime prevalence of schizophrenia is about 0.5%. Meaning that about 1.5 million Americans will be schizophrenic at some point in their lives. I think we’d have heard about it if 1.5 million people decided to commit these atrocities.

                2. How many of them were driven crazy by prison conditions?

      2. Adding to the fact that psychologist have a better chance in guessing who will be violent by flipping a coin then through any sort of test

        Indeed.

        The Rosenhan experiment was a famous experiment into the validity of psychiatric diagnosis conducted by psychologist David Rosenhan in 1973. … All [pseudopatients faking hallucinations] were admitted and diagnosed with psychiatric disorders. After admission, the pseudopatients acted normally and told staff that they felt fine and had not experienced any more hallucinations. Hospital staff failed to detect a single pseudopatient, and instead believed that all of the pseudopatients exhibited symptoms of ongoing mental illness. Several were confined for months.

    3. There’s some serious false dilemmaing going on here. The current state of the law is a decent compromise between the dangers of easy commitment and the dangers of violent mentally ill people running around in society.

      Don’t pretend the latter danger is negligible or unavoidable. Unlike other criminals, mentally ill criminals are not deterred by the law, the threat of punishment, or armed citizens.

      1. So in your opinion, if a mentally ill preson shows no signs of violence (and there is really no way you can ever know for sure) should they be forcibly committed? How would you test for that? It’s hard to find a middle ground for preventative care since you only know for certain once they harm themselves or someone else.

        1. It would be a tough road to hoe. But there’s significant peril on either side, so hoe it we must.

          I think clear signs that a person is taking pleasure in the thought of other people suffering grievous harm (without any plausible grievance being present for particular people) would be sufficient reason.

          1. Why? That doesn’t mean they have any desire to cause it. I mean (ignoring your grievance angle), I think Jerry Sandusky being raped to death in the prison shower would, at a minimum, not bother me a bit. Doesn’t mean I’m going to commit a crime to get myself sent to prison in an elaborate plot to make that happen.

          2. I think clear signs that a person is taking pleasure in the thought of other people suffering grievous harm (without any plausible grievance being present for particular people) would be sufficient reason.

            That is a very low threshold for institutionalization. By the standard you suggest, half of this website would have to be locked up.Until a person takes action on those thoughts, they get to remain free in society.

            1. In most cases there’s a plausible grievance. There are some people here who I think should be locked up, too.

              1. “I think clear signs that a person is taking pleasure in the thought of other people suffering grievous harm (without any plausible grievance being present for particular people) would be sufficient reason.”

                Ever played Grand Theft Auto? How do you describe mowing down civilians with automatic weapons as anything other than taking pleasure in the idea of grievous harm? (Unless, of course, you’re one of those weirdos who plays video games to avoid pleasure.) GTA 4 sold 22 million copies. Of those, I’d say 20 million were used to go on rampages in order to take pleasure in the thought of harming other people. That’s kind of a huge number.

                1. It’s damned hard to find any type of common trait shared by people who commit mass killings that isn’t also shared by a huge number of other people. Let’s go with schizophrenia, for instance. With a 0.5% lifetime incidence, that means that there are 1.5 million or more schizophrenics in the US.

                  I have trouble with the notion that we would even consider involuntarily committing that many people in the name of preventing violent acts. I think you’d be hard pressed to find another trait common to mass murderers that doesn’t lead to such gigantic numbers of involuntarily committed.

          3. I think clear signs that a person is taking pleasure in the thought of other people suffering grievous harm (without any plausible grievance being present for particular people) would be sufficient reason.

            So basically, you want to involuntarily commit anyone who’s ever seen one of the Saw movies?

      2. The current state of the law is a decent compromise between the dangers of easy commitment and the dangers of violent mentally ill people running around in society.

        yourlogicalfallacyis.com/middle-ground

        When the extremes are “people can be committed for thoughtcrimes” and “people can only be committed for harming someone else”, the middle ground of “people can only be committed for some thoughtcrimes” is immoral and wrong.

