Monday, May 21, 2007

"I miss Lakeshore, I miss Lakeshore..."

There is a good article this week in the Metro Pulse, our weekly alternative newspaper here in Knoxville, on the plight of the homeless, 55 % of whom are mentally ill. The story discusses Lakeshore Mental Health Institute, a facility that has downsized from 2400 beds in 1970 to about 180 beds today. I had to laugh recently when I saw some administrator in a news interview talking about all of the beds available here for the mentally ill in Knoxville after the Virginia Tech massacre. 180 beds? That's nothing. What happened to the patients who were taking up the other 2220 beds in 1970? Did they all get better? No, in 2007, they and probably their descendents are being humanely discharged to the streets.

Some of them end up at the Volunteer Ministry Center (VMC) here where they at least get shelter for the night but according to the executive director, Jenny Weatherstone, at VMC, the mentally ill need an atmosphere that is fairly structured and calm. "And that does not describe any shelter, including ours, nor does it describe life on the streets, yet that's where so many people end up." "Weatherstone remembers one lady who came into VMC. She sat in the waiting room, pulled her legs up to her chest, and gently rocked herself in the fetal position. She chanted as if it were a mantra, 'I miss Lakeshore, I miss Lakeshore, I miss Lakeshore....' Over and over and over."

So many civil libertarians want to believe that it is a good thing that patients were "humanely" dumped out of the mental hospitals to live "free" in the society. But I bet if you asked the woman above chanting her mantra, she might feel differently. I remember Lakeshore in the 1980's when there were more beds than now; I volunteered several days a week on a woman's ward after college and watched the medical personnel care for the patients with medical care, occupational therapy, exercise and nutritional meals. One woman I met there had lived most of her life in Lakeshore and felt that the facility was her home. I can't see how the streets are better.

The city of Knoxville now owns 60 acres of Lakeshore's 300-acre farm, it is a public park with beautiful rock gardens and a walking trail. I always feel slightly gypped when I walk on the grounds there and notice that some of the buildings are sitting empty and others have been torn down. I think of all the patients I have seen over the course of my career that needed inpatient services that couldn't get them or got them for too short of a time to be of any use, and I realize that deep down, I miss Lakeshore too.

90 Comments:

Anonymous TMink said...

Inappropriate hospitalization in a mental hospital is wrong and annoying, but inappropriate discharge or refusal to hospitalize people who are ill and require it is often deadly.

I am not speaking about long term hospitalization of a rational, healthy person, but our homeless problem is a mental health and an addiction problem. Same problem, different symptoms. It is unkind to not offer or even require folks with untreatable or unmanageable mental health problems a place to be safe and to call home. Just because the organ involved is the brain does not make a difference. These are still health problems.

Trey

2:24 PM, May 21, 2007  
Blogger Helen said...

Trey,

Yes, and in addition, the mentally ill often have more medical problems such as cardiovascular disease and other ailments that are not treated due to the person being mentally ill and not taking care of themselves. I think I read that the mentally ill live a full 22 fewer years than most people. It's a shame. I would rather see funds go to keep more beds open than to funnel that money into expensive rock gardens and walking trails but apparently I am in the minority.

2:29 PM, May 21, 2007  
Anonymous cathy said...

Diabetes is probably the most common physical ailment at Lakeshore, but that could be attributed to the typical Southern diet. If you look at the visitation records at Lakeshore, you quickly realize that the SPMI population have been abandoned by their families and they truly have nowhere to go when they leave the hospital. Anyone who has ever tried to get someone admitted to an in-patient program, even short term, will tell you how hard it is to get in there.

2:45 PM, May 21, 2007  
Anonymous Viola Jaynes said...

It is such a shame. We spend so much money on other things but our mentally ill people are left to themselves.

2:51 PM, May 21, 2007  
Blogger Helen said...

Cathy,

And the families are not just those with no money, many families of the middle and upper middle class are at their wit's end with family members who are mentally ill. Families often have to look after other members and cannot take care of someone who is severely mentally ill and provide the types of services that they need, sometimes on a daily basis.

2:55 PM, May 21, 2007  
Anonymous Anonymous said...

Ah yes, it's a shame that it isn't easier to circumvent the Constitution, etc. and imprison and assault innocent people. It's so inconvenient when you want to imprison, steal from, abuse, discredit, sabotage, etc. a spouse, family member, etc. and you're not able to. Too bad it isn't as easy to damage their brains and sterilize them like it used to be. But we can still take solace in being able to drug and chemically castrate rather easily. And I've heard that new horizons of genital mutilation are being tested.(albeit illegally)

4:33 PM, May 21, 2007  
Anonymous Anonymous said...

