We Shut Down State Mental Hospitals. Some People Want to Bring Them Back.
Is "mental illness" a fraudulent concept for locking up social deviants? Or does forced treatment free the ill "from the Bastille of their psychosis?"
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GoogleOn January 3, 1999, Andrew Goldstein wandered onto a New York City subway platform and shoved a stranger named Kendra Webdale into the path of an oncoming train. As the story made national news, reporters dug into Goldstein's past and found that he had been diagnosed with schizophrenia and had a history of violent episodes. He had been in and out of psychiatric facilities, but his caretakers had repeatedly released him back onto the streets against their better judgment because of a shortage of available beds.
The murder of Kendra Webdale brought attention to Americans with severe mental health problems and inadequate treatment, a social problem that 20 years later is still ongoing. Prisons and jails are filled with inmates who exhibit symptoms of mental illness. So do many of the homeless people crowding the streets of cities like Los Angeles, San Francisco, and New York. Violent episodes, like the Webdale murder and some recent mass shootings, have brought renewed calls to entrust the state with more authority to force psychiatric care on patients against their will.
This story looks at the history of mental illness, institutionalization, and the role of coercion in psychiatry. It features an array of voices and viewpoints, including Linda Mayo, the mother of twin daughers with severe psychiatric diagnoses, who advocates for court-ordered psychiatric treatment; Richard Krzyzanowski, a patients' rights advocate who fights against coercive treatment laws; DJ Jaffe, the founder of Mental Illness Policy Org., who argues that the state should make it much easier to commit mental patients; the late Thomas Szasz, a controversial libertarian psychiatrist who fought compulsory treatment and questioned the very existence of mental illness; and Scott Zeller, a psychiatrist who's developed a new model that he hopes will reduce coercion in the system. (Disclosure: Zeller has in the past donated to Reason Foundation, the 501c3 that publishes Reason.)
Produced by Zach Weissmueller. Camera by Weissmueller, Jim Epstein, Meredith Bragg, and Alexis Garcia.
"Mare," by Kai Engel, is licensed under a Creative Commons Attribution NC 3.0 license. Engel's music is available for purchase and download at his Bandcamp page.
"Seeker," by Kai Engel, is licensed under a Creative Commons Attribution NC 3.0 license. Engel's music is available for purchase and download at his Bandcamp page.
"Traffic," by Kai Engel, is licensed under a Creative Commons Attribution NC 3.0 license. Engel's music is available for purchase and download at his Bandcamp page.
"Imago Mundi Nove, Part 1," by Megatone, is licensed under a Creative Commons Attribution NC 3.0 license. Megatone's music is available for download at Free Music Archive.
"Aveu," by Kai Engel, is licensed under a Creative Commons Attribution NC 3.0 license. Engel's music is available for purchase and download at his Bandcamp page.
"Cendres," by Kai Engel, is licensed under a Creative Commons Attribution NC 3.0 license. Engel's music is available for purchase and download at his Bandcamp page.
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Photos of Adderall: Kristoffer Tripplaar/Sipa USA/Newscom
Photo of Andrew Goldstein: Marty Lederhandler/Associated Press
Photo of Gov. Pataki signing Kendra's Law: Jim McKnight/Associated Press
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What causes violence isn't 'mental illness' but 'treatment'. Because they teach vulnerable people that there is something wrong with their brain and you need to take meds and don't ever stop or there will be disaster. The parents are often complicit. It's modern day child sacrifice. Szasz is great! I remember discovering him when I saw his obit a few years ago.
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You have never been around someone with a severe mental illness, have you?
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I have, many times. They are destroyed by treatment. I had a friend who died recently. He was 'mentally ill' for years. His brother is too. Both his parents are psychiatrists. On Facebook last year a friend was bullied into getting a temporal lobotomy. I raised a cry and then his friends starting bullying me and telling me that I needed a lobotomy too. What was so weird is that no one intervened, other than me. Even though together we had hundreds of friends. Now he is sitting in an institution somewhere blowing bubbles. #treatmentkills
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Schizophrenia isn't a made up thing. It's real.
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The symptoms of schizophrenia are caused by long term, high dose antipsychotics. It is as real as cooties.
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Oh bullshit. Plenty of schizophrenics are schizophrenic without having first been medicated.
FFS..........
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Uhhh, you're an idiot. I have had family who suffered from this... It is a fucked up brain, plain and simple. And while it is true that some patients seemingly get worse with drugs, the majority are greatly improved.
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Meh ... please explain more about the reality of schizophrenia. List some symptoms that we can verify. A scientific concept must be falsifiable.
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If you understood the difference between signs and symptoms you wouldn't even make that statement.
And I'm someone who firmly believes that what we call schizophrenia is more likely many different disorders that we group together due to a lack of firm understanding. So schizophrenia qua schizophrenia may not be real, but the problems that schizophrenics have are very real.
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Except himself?