  4. Great, so since Republicans and Democrats are trying to vote libertarians off the island, I am going to guess that that island is a mental hospital.

    1. no, in that case they’re trying to vote us onto the island

      1. Yeah, you’re right:)

  5. What is it you in the media call your religion with this strange ritualistic fortnight of chest thumping over the dead whom are deemed worthy of collective grief, Lucy?

    1. My guess would be because it sells commercial time.

  6. Hopefully in a few years people will look at involuntary commitment of individuals with as much shame as we know look at the eugenics, the Tuskegee Experiment, or even the Japanese internment.

    Whoa whoa whoa whoa whoa.

    You’re claiming that ALL involuntary commitment is wrong? Cause that’s what it looks like you’re saying, and that’s pretty cra…. well, unusual.

    1. I have an instinctive, authoritarian urge to be okay with it some ways (again, mental illness IS real) but it’s certainly all wrong before someone has committed violence.

      1. Confess your authoritarian urges, my daughter.

        1. Never!

          1. You’ll never confess, or Tulpa will never be your father?

            1. Bill Steigerwald looks like a badass so I don’t want to be seen as competing for that position.

              1. The burden of having cool parents, I tell you guys.

      2. I think this is one of those areas where Libertarian ideology kind of falls on its ass, because it more or less expects people who are mentally ill to make rational decisions about their own mental illness, and would only intervene after they’ve attacked someone or killed themselves or what have you.

        Mental illness might be hard to define on the edges, but not so much with, for example, Ed Gein. Even before he killed anyone, he was barking mad and anybody who spent five minutes in his house could have told you that. We’re not talking about locking people up because they are a bit bipolar. You don’t see the type of people who get committed very often because they are committed, and if they get out its because they got better.

        1. The criteria of having to be a danger to yourself or someone else–there isn’t anything wrong with that.

          The ugly truth is that there is no freedom without risk. If you’re going to let people drive, and you’re going to let people drink alcohol–then given the way people are today, you’re going to have people killed by drunk drivers in the tens of thousands every year.

          That’s very sad. But I look at that, and, yeah, freedom isn’t free. It comes with risk and risk of harm.

          And I’d much rather live a free society where people who aren’t a danger to themselves or someone else–can’t be imprisoned. Than one where I’m marginally safer and people are locked up who shouldn’t be.

          By the way, I feel the same way about gun control. Even if–even IF, IF, IF–having handguns legal does mean a higher violent crime rate? I’d rather live with more crime than a society in which I don’t have the freedom to own a gun.

          This is why utilitarianism by itself is the sound of one hand clapping. The qualitative value of my freedom just doesn’t translate onto most people’s utilitarian spreadsheet.

          1. Gotta disagree with that last paragraph.

            1. Help me understand why.

              When other people are talking about whether handguns, cannabis, or large soft drinks are good or bad for society, where does the qualitative value I personally attach to some of those things enter into the conversation?

              We can talk about whether my freedom is a net plus or minus to society, but I hope that conversation is all happening within the context of the realization that I’m not here for society’s benefit.

              Neither I nor my rights exist for society’s benefit. It just so happens that respecting individuals like me and individual rights like mine tends to promote the best outcomes for the most people, and that’s certainly a good reason to protect them.

              But what if I value some things that maybe aren’t necessarily in the best interest of society? then aren’t the utilitarian aspects just icing on the cake?

              1. Excellently stated, Ken.

              2. That’s not an inherent problem with utilitarianism though, it’s a problem with a particular utility function. You can have a utility function that values individual freedom (just not at an infinite level).

                Every consistent moral/political philosophy is going to have weak points. Natural law philosophy, for instance, is powerless to deal with situations where rights come in conflict and leads to some positively awful conclusions, like in the pilot ejecting onto the boat in the middle of the ocean dilemma.

              3. Which brand of utilitarianism? Rawlsian, Mills, Benthem? Some are more delimiting than others.

                1. If we’re talking philosophy, I’m most familiar with Mill, and I think he failed in his attempt to account for qualitative aspects in his utilitarianism.

                  If we’re talking about what most people think of as utilitarianism in terms of our democracy and the market of ideas?

