Last year Davis Enterprise columnist Rich Rifkin wrote a piece that generated as much attention and criticism as any he has written. In his column, Mr. Rifkin describes a rather horrific and senseless crime, where an individual pulled out a knife and stabbed another individual without warning several times.
From that he picks his bone against the ACLU, arguing that the these stories are “the product of successful lawsuits decades ago by the ACLU that “freed” the mentally ill from psychiatric hospitals.”
“Involuntary commitment laws that require ‘imminent danger’ ignore that a person can be very, very sick and harmless. This results in people who are psychotic roaming our streets, helpless. It also results in people becoming dangerous because they are not being treated,” he continues.
While I do not support the idea of involuntary confinement, I do think the system for treating mentally ill individuals needs a drastic overhaul and I do acknowledge that Mr. Rifkin’s column from December has sensitized me to this issue.
Which gets me to a story by Cynthia Hubert from the Sacramento Bee that ran on Thursday about Tracy Sinclair, a mentally ill woman who assaulted a peace officer.
Ms. Feather has, according to the article, suffered from bipolar and other disorders since she was a teenager, and she has attempted suicide at least twice. Her attorney claims she has private insurance and could serve her time in a mental facility with no additional cost to the taxpayers. This is as opposed to the tens of thousands they are paying now for her treatment during incarceration.
Moreover, her attorney says that her mental condition has deteriorated dramatically during lock-up. The Sacramento County District Attorney’s office wants Ms. Feather to plead guilty to the felony before she can be transferred out of the jail to serve six months in the mental hospital.
“We can’t release a defendant while a case is still pending,” said Shelly Orio, a spokeswoman for the district attorney told the Sacramento Bee. “Our top priority is protecting public safety. We can’t just let her go without accountability or monitoring.”
Her attorney claims that Ms. Feather did not commit a felony during the standoff with Sacramento police officers that occurred on May 2, but given Ms. Feather’s deteriorating condition, she may have no choice but to accept that plea offer.
“I am very bothered by this resolution,” said Attorney Dennise Henderson, who represents Ms. Feather, to the Sacramento Bee. “But this is the problem when a mental health case becomes tangled in the criminal system. Tracy does not function well in jail, because she has never been there before. It is not a place for someone who is mentally ill.”
The article goes on to report that greater numbers of people with mental illnesses are showing up in jails, as a result of cuts to social services and safety-need programs. “In California, jails and prisons have become “today’s de facto mental health treatment facilities,” says a new report by a task force studying the issue for the Administrative Office of the Courts. A recent study found that four times as many mentally ill people in the state are in jails or prisons as in psychiatric hospitals,” the Bee reports.
Moreover this is coming at a huge cost to the public. Perhaps as much as $1,350 a day for “acute mental health services” in the psychiatric unit of county jails.
And how those patients are treated may be questionable. For instance the Bee reports, “In a jailhouse interview and in records supplied by her lawyer, Feather said that more than once during her stay, she was forced to lie on the floor of an empty “classroom,” handcuffed and shackled, after deputies told her they had no room for her in the psychiatric unit.”
But there is more to this story. While Ms. Feather’s condition is bad, she had attempted to harm herself and she has been placed in physical restraints, contrary to what some may think, her condition has only very recently deteriorated. The Bee reports, “Prior to budget cuts that closed the crisis center at the county’s mental hospital and slashed outpatient services, Feather, 48, had been stable for years.”
What has happened is that cutting mental health services has literally crippled people like Ms. Feather, who were otherwise productive citizens. The Bee reports, “Before her dust-up with the police, she lived independently in a midtown cottage owned by her mother, where she cared for her husband, a retired psychiatrist who suffers from dementia and other health problems. She managed her medications, kept house and prepared meals.”
However, once those services went away, Ms. Feather’s condition spiraled downward. With no crisis center, she started calling the police when she was suicidal and desperate, and despite claims to the contrary, the police are not well-equipped to handle such individuals.