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What was so weird is that no one intervened.
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Other than himself?
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"You have never been around someone with a severe mental illness, have you?"
The last time I visited a ward, only one patient out of 15 fit that description. The security was so lax that nobody who met the legal standard for detention could have been held there. That's a lot of illegal holds, and about $2 million in insurance/Medicaid fraud every year at that clinic alone.
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You know people go through swings in behavior don't you?
I've known people who were often a little weird, but okay, who would then become wildly out of control on a dime.
Either way, one can surely debate the specific grounds for forced hospitalization in good faith, without deciding the entire concept is nonsense.
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Apparently. I have, and that's total bullshit. I know people who'd be utterly incapable of functioning in society without treatment.
"Is "mental illness" a fraudulent concept for locking up social deviants? Or does forced treatment free the ill "from the Bastille of their psychosis?""
The problem is that it can be BOTH. Some people are sufficiently deranged to actually need either forced treatment or confinement, and in some societies both have been used on people who were just fine, for political reasons.
It's rather like the police don't need to be the Gestapo, but sometimes they are.
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THIS. People who try to turn this into an all or nothing argument are idiots. There were definitely people locked up who shouldn't have been in the past... But locking up almost nobody on a permanent basis has led to most of the major cities in the USA being filled with insane lunatics wandering the streets causing all manner of problems. I get accosted almost every single time when I visit certain neighborhoods in my city, and it is almost always by people so crazy they would be better off in a hospital than half starved and freezing to death on the streets in a tent.
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I've talked to enough youth shelter graduates from the pediatric psych ward at the county hospital to know that it's mostly a combination of day care and punishment that parents use instead of parenting. I understand that some parents need help from a talk therapist or cognitive behavioral therapist when there is sever trauma, just as some parents ask clergy for help in a time of need. However, psychiatry is based on the assumption that the kid was born with the wrong alleles and will never be sober. It's a way to escape our responsibility to provide a supportive environment for the next generation.
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"psychiatry is based on the assumption that the kid was born with the wrong alleles and will never be sober. It's a way to escape our responsibility to provide a supportive environment for the next generation."
Seconded.
Not long ago I knew a kid whose parents knocked him out with hard liquor to get him to sleep, then complained to a psychiatrist that he wasn't developing normally. He was given major tranquillizers and eventually died of the side effects. (They make you choke on your own spit.)
Both parents had explosive tempers and no respect for boundaries, so I probably wouldn't be able to sleep around them either.
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You're describing a subset of bad situations... But there are many people who are just fucked up. I have known a number of them in my life.
If you want to talk about addiction related issues, studies have basically conclusively figured out that alcoholism has a strong genetic component, so it seems likely other substances do too.
The fact is some people are simply defective. Hell, we're ALL defective in some ways. It's just that some peoples defects are so severe they can't function in civilized society. In the olden days in a hunter gatherer tribe, they either would have been forced to shape up and do something useful for the tribe to survive, or they would have been banished to starve to death. Nowadays we have the option of giving them a bed and food in their stomach without literally killing them, mainly to make ourselves feel better about it. But there have always been people who are a net negative on those around them, and crazy people are such people.
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*sigh*
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That is exactly the correct response.
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^yes. That. [sigh]
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You live in Seattle too... You know this is utter bullshit!
Open them hospitals back up! As much of a tightwad as I am, I would gladly pay higher taxes to lock the lunatics back up where they belong.
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Vote for democrats, you get democratic party policies.
This is no more an unintended consequence of the socialists forcing the incapable out into the cold than lack of rental housing is an unintended consequence of rent control.
You want to rule a country, you have to create enough social problems that people will accept force "for the children".
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^bingo
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Second
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I worked for years on the psych floor of a large urban jail. I stood by while psych nurses verified that inmates were swallowing the meds that prevented them (most of the time) from doing anti-social things. Reasons we heard why inmates did not take those meds when not in custody: (1) I don't feel like myself on them (2) they interfere with high of street drugs and (3) not a priority, too much management for someone who can't anything, like a roof over the head, etc.
There are still full-blown mental institutions in our state, housing those found to be criminally insane (several really gruesome murderers!) They get a tremendous workload of accused people waiting trial whose sanity needs to be evaluated in a two-month stay. This is a mysterious process a bit mindful to me of a short story that Franz Kafka once wrote.
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It's a tough issue. My own father was on the forefront of the de-institutionalization movement. He took that position after witnessing firsthand some of the horrific abuses in and of the mental health institutions of the day. For a single example, he watched helplessly as one of his patients was forced first through electro-convulsive therapy, then a lobotomy because her adult son was offended that a middle-aged woman might want to remain sexually active.
On the other hand, de-institutionalization has pushed many folks out onto the street with no resources, no skills and no ability to protect themselves. They are abused at far higher rates than others on the street and regularly die of abuse or exposure. Far too often, they are a danger to themselves and others. And the only "solution" we can offer is the penal system - an environment that is woefully unprepared to handle mental health issues.