                  I think most people have become downright hostile to the idea that respecting an individual’s qualitative preferences should have considerable weight when formulating public policy.

                  …becasue we all have to make sacrifices for the common good, you know?

                  Ignoring the individual’s right to make qualitative choices–in order to achieve some grand design, be it on ObamaCare, global warming or any one of a dozen other issues–is sort of what being a “progressive” has become all about.

                  Actually, making sacrifices for the common good has become what being a conservative is all about for a lot of Republicans, too. They just want different people to make different sacrifices.

        2. I think this is one of those areas where Libertarian ideology kind of falls on its ass,

          Not necessarily. Libertarianism presumes agency (in a pretty strong sense) as a condition of human freedom.

          Young kids don’t have it, which is why we let their parents be dictators. The genuinely crazy don’t have it, so its not necessarily a violation of libertarian ideology to commit them against their “will”.

          Sure, its abusable, but that’s in practice (hence the argument about burdens of proof, etc.). In principle? Maybe not.

      3. Before someone has committed violence? What if a person is hearing auditory hallucinations telling him to kill his mother? What if he is walking down the middle of the street screaming, wielding an axe? In both of these scenarios, according to your rule, they could not be committed.

      4. I have an instinctive, authoritarian urge to be okay with it some ways (again, mental illness IS real) but it’s certainly all wrong before someone has committed violence.

        As someone who has a family member in the direct line of fire within mental health services (CDMHP– County Designated Mental Health Professional– the people who have the authority to make the initial determination that someone should be given treatment against their will) I would argue that the system does about the best it can do under our current knowledge in the realm of the mentally ill.

        It’s actually quite rigorous and despite anything you’re seeing on CSI or Dexter or whatever current shows portray these situations, it’s harder than most people think to get someone “committed”. And the word “committed” is pretty broad. Sometimes “committed” simply means a brief period of treatment before they’re released.

        Either way, the whole process is much like a criminal trial. The person who has been identified for possible commitment has his/her case put before a judge, and there’s actually a defending attorney that does everything in their power to keep that person from being committed, even while they’re screaming “I’ll fucking kill all of you! Bread and toast! Bread and toast! I like the butter! Sandwiches! Judge not my sandwich! I’ll slice your baby in two for my sandwich!”

        1. I’d add that I’ve seen cases where patients are released by court appointed person that comes in and makes these judgements over the objections of the psychiatrist and other staff, too.

          So, it happens. Crazy people, who aren’t a danger to themselves or others, do get released.

          1. Actually, crazy people who are a danger to themselves or others get released as well. Because the standard is pretty damned high.

  7. No one’s blamed this on Reagan coldheartedly emptying the insane asylums by slashing their funding back in the ’80s, yet?

    I’m sure somebody will get around to it in this thread eventually, and when they do?

    They might want to explain why, if that caused such horrible problems, no one during the Bush Sr. Administration, the Clinton Administration, the Bush Jr. Administration, or the Obama Administration ever lifted a finger to turn the clock back to the way things used to be.

    1. So long as you feel it is necessary to defend Reagan, no one is going to take libertarianism seriously.

      1. I wasn’t really defending Reagan (in this thread, anyway) per se, but I was defending letting people with mental problems, who aren’t a reasonable threat to themselves or anyone else, to live their own lives and make their own choices–especially if the alternative is making it easier to involuntarily commit people.

        I worked for a couple years in a full lock down mental health hospital, had to go on the floor on a regular basis. I think being involuntarily committed to one of those places is about my worst nightmare.

        I’d much rather be homeless.

        1. It sure looked that way. Don’t worry. The rest of us will undo the damage.

          1. Yeah, you can’t keep a good movement down.

    2. Reagan didn’t empty the asylums that was Carter. Pretty cruel for the people who didn’t particularly want to leave.

      1. The Mental Health Systems Act was Carter, at the end of his term…

        Reagan more or less defunded that.

        It would be like if Ron Paul became president and then fought for and won a budget that purposely refused to fund college loans or something…

        My understanding is that’s when the criteria for being able to involuntarily commit someone became more difficult.