And regarding health and diet:

You should check out some of the links between psych medication and health problems like diabetes, etc. I wonder how much of the "shortened lifespan" of the "mentally ill" is due to the garbage brain candy.

4:41 PM, May 21, 2007  
Blogger dadvocate said...

I worked in the adolescent unit at Lakeshore in 1971-72 and again in 1975-76. In general the conditions were pretty good.

In the mid-80's I worked in the day treatment program of a local mental health center. Many of our patients were the ones de-institutionalized from Lakeshore. They mostly lived in various privately owned group homes around the city. The quality of care varied widely but enforcement of state regulations was soft because people willing to run group homes were rare.

A few few lived in wildly unsuccessfully "mutually supportive" homes where, theoretically, the group as a whole could perform all the functions necessary for daily living. They couldn't. For a time, we would go to the home and help them. Once we put a roast in the oven for them to cook for supper. Two days later, it was still there.

One group home lost its license but since the patients were technically legally responsible adults they could stay their if they wished. Most did. One ended up being killed by his roommate in an argument over a cigarette.

De-institutionalinizing these people did no one any favors and was cruel in many cases.

4:47 PM, May 21, 2007  
Anonymous Bugs said...

Coincidentally, I was just reading something about Carrie Buck - a citizen of my own state and one-time poster-girl for the "benefits" of involuntary institutionalization and sterilization. I think it was cases like hers and Rosemary Kennedy's that helped discredit the mental hospitals. So point taken.

However, there are people with real mental illnesses who have not been railroaded by the state or conniving relatives, and who probably would benefit from decent in-house treatment. I run into a few of them most weeks in some of the nicest parts of your nation's capitol. They're the ones too fucked up to beg for change. I can't say whether they're engaged in life, liberty, and the pursuit of happiness. They don't appear to be engaged in much of anything. But hey, at least they're exercising their Constitutional rights without interference from the authorities.

4:52 PM, May 21, 2007  
Blogger Helen said...

Anonymous 4:33:

You are the only one here discussing assaulting, stealing from and imprisoning the mentally ill. Mental hospitals do not typically engage in this type of behavior--those that do are usually out of business or shut down. BTW, the assault and stealing you mention usually takes place on the street where many of the mentally ill live because they have few other alternatives except sometimes jail (usually in an attempt to get some type of treatment) but at least they are "freely" being assaulted and stolen from in the greater society. That must make you feel good.

5:06 PM, May 21, 2007  
Blogger ricpic said...

Ain't liberal compassion great?

6:09 PM, May 21, 2007  
Anonymous Anonymous said...

helen-

You are the only one here discussing assaulting, stealing from and imprisoning the mentally ill. Mental hospitals do not typically engage in this type of behavior--those that do are usually out of business or shut down.

No, one of the themes of this thread is a complaint about the difficulty of involuntary commitment and the availibility of beds to commit them to. Involuntary commitment was and is used as a tool to steal from individuals, abuse them, get the upper hand in legal disputes, silence and discredit them, etc. If it was easier, like it was in the past, this kind of abuse and ciminality would increase.

Sometimes hospitals, facilities, "professionals", etc. do steal from, assault, and abuse people, but that's a seperate issue. I was addressing the issue of how easy it was/is to drop people into the hole of involuntary commitment, not what happens to people when they land in that hole. Fraudulently putting people in that hole to begin with is a vehicle for abuse in some cases.

BTW, the assault and stealing you mention usually takes place on the street where many of the mentally ill live because they have few other alternatives except sometimes jail (usually in an attempt to get some type of treatment) but at least they are "freely" being assaulted and stolen from in the greater society. That must make you feel good.

No - the situations you describe are tragic and unfortunate. (And no, it doesn't make me feel good. But thanks for implying that I'm a sadist - I'm not.) There should definitely be some efforts at outreach aimed at those kinds of people. But it shouldn't come in the form of making it easier to involuntarily commit everyone.

Note that in the involuntary commitment scenarios I outlined the harmful effects are compounded because you are also wasting valuable resources. Here's an outline of the victims:
(1) A normal person is having their civil and Constitutional rights violated and is having force and coercion used on them. There are also opportunity costs because this person is being prevented from pursuing a normal, rewarding life.
(2) Some criminals who are initiating and enabling the false commitment for whatever reason (profit, abuse, silencing, discrediting, etc.) are getting away with it and perhaps profiting.
(3) Valuable medical resources are being wasted by abusing an innocent person that doesn't need treatment. (Note that doctors, facilities, drug companies, etc. billing another entity might be profiting from this wasted treatment anyway, intentionally or unintentionally.)