I have come to the conclusion that we need a return to mental health hospitals - but a kinder, gentler version of them. In particular, I would severely restrict the ability to involuntarily commit a patient. One doctor alone should never have had that authority. Even today, I would refuse that authority to a purely medical panel. Involuntary commitment should come with controls and protections that protect patients and respect their rights. Yes, that will be slower and more expensive. I think on net, however, that it would be less expensive to society than the status quo.
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Great comment, thanks. I agree that some form of mental hospitals are needed, but they should not be run by the State. Would people donate enough money to have a private charity run such a facility?
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Gates alone could fund the whole deal.
If half the liberals backed their 'convictions' with donations, we could cut the feds by 60%.
Why no daily outcry about the socialists with three and even more houses? -
This is most glaring to me when the Planned Parenthood debate is brought up.
If abortion access is as important to progressives as they say it is, and if PP is as vital to it as progressives say it is, certainly there would be enough charitable interest to cover whatever amount the fed currently provides.
But it is not about the ability of PP to offer services - it's about demonstrating progressive power by forcing people with moral objections to acquiesce to progressive programs. -
^yes.
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A lot of what the left does is out of that " To crush your enemies, to see them driven before you, and to hear the lamentations of their women." motive.
Why else do you suppose they try to destroy any florist or baker who won't serve a SSM, instead of just going down the street to the next florist or baker? It's because forcing people to violate their own consciences is a power rush.
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In particular, I would severely restrict the ability to involuntarily commit a patient. One doctor alone should never have had that authority.
It's pretty severely restricted now. It takes dozens of people to involuntarily commit someone now, including healthcare professionals, clinical social workers, county designated health professionals (CDMHPs), and then some lawyers and a judge.
In the county where I live, the only doctor involved would be a psychiatrist-- who would only be one of those voices in that dozen or so people-- and not the most powerful voice.
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re: "It's pretty severely restricted now."
True but those current restrictions on involuntary commitment were also a result of the deinstitutionalization movement. The fear is that a return to the mental hospital approach of the past would also include a return to the involuntary commitment approach of the past. That would be ... bad.
To your specific situation, though, I would argue that the process you describe is still overly weighted to medical professionals - people who through training and career self-selection are deferential to medical authority and disinclined to fully respect patient autonomy. Experts have a role but it should be sharply limited. I would argue that, with some few exceptions, we do not yet have the right balance in the decision to involuntarily commit a patient.
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I am guessing that Kendra Webdale would favor involuntary commitment of some sort, if she were still alive.
But Kendra Webdale isn't alive because a man with untreated mental illness killed her. So, we can't ask her.
We could ask the man who killed her, Andrew Goldstein. He might favor involuntary commitment because then he wouldn't have spent 19 years in prison and had the death of a woman on his conscience.
Individual autonomy and rights presume that the individual can think rationally.
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And who decides what is rational? And do you trust them to decide?
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"It's pretty severely restricted now. It takes dozens of people to involuntarily commit someone now, including healthcare professionals, clinical social workers, county designated health professionals (CDMHPs), and then some lawyers and a judge."
None of that applies to an emergency hold in my district. That can be issued by any doctor, EMT or cop, lasts for several days and will cost the patient $5k before they get anywhere near a judge. They're also not entitled to a public defender IIRC, so the only lawyer guaranteed to be involved is for the other side.
The committent procedure is a little more structured, but it's still missing basic protections like conflict-of-interest reporting by the people collecting the evidence or any standard for what to collect. If the clinic received a $50,000 donation from the accuser in a case (a real example), they don't have to notify the judge or defence counsel. If a patient claims to be fleeing violence, the clinic isn't required to notify police or check court records.
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I can see allowing an emergency confinement without the whole clown car, for long enough to get the clown car together. But requiring the person so committed to pay for it is utterly bogus.
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But all it takes is an anonymous "red-flag" complaint to send a SWAT team to the house primed to kill the "armed and dangerous".
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Thank you; this is the best comment on this issue I've read in ages. The issues are exceptionally complex: there are people whose neurology can't manage contemporary life, but also there plenty of types of behavior that are odd but not incapacitating or antisocial. Plenty more people require a little help to manage, and a small number who won't ever be able to live independently. The categories have blurry edges. The fact that we only pay attention to this after a gruesome murder or when a famous person commits suicide makes it worse.
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This is one of the problems that cannot be solved by formula. As much as I detest governments, I don't think government institutions are markedly worse than private ones, because both involve people making serious decisions for other people. If no one makes that decision, ie there are no coerced mental institutions, then those who need help but can't recognize it themselves will die alone on the street, or robbing someone, or wandering in traffic.