        The world would not be a better place if a Medicare/Medicaid level of funding created a bubble in involuntary commitments–a bubble like we have now in student loans.

        Fer Christ sakes, that’s like paying judges by the conviction.

        Pretty cruel for the people who didn’t particularly want to leave.

        The reason a lot of crazy homeless people stay on the streets isn’t because there isn’t anywhere to put them. At our hospital, they used to come in towards the end of the month before their disability checks became available.

        You get fed. You get to watch TV…without any money! But as soon as the checks come in? They’d much rather be on the street.

        So, anyway, project whatever onto the kooks of 1982–there are plenty of crazy homeless people out there who are not in an institution by choice, today. And, like I said, just speaking for myself, I’d rather be on the street than locked in the hospital I worked in, that’s for sure.

    3. I thought it sort of went without saying.

    4. No, because it happened before Reagan as well.

      But, if the MSM admit the homeless problem had something to do with changes in the laws regarding mental illness, then they can’t keep telling the stories about how a 4% increase in funding for “social welfare” was really a 20% decrease because they wanted a 5% increase. Or how Reagan wanted to feed children only ketchup. (regard this as an attack on the MSM rather than a defense of Reagan, killa)

  8. Kind of a pointless point, really. By what standard would the Aurora shooter have been institutionalized ahead of time, to prevent his attack? He was a PhD student who had excelled academically, at least at the undergraduate level.

  9. A danger that rarely gets addressed is that if involuntary commitment is easy then people who are not mentally ill, but perhaps going through a rough time in their lives or working out a troubled past, will be very careful to avoid giving the slightest impression (aka blackmail material) that they have mental issues. So you can guarantee they’ll never mention their problems to anyone, which often has a way of making things worse.

    1. Yes, or downplaying some mental health problems for fear of being committed or being unable to leave.

      1. What, being locked up in a mental hospital for 70 years for stealing two shillings doesn’t sound like a life well lived?

        http://www.freerepublic.com/fo…..3618/posts

        1. Holy mother of God that is just terrible.

        2. This why people own handguns and auto rifles. The vermin relatives.

        3. If only Jim Homes had stolen 2 pence last christmas he’d be a certified victim instead of a mass murderer.

        4. That’s what it would be like if we started lowering the standards for involuntary commitment.

      2. Yes, or downplaying some mental health problems for fear of being committed or being unable to leave.

        Umm, ok this is beginning to go off the rails.

        The people who tend to be involuntarily committed are so far gone on the cognitive scale that they’re not capable of “downplaying” their issues. The guy standing in traffic in his underwear while spraying air freshener into his mouth while screaming “Grateful dead tapes! Grateful dead tapes!” doesn’t downplay jack shit, and jack left town.

        I can’t speak for every municipality or every burg in the country, but I can tell that ’round these parts, that if you’re capable of downplaying your mental illness, then yes, you’re not going to be committed, because by virtue of the fact you can downplay your illness, you won’t be identified as a danger to yourself or others. That’s kind of how it works.

        1. Paul, no one is disputing the state of where things are now and I havn’t even seen anyone advocate for tightening the standards from where they are to make involuntary commitment even more difficult than it is, what they are discussing is the potential world we would be in of those rules were relaxed to make it easier because there are people out there making the argument that we need to do just that.

  10. I abhor involuntary commitment. It leads to oppression in the name of “safety” and enemies lists to get people locked up arbitrarily.

    You know who else had people involuntarily committed in the public interest?

    1. A lot of different governments including the U.S.?

        1. Is my prize sadness?

          1. Nah. Too many things in the world to be happy about.

            1. Screw you and your non-self-inflicted orgasms.

              1. Surely you can afford to set a cute grad student up in a decent apartment for the price of frisky time with the professor.

                1. I thought you made clear the other day that porn and a fleshlight were sufficient.

                  1. No, no. Tulpa took a page from Tagliaferro’s book and got himself a Realdoll. Then he painted it green and pretends he’s Ryker raping an Orion slave girl. I’ve seen the footage from the hidden camera Warty put in his room. Let me tell you, it’s fucking disturbing.