So the situation I outlined also harms people who are actually mentally ill, since valuable resources are being wasted to abuse people who aren't mentally ill. So investigating cases where there's a person saying: "No, I'm not crazy, who is claiming that I am?" might warrant some investigation, fact-finding, and prosecution.

6:20 PM, May 21, 2007  
Anonymous Anonymous said...

ricpic-

Ain't liberal compassion great?

I'm not a liberal. And helen misunderstood or misrepresented my position.

6:21 PM, May 21, 2007  
Blogger Helen said...

anonymous 6:21:

Perhaps I misunderstood you and BTW, I never thought you were a liberal, my guess is a libertarian but I could be wrong.

I assume from your post that you believe that most people are being "forced" against their wishes by ill-meaning family or friends into hideous conditions in a mental hospital where they are subsequently treated poorly, assaulted and pretty much subjected to "One Flew Over the Cuckoo's Nest" with Nurse Ratched forcefeeding them Thorazine. This is hardly the case. There are many patients out there who need mental health treatment in an inpatient facility. However, due to the closing of many of our mental hospitals, no help is forthcoming. I am not talking here about friends and family trying to have people committed for being "uppity" or a pain, of course that is wrong. I am talking about someone who suffers from severe psychological disorders that warrant therapy, treatment and yes, perhaps some supervision. This seems more humane than leaving the mentally ill on the streets to be assaulted, robbed, or homeless with no treatment at all. Believe it or not, the mentally ill sometimes prefer a hospital to the streets.

6:35 PM, May 21, 2007  
Anonymous Bugs said...

So maybe the question should become: How can we ensure proper care for people whose mental condition may not allow them to seek it voluntarily, while preventing of healthy people from being hospitalized by mistake or under false pretenses?

Sort of goes back to how they handled Cho. Who determines the criteria for involuntary treatment, and exactly what should they be? And who's going to take responsibility for acting on them? You don't want healthy but maybe "eccentric" or merely unwanted people being packed off to the state hospital. On the other hand, you don't want a system which, confronted with someone like Cho, just says "Sorry, we're not authorized."

Easy answers, anyone?

6:48 PM, May 21, 2007  
Blogger br549 said...

For reasons I needn't go into, I have spent untold hours struggling with what to do about a family member suffering mental illness.

It's the type of illness that cannot be dealt with by family, and the person can not be in the home, or left unattended in the home. They can't be around children unassisted (all day).

In this world, a family cannot let someone who is ill and unable to function "control" the rest of the family because of the illness. It is gut wrenching, heart breaking, life changing, forever.

No answer prevents, even softens the blow of the previous sentence. When it is one of the parents, the kids are always wondering if it will happen to them some day, too. "Didn't my mom inherit it from her mom?"

One of my children is agoraphobic that is most likely related to what has transpired over time. Hasn't been out of the house except with me by his side in years.

No easy answers.

Lots of wishing and hoping.

7:35 PM, May 21, 2007  
Anonymous Anonymous said...

helen-

I assume from your post that you believe that most people are being "forced" against their wishes by ill-meaning family or friends into hideous conditions in a mental hospital where they are subsequently treated poorly, assaulted and pretty much subjected to "One Flew Over the Cuckoo's Nest" with Nurse Ratched forcefeeding them Thorazine. This is hardly the case. There are many patients out there who need mental health treatment in an inpatient facility.

No, I don't assume that most people are receiving mental health treatment against their will. But I do believe some are, and that easing the controls on involuntary commitment would make it easier for those kinds of crimes, frauds, and rights violations to occur.

However, due to the closing of many of our mental hospitals, no help is forthcoming. I am not talking here about friends and family trying to have people committed for being "uppity" or a pain, of course that is wrong. I am talking about someone who suffers from severe psychological disorders that warrant therapy, treatment and yes, perhaps some supervision. This seems more humane than leaving the mentally ill on the streets to be assaulted, robbed, or homeless with no treatment at all. Believe it or not, the mentally ill sometimes prefer a hospital to the streets.

And I acknowledged that outreach needs to be done for mentally ill people who are on the streets. That's the place to do it, providing it is done without coercion. But the thing is, you don't need to change the rules on involuntary commitment for that.

11:35 PM, May 21, 2007  
Anonymous TMink said...

Anon wrote: "That's the place to do it, providing it is done without coercion."

Have you worked with or do you know many people who are severely and persistently mentally ill? Coercion can and did save their lives once upon a time. The rest of us are talking about people who cannot protect themselves out of a contained, safe environment and who are too ill to make the choice to stay there and stay alive on their own.