As soon as you allow for some kind of coerced guardianship, you end up with tragedy. I have little respect for modern psychiatry; it seems from 2nd, 4rd, 4th hand stories that their solution is either hundreds of hour of talk talk talk, or expensive meds which don't work too well and have nasty side effects. But the alternative is locked up for society's protection, or free on their own and liable to hurt others and themselves.
If you insist on family or friends for guardian, you risk lousy cheap care by those who stand to inherit. If you insist on government care, you risk getting bureaucrats who don't care about anything except expanding their budgets.
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Well said, Alphabet Stew, AKA a ab abc abcd abcde abcdef ahf!!! ^+Many-Many!!!
Your concluding note is notable...
"If you insist on government care, you risk getting bureaucrats who don't care about anything except expanding their budgets."
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^^
This. It is a wicked-hard problem. My sister was wonderful and productive and loving when she stayed on her meds, but she hated the way that they slowed her down, and affected the parts of her mind that were not screwed up. So, she tried to avoid taking them. I watched her do this, in an institution, and I turned her in for it. They became more strict about it, and she got better.
But then she was released on her own recognizance, and she stopped taking the meds, and then decided to try to fly off of a building. She was not a threat to anyone but herself, and no amount of talk could make her change.
We don't know what to do with people like her (I have personally known of 3 who decided to try to fly). Society is not set up for them. Unless we assign each one with a personal minder, to watch them 24/7, we will get bad outcomes. And even then, they will not take kindly to being surveilled 24/7
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The psychiatrist at the end of the documentary, Dr. Zeller, is creating non-coercive supportive psychiatric facilities that are all about collaboration rather than coercion. I know of his work and it gives everyone hope, probably why they ended the documentary on that uplifting story. He's a libertarian, btw, and based his treatment philosophy on the Non-Aggression Principle.
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I think we need mental hospitals for those who are actually dangerous to others along the lines you are thinking.
The bigger issue is that we don't have a 'solution' for those who aren't dangerous but also just simply aren't capable of fully taking care of themselves (and more often than not who know they can't). Don't need to label 'why' and don't need to pretend that we are going to somehow 'fix' them as the justification for it. We just need places where they CAN BE - and enough of those places so there is no need to strictly ration who is there.
I think it was the right track 50 years ago when the notion was 'community care' but cities/burbs are not and have never been 'community'. That's smaller town. And they wouldn't separate that need into specialized care like 'mental ill'. It would look more like a no-stress slow-pace 'community' on the outskirts of town where residents tended animals, garden/orchard, do routinized stuff, tinker/repair/craft, etc. Not separate from the town but not on their own in having to deal with keeping the community going. And it would be a mix of folks from slow to ill/recuperating to widows/elderly to just not fitting in with life on their own.
Most of our efforts now seem to be ignoring everything until it becomes 10,000 different crises and then panicking cuz crises look and are unsolvable and expensive in an institution setting.
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A friend of mine had her brother in confined treatment (they had the means for quality care) and made the observation that on the whole it functioned as a parallel community. There was an internal logic at work that required interjection from staff mostly when patients were in obvious danger. I was impressed that every facet from commerce to government to romance could be found in her descriptions, negotiated by the residents as they waxed and waned through their illness. I also volunteered in for a group home of admittedly fairly high functioning DD and found much the same- if left to their own devises in a safe environment, they do fairly well. It's the imposition from without and forcing people into notions of "sane" that seems to cause most of the problems.
There were also people who were (in my estimation) impossible to treat. They were operating so far detached from notions of conventional reality it was hard to say what they were experiencing. There was also a juvenile treatment center I observed that had an outside patient advocate dissecting every treatment decision from staff, making them justify every modality as the least obtrusive at every turn. That also seemed to work okay.
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This. Sometimes there are no happy happy solutions, only less horrible ones.
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Surely there is a middle ground between "One Flew Over the Cuckoo's Nest" and mentally ill people wandering the streets or languishing in jail.
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I sure hope you're right. But either approach tends to slide to the extremes from what I've seen. The mentally ill warehouses were god-awful. Letting these obviously ill people wander about leads to their deaths.
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High levels of nonconformity and low levels of violence bring people into the mental health system. Consider the argument that we need hospitals because "many of the homeless people crowding the streets of cities like Los Angeles, San Francisco, and New York. Violent episodes, like the Webdale murder and some recent mass shootings, have brought renewed calls to entrust the state with more authority to force psychiatric care on patients against their will."
We've read extensively on the regulations in those city that make housing unaffordable for the vast majority of Americans. Most Americans choose to live somewhere else, but what if you belong to a cultural minority that makes it difficult to live in the middle of North Carolina?
Now think of the neighborhoods in those cities that have low rents because the middle class renters are scared away by the high crime rates. If you hang out there long enough, you learn that locals tend to target outsiders and leave each other alone. That's why living in those neighborhoods for generations gives politicians like Alexandria Ocasio-Cortez bragging rights among the neighbors. Sometimes, the violence is organized through gangs that mark territory and have a working relationship with neighbors and police.