And so, the Bee reports, “On May 2, she called police to report she wanted to kill herself and emerged from her home with a knife.”
They continue, “She has since said she had no intention of harming anyone but herself, but police perceived her behavior as a threat. Officers deployed a Taser, then handcuffed and arrested her. She has been in jail since, with bail set at $500,000.”
So we can now see clearly what has happened here. First, we have an individual who, with proper treatment and support services, was stable for years, able to live a productive life and even care for her incapacitated husband. Second, the mental health services were cut. Third, the police became the de facto crisis service. Fourth, the police do not have the training or expertise, so they turn the situation into an arrest, a Tasering and a felony charge. Fifth, her condition deteriorates. Sixth, despite the fact that she is clearly mentally ill, the DA is unwilling to allow her to get proper treatment unless she admits to a felony in an incident in which she was clearly mentally disturbed.
Every single aspect of the system has failed people like Ms. Feather. She does not need to have involuntary confinement to be healthy and a non-threat, she needs to have functioning outpatient services. This is a real tragedy, and as county services get cut to the bone, there are going to be far more of these cases.
If we lack the resources to have these kinds of care facilities, maybe we ought, at least, to properly train the police and DA to avoid unnecessary incidents of this kind.
—David M. Greenwald reporting
The mentally ill are such a fragile part of our society, that has always been on the fringe edges of society’s social service network. When they were treated in mental hospitals of old, there were terrible scandals as to what types of treatments they were subjected to. (If you ever get the chance, see the movie One Flew Over the Cuckoo’s Nest.) One of the most famous cases was the closing of the Patuxant Mental Institution in MD, for cruel and vicious practices. Ironically the closing of the PMI in MD happened within a few weeks after the above mentioned movie hit the movie theaters – it was uncanny. So along came President Reagan (I think he was a good president, but this is one area I did not agree with his policies), who decided to close mental institutions to save the taxpayers money and ordered individual localities (states and counties) deal with the mentally ill. What happened? The locals did not have the proper resources to fund such services, but did the best they could with very limited resources. Suddenly we had a mushrooming homeless population of mentally ill folks. Then along comes the current economic recession, and Mental Health Services are cut to the bone. These mentally ill people are already on the edge of survival – expect more and more run-ins by mentally ill folks with the police, bc these people cannot get the services they so desperately need. It is an incredibly sad story…
And my heart goes out to the families of those who are mentally ill. Can you imagine how difficult it is to watch your loved one deteriorate, bc they cannot get the help they so desperately need…
And the police are not well equipped to handle such cases, as we saw with the recent case of the mentally ill person that was tasered and accidently ashyxiated by the police…
The same day as Tracy’s motion for bail hearing was taking place, literally in the courtroom next door, there was a hearing for a violent felon, Russell Gettemy. On Sunday 8/15/10 Russell Gettemy punched a female parking control officer in the face, stole her ticketing device and fled the scene. Mr. Gettemy has a long felony record that includes DUI, battery and rape of a minor under 14. 1999 DUI, served 7 days, dismissed after conviction. 2001 pc 261.5 D:unlawful sexual intercourse with a minor who is under 16 years of age, 270 days work furlough, dismissed after conviction. 2001 DUI dropped to a wet reckless, served 8 days, dismissed after conviction. 2003 battery, 20 days served on weekends. We can only assume he has had something to trade for the leniency shown him so far. Not being a career criminal, Tracy had no such useful information with which to bargain. Like too many DAs, Jan Scully is only concerned with conviction rates. As I have observed elsewhere, Justice doesn’t need a blindfold if she looks the other way. While I am informed that Tracy has been released, I am not aware of the circumstances. If anyone here knows more, I would be keenly interested.
[i]”So along came President Reagan (I think he was a good president, but this is one area I did not agree with his policies), who decided to close mental institutions to save the taxpayers money and ordered individual localities (states and counties) deal with the mentally ill.”[/i]
For the record, every “fact” in Elaine’s “history” in this sentence is false.