Loss of liberty, or loss of life. That is not a huge moral struggle for me. I do not think you understand just who we are talking about. Or we just have very different morals.

Trey

11:53 PM, May 21, 2007  
Anonymous Anonymous said...

tmink-

Have you worked with or do you know many people who are severely and persistently mentally ill?

Yes, briefly.

Coercion can and did save their lives once upon a time.

That doesn't follow. Are you talking specifically or collectively?

The rest of us are talking about people who cannot protect themselves out of a contained, safe environment and who are too ill to make the choice to stay there and stay alive on their own.

If you are talking about someone that can't feed or clean themselves then the minimum amount of force required to bring them to a safe place for an evaluation might be warranted. Other than that I'd say no coercion is justified.

Loss of liberty, or loss of life. That is not a huge moral struggle for me. I do not think you understand just who we are talking about. Or we just have very different morals.

I know who you are talking about and they can be quite adequately looked after without eroding civil and Constitutional rights by loosening the involuntary commitment laws. Apparently my morals include not trying to use the mental health system to erode civil, Constitutional, and human rights.

1:33 AM, May 22, 2007  
Blogger Helen said...

Anonymous 1:33:

I can appreciate your position. However, what do you say about those who are a danger to themselves or more importantly, to others? Should there be no coercion then? What about the innocent people who are in their path? Do they have any rights at all?

6:32 AM, May 22, 2007  
Blogger br549 said...

anon 1:33, this needs to be said.

You have just enough knowledge to expose your lack of experience with the severity of some types of mental illness - i.e., "yes, briefly". I believe you are talking out of the same orifice Jim Cary spoke through at one of the Academy Awards ceremonies.

Try losing your home, life savings, 25 year career, and having to pack up your children and literally move out of state (as recommended strongly by the doctors involved) to get away from an individual whose rights exceed yours and your children. The only people the person "goes off on" are immediate family. How do you explain it to your belt buckle tall kids?

Imagine it is also the one person in your life that you at one time loved with every fiber of your being. How do you deal with the promise you made, among others, of "in sickness and in health"? I've never figured it out. You'd give anything, you've already given everything. All you can do is reach a place that allows you to keep on keeping on.

I could write a book on what we've been through. Yet I can't for the life of me, understand what has happened.

7:27 AM, May 22, 2007  
Blogger Helen said...

br549,

Sometimes there is no real way to understand what happened in the situation you describe--the main thing is to get through it. Dealing with and living with a mentally ill person, especially one with a personality disorder is enormously draining and at times, impossible. Unless one has been through it and lived for years in the aftermath it is hard to imagine. It is so very easy to stand back and advocate to do nothing for the mentally ill or to think that each of them can be treated in the community with a team of wonderful therapists but that is not forthcoming and even if it were, it does not work with many people who are too sick to even want help or for whom wrecking havoc on others is a pleasurable way to live. I am sorry for what you have been through, I would not wish it on anyone.

8:36 AM, May 22, 2007  
Anonymous Anonymous said...

Anon,

I understand your position; you've stated it well. There was no need for the abuse you took but commenters on this blog tend to do that. If it sounds as if you disagree with Helen, you must be a stupid liberal, and it is accepted to be incredibly rude to stupid liberals. I will congratulate you for sticking to your point long enough for Helen to treat you as an individual with a valid opinion--though her initial snotty response ("That must make you feel good.") is her usual game.

9:10 AM, May 22, 2007  
Anonymous Anonymous said...

There will always be disagreement on the allowing individuals liberty, even though it appears their lifestyle is poor such as on the streets homeless, versus security, a clean bed with medications and supervision and counseling and et cetera.


What I am curious about is to debate mental hospitals as public (government) funded versus private funded. Are there any private funded ones (other than the spas for the Beverly Hills celebrities)? Automobile insurance industry rules require companies to accept some percent of higher risk cases, in order to extend the benefit of insurance not just to the safely profitable but also as a collective consumer benefit. Could we require these $50k per day facilities for Britney and company to also treat (or at least do outreach to) some share of the less able to pay? Could cultural attitudes encourage the mental health hospital infrastructure to have 'pro bono' type treatment, as a public image side to balance their treatment of the rich and famous?

I emotionally sympathize with the desire for more beds at mental health facilities, but that means digging into my pocket via taxes to fund the government facilities (or the prisons, I suppose).