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I'm not advocating a mad militia, but mad people could easily solve their housing problem by organizing in gangs that take over neighborhoods. However, the stigma associated with mental health makes it difficult for mad people to acquire the tools necessary to drive the normals out of an area. Perhaps a mad militia could start by recruiting people with less stigmatizing diagnoses. In other words, the revolution will begin once the dyslexics of the world untie.
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Your general thrust is right - We need to bring back hospitals, but more kindly run.
As far as forced commitment... Yes and no. The devil is in the details.
I had a relative who was not violent/too bad when on meds who lived in a small "home" for people with problems vs a full on big nut house. BUT sometimes he would get tired of it and escape, go do stupid shit, and then have to be sent back forcibly at first. It was tragic. But there was nothing to be done about it, but force them to go back for their own good.
Crazies are sometimes too crazy to make up their own minds. They're like children. Depending on the individual they can be allowed different amounts of autonomy as they age, but certainly cannot have full autonomy. Lunatics are basically like this their whole life.
People always try to find a "perfect" way to do things, when perfection is not an option. We'll either end up not putting away enough crazies to prevent tons of tragedy to them or others, or we'll end up putting away too many creating a tragedy for those that didn't REALLY need to be locked up. The reality is we just need to try to get as close as we can to the "just right" line, and accept that there will be exceptions to things working perfectly. This is reality, not utopia.
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I agree with all points. Except that it should be illegal for those not involuntarily committed to take up residence in public places. An enlightened outlook on care should go hand in hand with an intolerance for having the mentally unfit take over places that belong to the community. That's terribly destructive. No one wants to walk down a street, stepping over drunks, fending off bums and evading lunatics. No parent wants to take kids to a park where homeless people are sleeping, defecating and barfing. I live in the Bay Area, and I've been subjected to enough of this stuff, that now I live behind a gate and avoid public places. Is that the kind of world we want?
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Prisons are full of people who need mental help more than a revenge sentence.
Mental hospitals were not run well in the past, so they probably wouldn't be run well if we brought them back. Of course, prisons were run like Lord of the Flies in the past compared to today.
Although, housing mental cases with violent felons is not a good recipe either.
Its a topic worth discussing.
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It's a hard problem with no cost free solutions.
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We should house prisoners in single occupancy cells. Half the prison population is there due to consensual crimes. If we repeal all consensual crimes, we can give each remaining prisoner his own cell with our current capacity. Having a private space to retreat to would greatly reduce the odds of a prisoner getting into a fight. Fewer fights mean prisoners can spend more time on reforming themselves instead of learning the combat skills necessary to stay safe in our current system.
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While single cells might seem like a solution, many humans crave contact with other humans. Solitary confinement has been shown to lead to increased violence by prisoners.
Rewarded behavior has worked in the prison system for decades.
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That's the messed up thing, we're probably spending half the money we need to to more properly deal with this issue already by locking them up in prisons.
By having mental hospitals come back around, in a kinder gentler form, we could probably cut prison costs dramatically. We'll likely end up spending more than we do now as doctors and nurses cost more than prison guards, but it would be a more correct way of dealing with the people in question. A guy who thinks he is Napoleon, and also steals stuff habitually and ends up in jail, doesn't need to be in there with gang bangers who have repeatedly assaulted people etc.
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They are animals in the shape of humans.
Put them in shelters, and if there are not enough beds, euthanize them.
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This is essentially a call for eugenics. People who are not perfect should be culled from our society. Removing the mentally ill is no different that remove the mentally or physically challenged person from society.
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Well, then, how do you feel about the death penalty? Keep in mind that without it, murders may murder again... They may kill while imprisoned, they may escape and kill you or me, or some bleeding-heart crazy judge may release them ahead of time... Notice that bleeding-heart crazy judge NEVER invites parolees to join him or her (and his or her teenage daughters) to live at THEIR house, after release!
Yet I have NEVER heard of a "terminally punished" offender EVER re-offending, from beyond the grave! (Not that I am in favor of ANY "capital punishment" for ANYTHING other than clear-cut cases of murder, let it be noted... )
What baffles me to no end, though, is the "not guilty by insanity" plea. An insane asshole-type killer is EVERY bit as much a threat to society, as a NON-insane asshole-type killer! Killing a person says we don't value them. I have not ONE single clue, WHY the insane should be more highly valued than the sane!
But yes, I agree, Michael Ejercito is an evil idiot if he really-really holds the opinion that he posted, if I understand what he posted, correctly... I note that he made no distinction between insane people who hurt others, and those who do not...
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"Would you kill a baby Hitler?" was a philosophy question people used to ask decades ago. My answer is "No." We don't know ahead of time who will become Hitler and who will not. The hubris that makes people pretend they can predict crime is mostly an excuse for people to attack babies so they can look like heroes without the risk of challenging the Hitlers out there.