First, the blame assigned to Reagan came when he was governor of California, not when he was president. (By 1981, when he took office, more than 95% of all public mental hospital beds which had been in existance in 1961, 20 years prior, were gone!)
Second, Reagan never did close the mental hospitals in California. He did, as governor, sign the Lanterman-Petris-Short Act of 1967. That Act effectively ended all involuntary commitment of psychiatric patients in California. If you care to know what happened to the thousands of mental patients who “chose” to leave those hospitals, read this book ([url]http://2.bp.blogspot.com/_-iCrgpX1jNM/Syu6R2A9orI/AAAAAAAAAUI/FDwVF_AiGNY/s1600-h/tio.jpg[/url]).
Third, Reagan, as governor of California, had nothing to do with what other states did. Many (pushed by the ACLU and similar “civil rights” lawsuits) passed laws similar to Lanterman-Petris-Short. However, it was a federal lawsuit in Wisconsin in the early 1970s which led to the emptying out of the mental hospitals all over the country.
Fourth, the one active thing Reagan tried to do failed–as governor, he tried to defund the mental hospitals. However, the legislature would not go along with him and all the funds were restored to those which still had patients. The irony of the legislature not cutting the funding is that there were about 500 gruesome murders in the years following Lanterman-Petris-Short and Californians were becoming very scared of all of these psychiatric patients who were not being treated. One patient in Santa Cruz, who had “chosen” to be released shortly after Lanterman-Petris-Short took full effect (in 1972) killed 16 people in a few months. It was his case (which never would have happened but for Nicholas Petris and his colleagues) that scared the legislature into restoring funding. But that was really too late. The mentally ill were largely left on their own and they have suffered for it ever since.
[i]”If you ever get the chance, see the movie One Flew Over the Cuckoo’s Nest.”[/i]
That is a great movie. However, it is bogus as history.
The book was written in 1963. It was almost 20 years out of date when it was published. That is to say, the conditions described in the book about how mental hopsitals were in the early 1960s were false. Kesey took extraordinary stories he heard from the 1940s and plopped them into his book for dramatic effect. But huges changes happened in psychiatric medicine in the early 1950s, when effective pharmaceutical treatments (as opposed to labotomies) were developed.
People who saw that movie in 1975, by which time almost all involuntary mental patients were living on the streets or in homeless shelters without any treatment or in prisons, got the idea that the story in the movie had some basis in present reality. It had none.
Moreover, it’s important to understand something about Ken Kesey himself. He was a great believer in pushing people to take LSD and other psychedelic drugs. He was a leading member of a fringe group which pushed the notion that there was no such thing as mental illness. Rather, the people we call mentally ill, according to Kesey and his crowd, were just “artistic” and creative thinkers who society was holding back. The reason that fringe movement, which was started by a doctor in England in about 1950 and pushed further ahead by an American doctor (who himself was schizophrenic), is important is because a lot of right-wing politicians bought into the idea that psychiatry was “a Jew conspiracy” since most top psychiatrists were in fact Jewish.
Those right wingers (led by the John Birch Society) joined up with the ACLU-types to close the mental hospitals. Petris was the ACLU-type who led the movement here. Lanterman was a Bircher.
The Bee reports, “Prior to budget cuts that closed the crisis center at the county’s mental hospital and slashed outpatient services, Feather, 48, had been stable for years.” The article states, “Her attorney claims she has private insurance and could serve her time in a mental facility with no additional cost to the taxpayers.” AndIf that is true, how can the cutbacks in mental health services be blamed for her spiraling down and out of control?
I should have added this: the book which drove the anti-psychiatry movement, of which Ken Kesey was a leading advocate, was “The Myth of Mental Illnees” by Thoas Szasz. Its views are similar to those of the science fiction writer (cum cult leader) L. Ron Hubbard, who for many years saw “Scientology” as the answer to curing mental illness. Perhaps the only person more influential in the pseudo-science of the anti-psychiatry movement was a Scot named R.D. Laing. He wrote a large library of books which influenced others in the anti-psychiatry movement.