Anyone care to comment, to shift this thread to how to balance Property Rights (my money, my liberty to keep and use it) versus compassionate care provided by government funded institutions? There is a right to the PURSUIT of happiness, but those with mental problems do not have a right to live comfortably on my dime. How much of this compassionate burden to help the mentally needed is or can be shifted to church groups/hospitals or to private industry? The latter would be as pro bono type care (like the lawyer profession) or a regulated percent of people services (like the insurance industry).

9:15 AM, May 22, 2007  
Blogger Helen said...

Anonymous 9:15:

I agree that the mentally ill do not have the right to live comfortably on your dime. In a perfect world, as a libertarian, I do not believe in using force to collect taxes from one group to give to others. That said, if we are living in a world where taxes are paid and we use that money to pay for certain things, why should mental health be given lower priority than say, a bridge to nowhere in Alaska, or federal funding of the homeless but not for the mentally ill? Or for that matter, we are ending up paying even more at times for prisons and jails to care for and house the mentally ill than we would for extra inpatient treatment. So the money is being spent in one way or another. I do not believe in paying more money in taxes to pay for mental hospitals. We pay enough in taxes already.

However, why should my city be pumping money into a public park with walking trails rather than put the money towards opening up more beds in the hospital? Is the walking trail and it's upkeep more important than treating those who are mentally ill? I don't think so but then, that is just my opinion. If we decide to do nothing for the mentally ill, than we should have some liability in our schools, universities and other areas of society should the mentally ill cause harm.

And pro bono work with the mentally ill? It is sometimes a lifelong endeavor--hard to do pro bono work in some quick or fast way with people who may need months or years of care. It can cost upwards of 300.00 per day to treat someone.

9:51 AM, May 22, 2007  
Anonymous TMink said...

Anon, you are missing our points because you do not understand the level of illness that we are addressing. Let me be more specific.

When I was in training, I did some intern work at Middle Tennesse Mental Health Institute. Fancy name for a mental hospital. Let me tell you about Sara (not her real name.)

I met Sara as she followed a staff person to the coke machine. She was in a straight jacket, and her face was more scar tissue than skin. I was quite troubled at what I saw, and worried that she had been abused. I spoke to the director of clinical services about my concerns, he thanked me for my concerns, and suggested I read one of her charts. Plural. This was in the paper days, and she had about 4 feet of charts at that institution.

Sara was the most pervasively self-injurious person I have ever seen or read about. The mutilation of her face was self-inflicted over the last 15 years. If not supervised she would head bang, find a sharp corner and use it to cut a gash in her cheek, rub her skin raw against a screen, and all this while in a straightjacket.

Then there was the time, when she was not in a straightjacket, that she found a piece of glass and sliced open her abdomen. After those lacerations were stitched up, a new doctor ordered her let out of her straightjacket. He was concerned with her liberty and had not read her chart. She was dutifully taken out of her straightjacket, she opened up the lacerations by pulling out the stitches, and began to eat her own body fat.

I could go on.

This is the degree of illness we are discussing. I have not read any insults of you, maybe I missed them. I am not insulting you when I say that you either do not understand or have a different set of morals than I do. I am guessing that you did not uderstand.

I love liberty, mine, yours, and Sara's. But I love her life more. Incidently she did all this while on enough medicine to kill a horse.

There are more Saras in the world. I think they deserve to live more than they deserve to be free to torture and kill themselves. That is what we are talking about, not the willy nilly hospitalization of ecentric people. We are talking about dangerous, ill people who will hurt themselves and/or others.

Now, perhaps we can all discuss on the same level.

Trey

10:43 AM, May 22, 2007  
Anonymous Anonymous said...

I am not missing your points.

I am looking for some metrics, rather than generalities.

A) What are the right number of hospitals and beds per some geospatial area and population size. Or use population density.
Are there any statistics studies that show the number of people in an area and population that are SO MENTALLY ILL that they are a harm to themselves and others; therefore, X number of hospitals with Y number of beds and Z staff people are needed => Minimum infrastructure or median infrastructure needed for the severely mental ill.

B)Given a showing of X,Y,Z numbers, where can the resources be found? Must we assume all the resources are from the public/govt? Can't some of the less severely ill be treated from charity (e.g. domestic violence support centers, suicide prevention lines, employer insurance supporting counseling)?

I think the above questions are beyond the scope of the comments preceding mine.

I'm just curious if any of the psych literature ever looks at the economics viewpoint. I understand that feelings want more than 180 Lakeshore beds: how many more and how do you explain to taxpayers or charity donors that you have the right number versus excessive spending? Explain it numerically, not emotionally. Or are there just no studies available to show any numbers?

I am not criticizing the need, and I would probably say that anecdotal evidence indicates 180 Lakeshore beds is insufficient. It's intellectual curiosity on how to justify the addition beds.