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I agree w/you for different reasons. Say I have "magic knowledge" and really DO know that baby Hitler will grow up to be a mass murderer.
Don't kill him, because others (Rudolf Hess 2nd in command, Goering, etc.) will fill the vacancy that is created by the "time and space" anyway. Kill one asshole, other assholes pop right up to replace them. Whack-a-mole writ large!
Above and beyond that...
Do NOT kill him, I say, because, by short-circuiting the suffering, we also short-circuit the learning!!! The German nation apparently has to learn some lessons the hard way. And the USA learned that it is hypocritical to fight and condemn a racist, while fighting with segregated armed forces, and treating black people like shit. Hitler's racism woke us up to our own hypocrisy. -
If you want a REAL head trip, consider this:
The world is a BETTER place because Hitler existed.
If Hitler hadn't existed, there is every possibility that nobody around with the skills needed to save Germany from the communists would have existed. Communists would have taken over Germany. Therefore, no Germany helping Spain in their civil war, or if they did backing the commies. Therefore, Communist Spain. France was also very dodgy, and probably would have fallen to the commies.
If even JUST Germany and Russia were communist, they would have easily been able to topple internally through backing political parties, or through outright war, all of Eastern Europe, and then probably taken the west too for kicks. Completely communist Europe, YAY!
There are many variations here, but in almost all conceivable instances the world would have been a WORSE place.
The caveat here is that IF a more laid back Mussolini type had come to power in Germany instead that would have been a better outcome, because Hitler took things too far. Germany NEEDED a strong man to fight the commies, as republican/democratic pussies couldn't have got the job done. There's a REASON strong men come to power in places that are super dysfunctional, because democratic and light handed approached DO NOT WORK when things are too crazy.
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Even the worst human actions Created environments where there were good deeds.
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Sure. And sometimes purely shitty things accidentally lead to something happening that is better than if the shitty thing hadn't happened at all. The universe is a mighty random thing.
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Vek, I agree with a lot of the things you said here. I would also point at Pinochet of Chile. OK, he and his people killed some folks... BUT they prevented asshole commies from taking over Chile!
We worship democracy too much, and don't fully acknowledge that dictators have the good deeds from time to time... I don't like saying this, either, truth be told, but there it is...
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There is nothing inherently wrong with the concept of eugenics... It is actually a positive thing.
Almost all positive traits are known to be genetic now... People intuitively knew this back in the day, but now we have the science to back it up. Everything from intelligence, to alcoholism, to personality traits are genetic.
So removing extremely negative genetic elements from society WOULD create a better world. The BIGGUN here is HOW to do it in a non evil way. Killing people is too mean. As is forced sterilization. Etc. However removing government subsidies that encourage bad breeding (welfare!) is a non evil thing to do that will slightly skew things in an improved direction. One could also offer incentives to those with positive traits.
I don't think any of it is NEEDED, but I always get pissed when people throw around eugenics like it doesn't actually work, or that it is inherently a bad thing. Science says otherwise. It's the morality of it that can be dodgy if done wrong, but it is an inherently good thing, and is real, not imagined.
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It may be worth while here to say that mental illness is a very broad topic that cannot be addressed with a simple solution. Large numbers of people will experience mental illness in the course of their lifetime. For most it will be a time limited problem. Examples are depression over a romantic breakup or a job loss. They may get over the problem by themselves, or with help of drugs or talk therapy. Some people will deal with the problem throughout their life. It will be a chronic condition that they treat forever in the same way as a type 1 diabetic takes insulin. Sadly some will never respond to therapy, will lead difficult sad lives that end early. What is needed is a recognition by all that mental illness needs to be treated in the same matter as physical illnesses. If your insurance pays for insulin for the diabetic it must pay for antidepressants. If your insurance pays for a chiropractor for your back, it must pay for talk therapy for your anxiety.
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Yes, but we need cutting edge research to discover the most cost effective therapies. There's no reason why medicare should pay for a psychiatrist to treat depression without also paying for stripper therapy. It's a matter of choice and competition.
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In before Ronald Reagan is blamed for homeless mentally ill people after Progressives spent decades working to make it happen
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You beat me to it.
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Yup. Everybody blames it on Reagan because all the stuff Carter put in motion went into effect when he was in office.
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Perhaps the very last people we should ever entrust the care of mentally ill people to is the government.
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Then take care of them yourself. But someone needs to care for them because they can't care for themselves.
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The billion dollar (trillions of dollars really, literally, if taken society-wide) question is, WHO qualifies for being "mentally ill", and therefor WHO can legitimately be the subject of the ever-increasing tender mercies of Government-Almighty-blessed caretakers?
The low-IQ, I have lots of sympathy for... They should NOT be abused or neglected in any way! I treasure my pets (cats-dogs etc.) despite them not being as smart as I am.