                    1. So wait, does he have a fake beard to put on, or does he play season one Riker?

                    2. He does both. He only does season one Riker when he’s feeling particularly useless.

                      I swear he was screaming out “Number One! Number One!” as he was doing it but the audio on those things is terrible.

                    3. I like Star Trek TNG as much as the next guy, but you two have problems and should be committed.

    2. So any power that could possibly be abused should not exist? Even if the lack of it could also have horrible consequences?

      The price of freedom is _____ _______.

      1. A different set of cost and benefits than the system we have?

      2. I’m not saying that, but any power that could forcibly confine someone against their will involuntarily without a crime being committed should not exist.

        I’m not sure if this is a strawman or your latest foray into trolling. Can I get a ruling, guys?

      3. But again, forcible commitment is inherently abusive, not just “possible” abuse if it is done in anticipation of some guessed-at future crime. If it is done after a crime is committed, we can talk about the pros and cons of that, but that’s just jail.

        1. I wish I had typed my response as eloquently as you. That’s why you’re there and I’m here, I suppose.

        2. If you assume involuntary commitment without a crime is inherently wrong, then involuntary commitment without a crime is inherently wrong.

          What Mr Inca is arguing is apparently that even if it isn’t inherently wrong we shouldn’t trust the govt to do it; he’s not making that assumption.

      4. Hey Tulpa, you might drive drunk and kill someone–maybe, your car doesn’t weigh anything–tomorrow. I think we’d better lock you up.

      5. So any power that could possibly be abused should not exist?

        Any governmental power that is invariably an abuse should not exist, yes. Locking people up for thoughtcrimes that they have not acted upon fits that standard of “invariably an abuse” for me.

    3. The TSA?

    4. I think, at a minimum, that involuntary incarceration for mental problems should afford the potential ward of the state at least as much due process (including a jury) as involuntary incarceration as criminal sanction. Given that there is no defined “sentence” for non-criminally crazy, the state should be required to prove to a jury the need for commitment every 5 years or so (the criminally insane could receive a longer sentence at trial and would not be subject to re-evaluation before then unless the verdict was called into question).

      Of course, plea bargains are pretty much irrelevant in the case of mental health commitment, so persecutors might have to learn to argue at trials again.

      1. A jury deciding that? Might as well play roulette to determine if they’re gonna lock you up or not.

        Seriously, juries shouldn’t be trusted with involuntarily committing someone under any circumstances.

        Story: my dad did insurance claims, and their attorney presented a great case to a jury in a liability claim where the claimant was obviously 100% at fault (He fell asleep at the wheel plowing into their insured’s work truck killing someone). After closing, he asked my dad what he thought, and my dad’s exact words were, “you just presented a perfect case, but the jury foreman is a shift manager at Burger King. He’s probably the smartest person on the jury. There’s no way we’re gonna win this case.”

        They lost the case because it was a comparative negligence state and the jury figured it was better to make the big insurance company pay than a guy that couldn’t afford to.

        Yeah, I wouldn’t want the fate of a person never charged with a crime to be in the hands of an American jury.

  11. The lawyers can still plead insanity, which is an outrage in itself.

    1. Since only the insane would be lawyers in the first place, it’s a fair cop.

      1. Fair cop? Never thought I’d see you put those words together, sloo.

        1. See now THAT deserves a rimshot.

  12. What else do you call hunting down children in order to keep your country free from immigrants?

    Evil?

    1. What else do you call hunting down children in order to keep your country free from immigrants?

      An interesting concept for a movie.

      1. I’m not tipping the waitress, dude.

        1. You need to change your name to “Tulpa The Pink” if that’s a Reservoir Dogs reference. If not, you still need to.

      2. What else do you call hunting down children in order to keep your country free from immigrants?

        The Hunger Games? Although I guess that was to keep the country free from emigrants

  13. Maybe if the state’s mental health apparatus was less coercive, people wouldn’t be so afraid to get them involved when their family members or friends display signs of mental illness.