Is there any statistical/demographic evidence, instead of anecdotes? I may emotionally sympathize with you, but I can't use emotion and anecdotes to convince certain of my neighbors. Data is needed.

11:12 AM, May 22, 2007  
Anonymous Anonymous said...

By the way, the DEGREE of mental illness was not specifically defined in the original article, nor did it necessarily stay consistent between commenters.

E.g. from Helen:
"...federal funding of the homeless but not for the mentally ill..."
So maybe that's a place to start: how many homeless are mentally ill enough for involuntary (or voluntary) institutionalization. Percents for permanent and temporary (less than six months) instituionalization desired.

My cousin was autistic. He lived in a support community as an adult. Is he in the "mentally ill" definition, or some other assistance category? Another cousin has Down's Syndrome. Is there a pie chart anywhere for the 'needs permanent assistance' people versus the percent source/cause of the need?

11:22 AM, May 22, 2007  
Anonymous TMink said...

Anon, I think you are missing the human element. Data is helpful in terms of politics. Treatment is necessary in terms of lives.

And perhaps you are another anon, it is impossible to keep y'all straight. Why not think up some name to help us regulars out? Please.

Cause another anon was talking about freedom, not funding. I was addressing my remarks to that anon. If that was not you, get a name! If that was you, why are you changing the point of discussion? We were talking about freedom and morality.

Trey

11:24 AM, May 22, 2007  
Anonymous Anonymous said...

"Lakeshore Mental Health Institute, a facility that has downsized from 2400 beds in 1970 to about 180 beds today."

It IS about the funding. There's a big gap between 2400 and 180. Money is not independent from the concept of freedom. Jamestown succeeded because of private property rights. I am a human element too, who needs to provide three square and a roof for my family.

But since I'm keying on a different perspective, guess it should be on my own blog site, someday. Sorry to have bothered you. Thanks for the dialogue.

A 9:51,11:12,11:22, and this.

11:38 AM, May 22, 2007  
Anonymous Bugs said...

Jesus, now I'm starting to miss Lakeshore...

11:44 AM, May 22, 2007  
Blogger br549 said...

bugs!

11:57 AM, May 22, 2007  
Anonymous Still TMink said...

Anon, I just want to have a coherent discussion with you, not to run you off. My agenda with you is to get more engaged. Perhaps we disagree, but that is part of the fun. If I have offended you, I appologize, that has not been my intent but I am clumsy about these things sometimes.

This is TMink, Trey, I posted with another name to show how easy it is to do. So stick around, disagree, show us where we are wrong. Please.

Trey

11:58 AM, May 22, 2007  
Blogger br549 said...

That goes for me too, anon.

If I was short or sharp, I am sincerely sorry. It gets hard to tell a real anon from a troll anon at times.

12:33 PM, May 22, 2007  
Anonymous Anonymous said...

You're not running me off or offending me.

I started off wrong: introduced too many parts of a multi-variable problem. I should have just started with the 2400 versus 180 quote, I guess.

My apologies for being confusing; something I'm working on. I don't feel link restarting (since I need to focus on analysis that pays the mortgage for the rest of the week).

I'm sure there'll be an opportunity to restart, in some way, in a future thread. Interesting stuff here. I'll think about the login thing. C.

12:41 PM, May 22, 2007  
Anonymous Anonymous said...

helen-

I can appreciate your position. However, what do you say about those who are a danger to themselves or more importantly, to others? Should there be no coercion then? What about the innocent people who are in their path? Do they have any rights at all?

I didn't say there should be no coercion, just that the rules shouldn't be loosened to allow more coercion or make it easier to use coercion. And of course coercion shouldn't be used on someone that isn't mentally ill. Here's a hypothetical for you:

Some neighbors and/or coworkers start a harassment campaign against someone involving the commission of crimes and torts - threats, death threats, harassment, stalking. This person justifiably becomes angry. Now these people claim to be "afraid" and want to have this person falsely classified as mentally ill to avoid any of the consequences of their actions. Should it be easier to falsely classify someone as mentally ill, so that these criminals can assault and abuse someone using the mental health system, feel "safe", avoid criminal and civil liability, silence and discredit a victim of their criminal behavior, etc.? Of course not. And we shouldn't make it easier for them to waste mental health resources to try to avoid the consequences of their actions. Same goes for people trying to swindle money, get the upper hand in legal disputes, avoid malpractice liability, etc, etc, etc...

1:22 PM, May 22, 2007  
Anonymous Anonymous said...

br549-

You have just enough knowledge to expose your lack of experience with the severity of some types of mental illness - i.e., "yes, briefly". I believe you are talking out of the same orifice Jim Cary spoke through at one of the Academy Awards ceremonies.