Those with "personality disorders"? Some of them are just willful assholes!!! This crap about "don't stigmatize them" is just a bunch of medicalizing EVERYTHING, when they DO have the free-will choice of NOT being assholes!!!
Depressed? OK, take some anti-depressants. But get the rent-seeking shrinks, tolls under the bridge who charge $200 an hour, OUT of the way of rent-seeking on your meds!
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Yup. This is the biggest question really.
As with many things, there are lots of things that are easy to put on one side of the line or another. A guy who runs around saying Satan tells him he needs to kill and then rape the corpses of as many 12 year old virgins as possible to secure a place for him in hell as 2nd in command... Definitely needs to be locked away or medicated. A kid who is a little hyper probably doesn't even need ritalin, let alone to be locked away or whatever.
But then there's all the chaos in between.
The truth is we need to accept whether we go slightly too lenient or slightly too hard, there will be avoidable negative outcomes either way. The guy who kills somebody because we didn't lock them up, or the person put in a hospital that COULD have lived an okay life on the outside.
We just have to try to get as close to the line as possible, so there is minimal error either direction. Whatever errors happen we just have to try to tweak the system to avoid them in the future if possible, and if it's not, just accept them.
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Everyone should see this documentary and then decide how "mental illness" should or shouldn't be *treated*.
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@Rossami, thanks for the excellent post. I especially appreciate your suggestion here:
"I would severely restrict the ability to involuntarily commit a patient. One doctor alone should never have had that authority. Even today, I would refuse that authority to a purely medical panel. Involuntary commitment should come with controls and protections that protect patients and respect their rights."
Why do you think that it would be more expensive, though? An unnecessary detention costs about $1,500 per day, and even an evaluation costs several hundred.
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I have, many times. They are destroyed by treatment. I had a friend who died recently. He was 'mentally ill' for years. His brother is too. Both his parents are psychiatrists. On Facebook last year a friend was bullied into getting a temporal lobotomy. I raised a cry and then his friends starting bullying me and telling me that I needed a lobotomy too. What was so weird is that no one intervened, other than me. Even though together we had hundreds of friends. Now he is sitting in an institution somewhere blowing bubbles. #treatmentkills
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As mentioned above, as a general assertion this is nonsense.
I have NO CLUE about your friend... But I have a hard time believing somebody without major mental illness was given a lobotomy in the 2010s. It just isn't done anymore.
Whatever the case, the fact is there are many people who are far too insane to function in society. Including if they get as much help as possible. I have had relatives who fell into this category, and I see them every single day in Seattle. There is no one size fits all approach here, it requires evaluating individual histories and situations.
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So what is the answer?If it is not mental hospitals, and it is certainly not having the mentally ill wandering around our cities homeless in all weather conditions panhandling. What do you do that is humane and supportable?
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It is mental hospitals. Anybody who says otherwise is a moron.
The trick is to properly diagnose and deal with people on an individual basis. We locked up too many in the past, and the hospitals were excessively shitty. But that doesn't mean there aren't lots of people who need to be in there.
We can do more outpatient now with drugs, provided people make sure they stay on their meds.
The truth nobody ever wants to admit is that some people are just born defective. Nature is fucked. People born with bad brains are every bit as screwed as people born without legs or arms. Because they LOOK normal, people want to THINK they must be savable... But many of them are not. They are doomed to a life of hell from the moment they're born, and nothing in current medical science can fix them. They exist only to suffer.
It sucks, but it's true. We as a society can try to ease their suffering to some degree, and minimize the trouble they cause everybody else, but that's it.
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The advocate for more mental health treatment says that his patients are delusional. A delusion is basically a false belief. There's no way to treat delusions without an official in charge of declaring what is true and what is false. In related news, my local dollar store is selling Easter baskets, Progressives think we will find a way to pay for the Green New Deal, and I won't be driving today.
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While technically correct, this is a gross oversimplification and you know it.
The truth is if we just ignore small and silly things, and just focus on the obvious delusions that cause actual problems, it will be fine.
There are many people who are so insane they cannot exist on their own in the outside world... And if we let them try, it ruins the world for everybody else. Criminals and lunatics should be locked away, whether it is to THEIR benefit or not. The fact that is often IS to their benefit is icing on the cake, but even if it wasn't they should still be put away.
The idiot who argued we need to accept people living in tents in the middle of the city... FUCK THAT GUY.
I work hard to live in an expensive city, one that USED to be nice, and I don't want to have to look at insane bums every day, AND I don't need them harassing me like they regularly do. Their very existence in a manner as that infringes on my life and happiness. If they want to live in a tent in the middle of public property in Wyoming, fine... But not around here.
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Check out the body language between time stamp 15:00 and time stamp 15:05.
:P
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If you chart the rise in mass shootings it coincides with closing mental institutions and the patients' rights movement.
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The state mental hospitals were shut down mainly over the abuse of patients which resulted in embarrassing scandals.