I will definitely respect Rich’s much greater knowledge and research on this topic. But I was in high school civics the year after the Lanterman-Petris-Short Act took full effect (it took effect in 1972, I took civics in 1973), so it happened to be a major topic of discussion for us. The overwhelming consensus of pundits at the time was that the Act corrected serious abuses that occurred regularly whereby individuals were institutionalized against their will indefinitely, often with as little supporting evidence as a doctor and a family member. I am curious why so much blame is fixed on Reagan, the Act’s authors, and the ACLU, when the major court case decided by the U.S. Supreme Court in 1975 (O’Connor v Donaldson) effected the same thing as the Act nationwide ([url]http://en.wikipedia.org/wiki/O’Connor_v._Donaldson[/url]). Overall I think there was broad, bipartisan support for this change, and the undesirable side-effects were not realized until years later.
[i]”I am curious why so much blame is fixed on Reagan …”[/i]
It is misplaced. It began in the mid 1970s (during the Jerry Brown Administration), by which time it was obvious we had a serious problem in the wake of Lanterman-Petris. The left* continued to support Lanterman-Petris, so they needed a scapegoat. They picked Reagan. He was a convenient target for two reasons: 1) he tried to defund psychiatric hospitals (but failed); and 2) he signed into law Lanterman-Petris.
*It is wrong to say that only the left supported Lanterman-Petris. The far right Birchers also were on board with that. However, ALL of the lawsuits which played a role in emptying out the mental hospitals were filed be left-activist lawyers (usually with the support of the ACLU).
[i]”I am curious why so much blame is fixed on … the Act’s authors …”[/i]
Petris was the real author. Lanterman was a dumb stooge. (Short didn’t write one word of the bill.) Petris gets blame from me because it was his Act which resulted in terrible harm to thousands of patients who were turned out of hospitals and “chose” to no longer take medicine which was helping them in many cases. In other cases, where they were very sick and the meds were doing no good, being locked in a mental hospital was far better than in a prison or in the gutter, which is where those folks ended up.
The Petris Act was important beyond California, largely because many other states copied it. The impetus was both to “free these victims” and to save money. It was a horrible mistake.
[i]”I am curious why so much blame is fixed on … the ACLU …”[/i]
The ACLU played a pivotal role in the nationalization of the lawsuits. They did not directly file any of the important ones, but they gave legal aid and money to those that did. The case which changed our national policy was the Lessard vs. Schmidt case of 1974. It was filed on behalf of a paranoid schizophrenic woman named Alberta Lessard. She was represented by a left-activist group of lawyers known as Milwaukee Legal Services. It attorneys were anti-psychiatry followers of Thomas Szasz. They were not directly tied to the ACLU. However, as with similar cases in state courts, the ACLU sent attorneys to help out with the Lessard case. They guided MLS in its attack on involuntary commitment. When the judge decided in their favor in Lessard–he cited the Thomas Szasz nonsense book “The Myth of Mental Illness” in his decision–the result around the rest of the United States was the end of involuntary commitment, save in a few crisis situations.
The problem in our mental health system for those with serious, chronic mental illnesses like bipolar and schizophrenia is not a lack of involuntary commitment, today. The real problem is that they need to take medications to function in society and on their own, without supervision, they very often will not. The role of involuntary commitment should be short term for most. But just because someone can live in society does not mean he can live successfully without supervision. Ideally, we would have a fully functioning Laura’s Law program everywhere, which would force these incompetent patients to take their meds or be committed. But the sad truth is, we have never funded or enforced Laura’s Law (not even here in Yolo County, where its author, Helen Thomson, was a supervisor).
The medical/psychiatric profession has historically felt that they were best equipped to determine what’s in the best interest of people with psychiatric disabilities. Some still buy into the most extreme elements of that perspective–in the person of E. Fuller Torrey.