I believe you are being an obnoxious dolt that has absolutely no idea what experience I have. (There is experience that can be documented and experience that can't be.)

Try losing your home, life savings, 25 year career, and having to pack up your children and literally move out of state (as recommended strongly by the doctors involved) to get away from an individual whose rights exceed yours and your children. The only people the person "goes off on" are immediate family. How do you explain it to your belt buckle tall kids?

I have no way of evaluating the veracity of this. For all I know you could be the mentally ill one and the person you are "running" from could be the normal one.

Imagine it is also the one person in your life that you at one time loved with every fiber of your being. How do you deal with the promise you made, among others, of "in sickness and in health"? I've never figured it out. You'd give anything, you've already given everything. All you can do is reach a place that allows you to keep on keeping on...I could write a book on what we've been through. Yet I can't for the life of me, understand what has happened.

Again, you could be the mentally ill one. Happens all the time in divorces - the wife makes false claims against the husband to get the upper hand. How are we going to protect people from false mental illness claims?

1:34 PM, May 22, 2007  
Anonymous Anonymous said...

Com-box discussions read like the parable of the blind men and the elephant. The legs, trunk, tail and sides of the elephant are all elephant, but each commenter wants emphasis only (or primarily) on their part of the elephant because, in their mind, it is most important or most overlooked part.

Quasimodo

1:35 PM, May 22, 2007  
Blogger knoxwhirled said...

Dr. Helen,

About ten years ago I had a friend who worked for Helen Ross McNabb, checking in on ten to twenty clients per week, most of them schizophrenics who lived alone in some sort of subsidized housing. She said that over and over again they would go off their medications, wander the streets, until inevitably she would get a call from police or a shelter. She'd get them resettled and back on meds, and the cycle would start all over again. There's got to be a better way, and it seems the closing of mental health facilities is a big part of the problem.

(re: Lakeshore... Lakeshore is smack in the middle of one of the most high-profile, ritziest neighborhoods in Knoxville. Unfortunately, I can't say I'm surprised that funds that could be better spent elsewhere are being used to glam it up.)

1:40 PM, May 22, 2007  
Anonymous Anonymous said...

anonymous 9:15-

There is a right to the PURSUIT of happiness, but those with mental problems do not have a right to live comfortably on my dime.

There is also not a right for criminals to use the mental health system to abuse, destroy, and steal from others. (Often so they can live comfortably on someone else's dime.)

And about the "pursuit" thing: It can be a crime and/or tort for someone to restrict, prevent, or sabotage your "pursuit". In fact, that's what a lot of criminal and tort laws are designed to protect against.

1:43 PM, May 22, 2007  
Anonymous Anonymous said...

Quasimodo-

Com-box discussions read like the parable of the blind men and the elephant. The legs, trunk, tail and sides of the elephant are all elephant, but each commenter wants emphasis only (or primarily) on their part of the elephant because, in their mind, it is most important or most overlooked part.

Competent, objective fact-finding -i.e. not getting less than half the story from one side in a dispute - helps with these "dilemmas".

1:50 PM, May 22, 2007  
Anonymous Anonymous said...

tmink-

Your story about the self-mutilator is sufficiently distasteful. But that individual would be identifiable without loosening the rules for involuntary commitment. So you're sort of making my point for me.

1:55 PM, May 22, 2007  
Blogger serket said...

60 Minutes did a segment on hospitals in California dumping homeless patients on the street.

2:56 PM, May 22, 2007  
Anonymous Bugs said...

I can't really address anon(1)'s fear of loosening the rules for involuntary incarceration/ treatment because I don't know what the rules are. I can understand his fear because the scenarios he paints are indeed frightening. What I don't know is that our current system really allows those kinds of things to happen, or that they would necessarily happen if the laws were changed. I like to think we've learned a few things since Rosemary Kennedy's day. But maybe I'm too optimistic...

3:14 PM, May 22, 2007  
Anonymous TMink said...

Anon wrote: "But that individual would be identifiable without loosening the rules for involuntary commitment. So you're sort of making my point for me."

I think you are missing the point anon. Take it in context, it was written in response to someone, maybe you, that was arguing against involuntary commitment. I guess that you agree that this person needs to be committed against their will.

So now, if you are willing, we can have a discussion about who else should be committed against their will. It is your turn to add to the discussion. Who else should or should not be institutionalized?

And pick a phony name please. It is easy and helpful.

Trey

3:16 PM, May 22, 2007  
Anonymous TMink said...