A secondary factor was that parents who had children with mental defects like downs syndrome would turn them over to the state for warehousing rather that caring for them at home. -
It is not hard to understand the problem with eliminating mental treatment when you are walking around the corner from you Los Angeles home with your 9 year old daughter and you run into a homeless person searching through the garbage. This is despite LA's misguided support system the encourages homeless to come to the city to get shelter and food benefits.
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Our first excursion to downtown Seattle in 1985 a homeless person approached our young daughter and threw up on her shoes. My career working in the downtown jail and in courts convinced me that the NUMBER ONE thing that attracts urban campers, the insane, and low echelon criminals to large cities is the failure to enforce any petty crimes.
NUMBER TWO, of course, is the generous welfare system, which includes successful people passing between their offices and Starbucks shops who will give handouts.
NUMBER THREE, is illegal drug availability. You can get heroin anywhere in America but the street price in Seattle has famously been much lower for decades. Like the lack of petty crime enforcement, this goes back to prosecutors' offices in big blue cities hating to lock people up in mental institutions or anywhere, for that matter. Cost of doing business is lower here therefore.
Not long ago my wife and I walked around downtown Shanghai at night admiring the spectacular lights. We were with folks from San Francisco, who remarked they would never feel safe strolling downtown in their home city. We agreed. Ironic to remember the days when Shanghai was the exotic cesspool of the world where you had to beware of everything, and particularly watch your feet taking a step.
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Freedom is messy sometimes.
shanghai is the way it is because of communists. Why crime may be low there, they have no real say in who runs the government and you can be picked up in a night raid without any legal recourse that checks government power.
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That's not really true though. You can have rule of law, and actually enforce reasonable laws on people breaking them. Many towns in America STILL do this, and a lot more used to.
As he said, letting petty crime go on with zero enforcement is a major issue. 3/4 of the crazy/criminal homeless could be arrested and either put in jail or a mental hospital in a week if the SPD actually just enforced on the books laws.
I've been to plenty of other decent sized cities that aren't run by total retard progs, and they do NOT have this issue to an even remotely similar degree.
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On January 3, 1999, Andrew Goldstein wandered onto a New York City subway platform and shoved a stranger named Kendra Webdale into the path of an oncoming train.
Why wandered?
On January 3, 1999, Andrew Goldstein walked onto a New York City subway platform and shoved a stranger named Kendra Webdale into the path of an oncoming train.
Oh, that does sound different.
The first is a characterization while the second is a simple recitation of the facts.
Why the characterization Zach? Why are you shading his actions? And why in a manner that would seem (to this reader) to be minimizing his actions? Are you trying to imply that he is somehow less culpable for what he so clearly did?
If so, why?
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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When I was a kid, I thought Szasz' ideas were clever. Today, I think they are nonsense. Our public areas have been destroyed by derelicts and mentally incapable people. Above all else, this has driven people away from community centers and into private enclaves. Having bums, homeless people and mental cases occupying our streets, parks and common places has been devastating to an American sense of community. When it comes to dividing us, this is at the top of the list.
America should take the New Zealand approach. There is government housing and food available, and there are mental hospitals. They are voluntary. But it is illegal to live on the streets or in the parks. It isn't tolerated. People who are mentally ill can choose what kind of help they like. But they can't choose to live in community areas. That's illegal.
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The squirrels sure went out of control on this one!
But you're approximately correct.
The thing is, this is ALMOST what the US used to do. We had welfare. We had public housing. We had institutions. As my father has told me numerous times, if an obvious hobo came into their town they would ask if they had any reason to be there that was legit... And if not, kindly tell them to GTFO of their county, because vagrancy was against the law, and they would be arrested if caught sleeping out doors.
They then enforced it if they had to. They would often be so kind as to drive them to the county line.
Depending on the issue ones has they need to be helped back on their feet, thrown in jail, or thrown in a mental hospital. There really is no other option. Letting them shit on the sidewalk is not acceptable.
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I think all of us here are fiscally conservative at least... But so help me god, I would actually be willing to pay a higher tax rate if it went ONLY to locking up and dealing with these people.
It didn't used to be like this in America. My father told me about how when he was a kid there was literally not a SINGLE crazy bum in all of San Francisco that he can remember seeing. I'm sure there were a couple dozen floating around, but not the type of crazies we have now, or the scale.
This failed experiment in being excessively nice and fluffy with lunatics and shit heel druggies has to end.
I know some of our more feelz oriented posters hate to admit it... But the fact is being harsh with fucked up/useless people is sometimes the only way to deal with a problem. Not everybody actually is capable of being a civilized human being, and just as with criminals of various assortment, you have to be heavy handed with them sometimes.
Mind you, I actually think it is MORE humane to lock up in a nice warm facility and properly feed most of these crazy people. Tough but fair should be the order of the day. We can improve greatly on the issues with the old nut houses, but we have to put them somewhere that isn't the park 3 blocks from my house.