    1. A good point.

  14. In doing genealogical research about my ancestors (Thanks Mormons!), I learned that my Great-Great Grandmother was involuntarily committed. Apparently, she was “hysterical” for asking for a divorce after her husband abused her. She spent the rest of her life in a psychiatric facility.
    This was not an uncommon occurrence at the time for women who dared to challenge the authority of their husbands, fathers, or other male family members.

    1. Soooooo, is your family Sunni or Shi’a?

      1. Lutheran (non-practicing). Seriously though, this was not uncommon back then, all over the United States.

    2. Interesting. I recently discovered nearly the exact thing about my paternal grand mother. She spent her entire adult life in an insane asylum in Kansas. I grew up thinking she had died when my father was six years old.

  15. I imagine that the spectre of involuntary commitment would be less loathsome if there were some way for the wrongly committed to appeal and be released. But the way it is, IC seems like a life sentence without parole for the crime of acting weird.

    1. Also, assuming that one survived one’s initial encounter with the cops.

      1. Stop resisting, Hugh.

    2. OK, everyone, I will let you in on a secret. I work in an ER where there are 30-60 involuntary psychiatric commitments seen per day. I know all about these things, unlike the armchair experts that are basing their knowledge on having seen One Flew Over the Cuckoo’s Nest.

      Here are some things you should know:

      1. Though it varies by states and communities, the mental health involuntary commitment system is ALL about appeals and releases — unlike Hugh’s lament above. In California, if you are kept longer than 72 hours in an involuntary psychiatric hospital, you get a probable cause hearing in front of a hearing officer/judge where the burden of proof is on the hospital, and the individual gets to face his accusers, and has legal representation. If you lose that, you can apply for habeas corpus, and then get a full trial in front of a Superior Court judge. And this is just to keep you in the hospital, not to treat you — to give you medications against your will in any situation except an emergency, it is a whole separate series of legal hearings. It is not uncommon for one court to rule a patient has to stay in the hospital while the other says you cannot treat against their will while they are there.

      1. 2. It is VERY unusual for people to have lengthy hospitalizations any more. The national average length of stay in psychiatric hospitals now is between 7-8 days. Not exactly a “lifetime commitment”.

        3. Even when people are in hospitals involuntarily, the staff work with them constantly towards two goals — making the patient voluntary in all aspects of their care, and getting them out of the hospital and home as soon as possible.

        4. Medications now are far more targeted and far more effective, with a much better side effect profile for serious mental illnesses, than we had even twenty years ago.

        One topper to all this — I just came home today after being presented with a major award for improving psychiatric care in emergency rooms, making it more patient-centered and avoiding coercion. I don’t like the idea of anyone being committed. Sometimes there is no alternative, but we work to resolve that situation and get the person back in control and making their own care decisions as quickly as possible.

      2. OK, everyone, I will let you in on a secret. I work in an ER where there are 30-60 involuntary psychiatric commitments seen per day.

        Anacreon, your presence is appreciated. My ex-wife works in a major city ER and also per-diems as a CDMHP. She also testifies in court for involuntary commitment hearings.

        However, I have one (1) bone to pick with your excellent breakdown of “commitment” and the facts therein.

        30-60 involuntary commitments per day?

        Uhm, I’m sorry, but I just don’t believe that. Again, my ex-wife works as a CDMHP and is the designate to do the 14-day evaluations. There is no flipping way your ER is seeing 30-60 involuntaries a day. You’d have to have a staff of 700 people to keep up with that. Again, ex wife does the involuntaries for her major-city er, and she probably did a couple of involuntaries per week.

        1. Yeah, that number seems high to me, too.

          People who haven’t been directly exposed to involuntary commitment really don’t (and can’t) have any idea just how batshit nuts those people generally are.

          Round up the “no involuntary commitment under any circumstances” folks, and give them a week in a safety net ER, and I suspect many of them will have second thoughts.

          For the people involved in this, its not really so much about protecting third parties, its an act of simple humanity to get someone to a safer place before they do themselves a serious injury.