Voluntary treatment is almost always more effective and, for that reason alone, inherently more humane than forced treatment and involuntary institutionalization. Frank Lanterman was a true conservative–who valued personal autonomy and minimal state intrusion in the lives of individuals. He joined forces with civil libertarians, like Nick Petris and many others of both parties in the California Legislature, to end the abuses of forced incarceration without any semblance of due process or respect for the fundamental right to liberty.
Lanterman was also a primary author, some 30 years ago, of the Lanterman Developmental Disabilities Services Act, which established a voluntary community-based service system for people with developmental disabilities, including, an entitlement to services and supports needed to enable such persons to live independent and productive lives in the community. As a result, through establishment of a comprehensive voluntary service system, state institutionalization of people with developmental disabilities dropped from more than 13,000 to fewer than 2,000 today. This stands in stark contrast to how we still treat people with psychiatric disabilities. We have never made the same commitment of resources or created a similar entitlement to community-based mental health services. Many communities are, in fact, cutting what sparse services exist–and jails and prisons have, in fact, become the default providers of mental health “services.”
What’s needed is not a return to the days of segregation, disempowerment, and involuntary treatment and institutionalization. Instead, we should be listening to and joining forces with the vast majority of mental health consumers themselves, and advocating for a renewed and strengthened commitment to effective, voluntary mental health services.
Update from the Bee: [quote]Feather, 48, was admitted to the Sacramento psychiatric hospital, after agreeing to enter the no contest plea in exchange for spending 180 days undergoing treatment, Dennise Henderson, Feather’s lawyer, said in emails to The Bee.[/quote]
Most of you who have commented have absolutely no idea what it is like to have a person with severe mental health issues in your family. Some comments have been germane – the others are pure speculation.
If Rifkin, for example, has personal knowledge of a close relative with mental illness, he should disclose that. If not, he should quit pretending to be an expert.
Having dealt with schizophrenia for 11 years in a relative, I think I can provide some light on this subject. However, if the rest of you are convinced you know better, I will remain silent. This is an issue that destroys families.
Thanks for the update, David.
mental health: I think it would be useful if you would be willing to share your experiences with us.
I might, but I will wait for Rifkin’s response first.
[i]”If Rifkin, for example, has personal knowledge of a close relative with mental illness, he should disclose that. If not, he should quit pretending to be an expert.”[/i]
I am an expert–on the laws which have failed our society, failed people with severe mental illnesses and the families of people with these diseases.
I have mentioned this many, many times: I got into this issue with a relative who went from being a very well adjusted, productive person who had his own successful business and was in a happy marriage to an often jailed and otherwise homeless person after becoming ill with schizophrenia and who became firghtening to everyone who knew him.
What I learned along the way is that the laws, which by now I know extremely well, are designed to guarantee the patients’ “civil rights” at this expense of their well being and mental health. What I know is that my relative, who responded very well to his meds (with some adjustments over time) eventually would always stop taking them and no one could or would force him to be medicated. Despite a number of 5150 holds, he was always determined to be no imminent danger to himself or others (just prior to senselessly attacking an innocent woman who was “putting bad thoughts in his mind.”)
Fortunately, the only good the law ever brought about in his case was to take away his collection of about 100 guns, which he “needed to fight off the CIA which was hiding in his attic.” I just assume it is a matter of time before he is killed or kills someone.
By the way, you say you have had a relative in this condition for 11 years. Not that it makes any difference, but my relative’s case goes back almost 20 years now. He was a very, very smart guy and I think he probably had some mental illness when he was younger, but he never was diagnosed with schizophrenia until he was in his mid 30s, which is very late. Because it is a progressive disease, his symptoms got worse and worse over time, save when he was taking his meds. They worked. But no one in our family could force him to keep taking them. He also has a condition which makes him believe he is not sick. As such, he doesn’t understand why he needed the meds, because he does not understand that he is ill.
As a parent whose daughter also had the same “condition which makes [his relative] believe he is not sick” that Rich Rifkin described in his last paragraph, I am an advocate for changes to the treatment law in our state that requires someone to be a clear and present danger to self or others before treatment can be provided to someone too ill to seek help on their own.
A better word to use instead of “condition” is symptom, and, the word that is used for someone who believes they are not sick is anosognosia which is found in the current DSM-IV-TR (TR stands for Text Revision) on page 304: “A majority of individuals with Schizophrenia have poor insight regarding the fact that they have a psychotic illness. Evidence suggests that poor insight is a manifestation of the illness rather than a coping strategy. It many be comparable to the lack of awareness of neurological deficits seen in stroke, termed anosognosia. This symptom predisposes the individual to noncompliance with treatment and has been found to be predictive of higher relapse rates, increased number of involuntary hospital admissions, poorer psychological functioning, and a poorer course of illness”. Research has also shown that approximately 40% of people with bipolar disorder also have anosognosia.
For those individuals who have relatives with severe mental illness and anosognoisa, such as the two blogs posted by “mental health” and Rich Rifkin, involuntary treatment, including treatment in the community through assisted outpatient treatment (AOT) is both beneficial and sensible. Laws such as Laura’s Law in California (which needs to be further implemented) and Kendra’s Law in New York are the most compassionate, effective methods of providing sustained effective treatment for someone who is aware that they are sick. AOT laws have also been found to offer major reductions in hospitalizations, homelessness, and incarceration.
For additional information about AOT as well as to see a panel discussion “Confronting Anosognosia” at the NAMI National Convention from July 2010, visit http://www.treatmentadvocacycenter.org/
I left out the word “NOT” in the second to the last paragraph, second to the last sentence should state “Laws such as Laura’s Law in California (which needs to be further implemented) and Kendra’s Law in New York are the most compassionate, effective methods of providing sustained effective treatment for someone who is NOT aware that they are sick.
Excellent discussion with lots of good insight. To commenter named “mental health”, it would be very interesting to hear your perspective.
rich rifkin: “Don Shor: “I am curious why so much blame is fixed on Reagan …”
…They picked Reagan. He was a convenient target for two reasons: 1) he tried to defund psychiatric hospitals (but failed); and 2) he signed into law Lanterman-Petris.”
You answered your own question.
From my perspective, I lived in the state of MD when One Flew Over the Cuckoo’s nest came out. Only a few weeks after I saw it in the movie theaters, the Patuxant Mental Institution in MD was shut down bc of its horrific record of giving patients torturous treatments that were absolutely beyond the pale. I know at the time I was utterly horrified to learn of what had gone on. Many years later, I was working in the downtown Washington, D.C. area, and came into contact with a lot of homeless. It was clear to me that so many of them were mentally ill with no place to go.
Not being as politically savvy as I am now, I believed a lot of what I read in the newspapers (now I believe almost nothing I read in the newspaper!), including the blame placed on Reagan for turning people out of mental institutions without a plan in place of where they should go.
However, the bottom line is as Eric Gelber has said, “What’s needed is not a return to the days of segregation, disempowerment, and involuntary treatment and institutionalization. Instead, we should be listening to and joining forces with the vast majority of mental health consumers themselves, and advocating for a renewed and strengthened commitment to effective, voluntary mental health services.”
I also understand Rich Rifkin’s point, that often the mentally ill will not take meds unless closely supervised. I was involved with an eviction case, in which my mentally ill client would discontinue taking her medications as soon as she felt better, thinking she was cured and the medication was no longer necessary. Off the meds, she would quickly relapse. As I understand it, this is a common problem amongst the mentally ill.
There is no question that mental illness is difficult to deal with, for the person who is mentally ill and their loved ones who have to see them suffer. It is also difficult for society to deal with, but ultimately “there but for the Grace of God go I”.
[i]”the Patuxant Mental Institution in MD was shut down bc of its horrific record of giving patients torturous treatments that were absolutely beyond the pale”[/i]
I don’t doubt that. Many mental hospitals were very well run and greatly helped their patients. Others were lousy*. They all closed. What I wonder is what happened to the patients who were “freed” from Patuxant? That was 35 years ago. It would be interesting to know their plights as individuals.