          1. I just texted my EX and asked her how many she did per week… when she asked me why, I said there was a claim that someone was doing 30-60 per day. She didn’t respond to how many per week she did, but she did say that in her opinion the entire country probably doesn’t do 30-60 commits per day.

            If she responds to her personal figure for the ER, I’ll post it here. But yeah, there wouldn’t be enough beds in your city to maintain 30-60 commits a day. At your high number, that would be 21,000 people committed a year in your ER alone. Multiply that by every large hospital ER in the country and… you see where I’m going.

            I’m going to assume the OP made a typo and meant per year?

            1. This is all semantics. In some parts of the country “commitment” can mean many other things, and can only be done by a judge/magistrate, and might be intended for hospitalization after an initial evaluation.

              We do see that many and are not even the busiest shop in the state — but in California it is a different situation. Any mental health crisis where police intervene, they write a “5150” hold, which is an involuntary commitment for 72 hours for psychiatric evaluation. And yes, last year we saw over 17,000 in our ER, which is dedicated to psychiatric emergencies. Besides patients coming directly from the field, we also get transfers from nine other medical emergency rooms. We do all the involuntary adult psychiatric evaluations for a county of close to 2 million people.

              We discharge over 75% of those people within 24 hours. Very few end up in inpatient hospitalization, about 400/month. Our inpatient length of stay is about five days.

      3. But once you’re involuntarily committed you lose your 2nd amendment rights, and that’s going to show up on every background check for a job.

        So yeah, the detention might only last 72 hours, but it is permanent in a sense.

        1. Once again, I think this differs by state. In California you do not lose your 2nd Am. rights merely for being on a 72-hour hold. If you have that hold extended for a maximum of an additional 14 days, and then you lose your probable cause hearing on this hold, only then are you reported to the state for a five-year moratorium on gun ownership. This can be appealed to the court by the individual at any time during those five years.

    3. I imagine that the spectre of involuntary commitment would be less loathsome if there were some way for the wrongly committed to appeal and be released

      There is. Read my post above. The person identified for involuntary commitment gets a defense lawyer which does the exact same job a criminal defense lawyer does: He pleads your case and does everything in their power to jealously protect the interests of their client.

  16. I haven’t seen Lucy post in a while,so, first…

    LUUUUUUUUUUUUUCY!!! Good to see you posting!

    Second – I’m definitely ambivalent to some degree, but more biased toward Lucy’s position of not “committing” people [involuntarily] without some major process checks in place.

    We had a real cluster fuck in MI when Gov. Engler closed a bunch of state mental institutions in his last term. It was basically the same arguments you see around gun control – it would be chaos, mentally ill people would be roaming the streets…not so, we’re warehousing people and they should be set free, etc.

    A decade and a half or so on…not so much chaos, crime’s down in the state….but every other kid in public school is on ritalin, mom and dad need Lunesta to get to sleep and Wellbutrin to get through the day…

    Maybe everyone else is insane. I dunno. Good subject for more thought and discussion.

    1. I thought half the population of Detroit were released mental patients. Is that just an urban legend?

      1. I thought half the population of Detroit were released mental patients…

        And that is why they are going to make great zombies when the park opens up.

  17. I also recall a friend of ours who was “committed” when we were all quite young – early 20’s. She was suicidal.

    We visited her in the care facility. It was just plain a creepy place, and she was clearly…not quite right.

    But I always wrestled with “if someone wants to kill themselves, why should I stop them?” In most cases I know of, yeah, it’s a passing thing, they thank you. But for someone persistent who seems to mean it…??

    People are scary.

  18. Dangerous to yourself or others is a hypothesis of a future state of being, who will determine what is and when, and how will that determination be made?

  19. I can tell you stories of people who have come through the ER after suicide attempts, only to be lock up and after their release try again. There are just some people who don’t want to be saved.

  20. There is a show “Morgan Freeman’s Through the Wormhole: Can We Eliminate Evil” on the Science Channel tonight. Pre-cogs claim they can spot the evil, etc.