Chances are strong that many of them wound up homeless or in prison within a few years. Chances are also strong that some committed suicide or were killed on the streets. That is a very common outcome for the homeless mentally ill.
Ideally, they would have all been cared for by their families with the support and aid of community mental health programs. But think for a minute why that model generally does not work for most** of the severely mentally ill:
1) many of them likely had no families willing or able to care for them–that is the reason they were institutionalized;
2) the community mental health programs are designed to serve people who are cooperative patients who will voluntarily come to appointments and voluntarily take medications–neither of those is likely in the case of individuals with severs psychosis;
3) when a patient with a serious disorder is living with his family and he is not taking his meds or voluntarily following his doctor’s orders, he can be truly frightening to live with. (I know this from personal experience.) How many families are going to stay with a program like that if they fear their sick family member might kill their dog or bludgeon a neighbor’s child for no reason? Why would a family want this ill relative in their house if when they call the police in a crisis the cops cannot do anything? Or even when the patient is taken in for a psyche hold, he is released back to them 2-3 days later and has gotten no better?
Because of those realities in cases of very serious mental illnesses, the patients very often will wind up on the streets–and thus it is impossible to say their interests were well served by closing the hospitals and the ending of involuntary treatment.
*A side issue of “lousy” mental hospitals was the fact that many patients in thse hospitals in the 1970s did not have psychiatric illnesses–they were instead mentally retarded. It never made sense to house them in psychiatric hospitals or, in some cases, in convalescent hospitals. We have a “friend of the family” who is mentally retarded. He is now about 65 years old. I have known him since I was about 10 years old and he was about 30.
Because his family could not care for him when he was a child, he was placed in a mental hospital in California. When that hospital was shut in the early 1970s, he was sent to a convalescent hospital in Davis, where my mother got to know him and tried to help him. Eventually, he was helped by a program (I presume run by the state) which allows him to live in his own apartment in Woodland with help from caregivers who look after him. He has worked over the years in menial jobs which they have placed him in and he has enjoyed. All in all, this guy has had a good life since leaving the convalescent hospital roughly 30 years ago.
A man with his cognitive level never should have been hospitalized, let alone held in a psychiatric hospital. But the fact that he did not belong in a hospital does not excuse the closing of hospitals for those who needed them and wound up on the streets or in prison.
**I should note that I understand that there are some people with schizoprhenia and bipolar who do well in a home environment, who do take their meds and who pose no great threat to their loved ones. Ever. I am not talking about them. I am speaking of individuals who are very mentally ill but don’t understand that. They are disorganized in their thinking and cannot function in society unless they are forcibly medicated. That is why Eric Gelber’s attitude is inhumane. Those folks need involuntary treatment. Without it, they end up homeless, dead or in prison, and often they are a great danger to others. Because of that danger, Gelber’s policies end up stigmatizing all people with mental illnesses.
rich rifkin: “A man with his cognitive level never should have been hospitalized, let alone held in a psychiatric hospital. But the fact that he did not belong in a hospital does not excuse the closing of hospitals for those who needed them and wound up on the streets or in prison.”
Back in the day, my feeling is the mentally retarded were institutionalized to keep them away from the rest of the population. The average person didn’t want to have to deal with someone mentally retarded, which is incredibly sad and intolerant. With supervision, many of the mentally retarded can lead very productive and happy lives. I’d like to think we are a bit more enlightened these days.
rich rifkin: “**I should note that I understand that there are some people with schizoprhenia and bipolar who do well in a home environment, who do take their meds and who pose no great threat to their loved ones. Ever. I am not talking about them. I am speaking of individuals who are very mentally ill but don’t understand that. They are disorganized in their thinking and cannot function in society unless they are forcibly medicated. That is why Eric Gelber’s attitude is inhumane. Those folks need involuntary treatment. Without it, they end up homeless, dead or in prison, and often they are a great danger to others. Because of that danger, Gelber’s policies end up stigmatizing all people with mental illnesses.”
Clearly one size doesn’t fit all situations/mentally ill persons. But it doesn’t take away from Eric Gelber’s point, that more voluntary programs for the mentally ill are needed as opposed to the old model of institutionalization of all mentally ill/retarded folks so they are conveniently out of the public eye. The more we can mainstream them, provide them with the voluntary services they require, and provide the necessary supervision, the better off most of them will be. I don’t think anyone is arguing against institutionalization for some who are definitely a danger to themselves or others. Is the system we have now perfect? No. Can it be made better? I’m sure it can. Do we want to go back to blanket institutionalization – I don’t think so.
I think the whole business about keeping the mentally ill on their meds is perhaps one of the most intractable problems that mental health professionals have to deal with. And often that is a byproduct of the awful side effects of the medication. My hope is they will come out with safer, less stupifying drugs than are currently on the market. The reason my client wanted to go off her meds was bc they made her so sleepy…
[i]”The reason my client wanted to go off her meds was bc they made her so sleepy …” [/i]
That was the same complaint of my relative with severe schizophrenia. He was a contractor (he built luxury homes in the Los Altos area) and he felt like he could not function at work while so groggy. He also did not believe he was sick. So why take these meds if they do no good and make me tired?
As it happens, his doctor eventually found a pill regimen which controlled his symptoms very well and did not have much in terms of side effects (other than cotton mouth). But (as noted above) he would stop taking them and then shortly thereafter he would have a psychotic episode and spiral down from there. The cycles always got worse. He finally ended up living on the street until he attacked a lady and he was put in the psyche ward of the Santa Clara County jail. By then, he was really very far gone. He needed someone always to forcibly give him his meds.
GELBER: [i]”Voluntary treatment is [b]almost[/b] always more effective and, for that reason alone, inherently more humane than forced treatment and involuntary institutionalization. … What’s needed is not … involuntary treatment and institutionalization.”[/i]
This is the myth that the ideological civil libertarians push. They ignore the fact that voluntary treatment NEVER works for people who have severe psychoses off of their medicines. Their policy conclusion is the inhumane triumph of ideology over empirical reality.
[i]What do the civil libertarians have to offer people who need involuntary treatment? [/i] Nothing.
[i]What do the civil libertarians have to offer the families of such people?[/i] Nothing.
[i]What do the civil libertarians have to offer psychiatrists whose patients need meds but won’t follow through and take them? [/i] Nothing.
[i]What do the civil libertarians have to say to law enforcement officers and jailers who are every day dealing with the revolving door of people in psychotic trauma who have gone off of their medicines a fifth, sixth, seventh time and are creating a terrible life for themselves and others around them? [/i] Nothing.
[i]What is the result for individuals that Eric Gelber has tossed aside with his libertarian callous disregard? [/i]Today’s Washington Post ([url]http://voices.washingtonpost.com/crime-scene/homicide/md-man-charged-in-brothers-ax.html[/url]) has one fate from Maryland: [quote]Allegany County, Md., authorities say a man with [b]a history of mental illness[/b] is behind bars on charges he murdered his brother with an ax.
Forty-two-year-old Mark Collins is charged in the slaying of 46-year-old William Collins, who was found dead Saturday night on a couch in a trailer the men shared.
The Allegany County Bureau of Police says deputies found Mark Collins spattered with blood. He was charged with first-degree murder and first-degree assault and ordered held without bond.
Court records show that Mark Collins was committed to a mental institution in September 2004 after he was charged with arson in Allegany County. He was released in January 2006. [/quote] GELBER and his ilk don’t care about the millions of lives their extremist ideology have ruined. They attitude is inhumane and callous. It is Gelber and his ilk who are causing all people with mental illness to be stigmatized, because the stigma and fear comes from cases like that of Mark Collins. Stigma does not come from people with anxiety disorders.