    1. Odds the number one symptom of evil being distrust of authority? 4-1? 3-2? Even money?

      1. The experts they present claim they can identify people (through brain scans, “experiments”, etc)who are disposed to evil.
        But do the people disposed to do evil know that they are doing evil? They think they are doing good.

        1. Now in the next episode they have people playing these old grifter tricks with match sticks to prove psychic abilities.

            1. @ 11:09PM
              Here are the solutions: http://www.puzzles.com/puzzlep…..ntPlay.pdf

          1. Actually they were not trying to do anything with psychic abilities, they were trying to stimulate a normal person to have savant like abilities by electrically suppressing the portion of his brain that relies on previously identified patterns and stimulation the portion that deals with previously unencountered challenges, and it worked.

        2. They do get into that some, and the answer is sometimes, sometimes the person knows what they are doing is evil and they just don’t care, other times it is that the believe their actions to be right. The brainscans however were only used to identify the first group, basically sociopaths.

          However in an interesting twist the scientist who discovered the FMRI brainscan pattern that indicates a sociopathic individual also discovered that he himself had that exact same pattern and when he asked his friends and family they all told him, yeah they knew he was a sociopath but he was a fun guy, a good father, and not dangerous to anyone so they didn’t worry about his wierdness.

          Basically all sociopaths have this particular pattern and everyone with it will be at least a little off but nowhere near all of them go on to become full blown sociopaths.

          Basically the brains hardwiring makes it possible for you to be a sociopath or not but whether or not you do become one is dependent on upbringing and environmental factors.

          Meaning that the technology is effectively useless as a predictor of crime, or even violent crime because all it does is identify a subgroup of people who may be more suceptible to criminal behavior. Thing is even for full blown sociopaths the majority of them are not violent and they are just as likely to persue careers in law, business, or politics as crime. Where it can be useful however is in treatment after the fact.

  21. I won my ebay auction! Huzzah!

    1. So now you have a green Realdoll just like Tulpa. Congratulations.

    2. Let me guess…

      A good/used condition Planet of the Apes lunchbox?

    3. You don’t “win” auctions. You just agree to pay more than anyone else participating deems it to be worth.

      1. I dunno, SIV. Speaking as an auctioneer, I’ve seen plenty of people “win” things.

        If Jimbo feels like he won the auction, then he won the fucking thing.*

        *Unless the fleshlight is already out of it’s sealed pacckage.

      2. Generally when two people are competing in something, the one who attains his goal is said to have “won”. We didn’t reach the point at which the item was not “worth it” to either of us, we simply ran out of time and my bid was the last one.

        1. I always put mine in with a proxy right at the end (I know exactly what I’m willing to pay often the other bidders don’t and I’m not about to help). I only bid early to discourage a seller from taking an offer and ending the auction.

    4. Is that like winning a Quibid auction?
      You spend $500 on bids to get $50 off a toaster-oven?

  22. what is most surprising is how little people have been pushing the familiar narrative that a better, perhaps more coercive mental health system could have prevented tragedies like the …

    I only see one thing coming out of an idea like this. More cronyism. Imagine that.

  23. Are we still playing this game? Am I doing it right?

    1. uh, ok

    2. No. And wrong page.

      1. HAH!

  24. Passing all the mentally ill living in the streets convinces me that blindly worrying about their rights over considering their health is wrong headed and cruel.

    But I have no patience for any mental health professional who goes on TV to tell us what’s going on in the head of a person they’ve never done a proper evaluation of. They should lose their license for malpractice.

  25. Passing all the mentally ill living in the streets convinces me that blindly worrying about their rights over considering their health is wrong headed and cruel.

    But I have no patience for any mental health professional who goes on TV to tell us what’s going on in the head of a person they’ve never done a proper evaluation of. They should lose their license for malpractice.

  26. You want a gun? That’s crazy. Therefore, you can’t buy a gun.

  27. if we’re going to do this, we need to consider locking up the mental health professionals with them.

  28. They don’t know that they can call 911 or that they can call their local police.

    It’s cheaper than hiring a hit man.

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