Anon wrote: "And we shouldn't make it easier for them to waste mental health resources to try to avoid the consequences of their actions. Same goes for people trying to swindle money, get the upper hand in legal disputes, avoid malpractice liability, etc, etc, etc..."

We totally agree anon. Using mental illness as an excuse to avoid responsibility or a tool to defraud someone is reprehensible.

I think we are all against anything that would promote that sort of chicanery.

Trey

3:22 PM, May 22, 2007  
Anonymous Anonymous said...

tmink-

I think you are missing the point anon. Take it in context, it was written in response to someone, maybe you, that was arguing against involuntary commitment. I guess that you agree that this person needs to be committed against their will.

We seem to be partly talking past each other. In this thread I have been arguing against substantially weakening the controls against involuntary commitment. As I acknowledged above there are some individuals for which this is appropriate, like the case you described.

So now, if you are willing, we can have a discussion about who else should be committed against their will. It is your turn to add to the discussion. Who else should or should not be institutionalized?

Ok - I'll start with my desired corrections to the nuanced involuntary commitment laws of all 50 states. (kidding) I don't know the law of all 50 states, nor do I pretend to. I was just generally stating that I don't think its a good idea to decrease the controls on involuntary commitment since the stakes are so high and there are likely some fraudulent or erroneous commitments already occurring.

As I said earlier in the thread, I think it should be very difficult to involuntarily commit someone. If someone can't feed themselves or rudimentarily clean themselves or is in danger of dying from exposure it is probably warranted. (Note the goal is to look for extreme incompetence, not some anal type checking to see if everyone's eating their brussel sprouts.)

6:33 PM, May 22, 2007  
Blogger br549 said...

I'm "anoned" out on this thread.

So, anon 1:34, I understand where you say that perhaps I am the mentally ill one, how would you know? I agree with your statement. Anything's possible.

Actually, only people with a piece of paper from some hospital or doctor stating they are indeed of sound mind can say for sure they are not mentally ill. That leaves the rest of us out.

As far as being an obnoxious dolt, I did apologize for that earlier, thinking it was you I was apologizing to. That apology has now been retracted, though, since reading your 1:34 reply.

I am running from no one. It was a strong suggestion, as stated, and by the professionals that were/are-10 years later- dealing with my still not yet ex. It was for the kids, not me. I'm a male, by the way, in case there is any confusion over that as well.

But my opinion still stands that at least as far as my situation is concerned, your "yes, briefly" says more than anything else you have had to say in this thread. But that's just me.

7:02 PM, May 22, 2007  
Anonymous Anonymous said...

It seems obvious to me.

You loosen the controls, and you get more criminals abusing the system. Tighten the controls, and you get less criminal abuse, but more nuts wandering the streets endangering themselves and others.

There is not a perfect solution here.

And I've seen all sides of this issue. I know someone who has court-ordered meds, who has occasionally thought they didn't need them, and then slowly went nuts when they went off them (yup, a paranoid schizophrenic--it seems from an earlier comment that this is ordinary among schizophrenics). I've also seen this person given treatments, electroshock therapy, that were decidedly bad. And lastly, I've been the victim of persecution by secret report (although we beat it off successfully, with considerable strain on my equanamity.)

So, I've seen all sides of this, and would say thus:

1. I'm not a Libertarian, and this is one of the reasons why. I prefer Reality with its complexities to a simplistic ideology. This is not to say, I don't like Libertarianism...its a good place to start, and a bad place to end. Coercion is neccessary at times, at certain extremes.

2. Sometimes injustice, negligence, outright cruelty, and gross examples of moral stupidity occur in the pshcyological professions. One might argue that this profession was founded in organized cruelty as they used electroshock to cure shellshock in WW1.

3. There is a reason the Constitution requires one to be able to face one's accusers. Its a primary method of keeping character assassination within bounds.

The strong and the sane do have an obligation to the weak and the insane. If you see a man in a wheelchair fall into a river, you have an obligation to try to save him. If you see a man living on a street corner because the Voices won't leave him alone, and he screeches like a monkey at anyone who tries to help him, and you know that a few pills would take him out of his terror and pain and misery and maybe let him smile just a little bit because he might never be truly happy, then do you not have an obligation as well?

Tennwriter

7:16 PM, May 22, 2007  
Blogger br549 said...

What??

10:24 PM, May 22, 2007  
Anonymous Anonymous said...

br549-

But my opinion still stands that at least as far as my situation is concerned, your "yes, briefly" says more than anything else you have had to say in this thread. But that's just me.

And my response stands that there is experience that can be documented and experience that can't be, and that you have no idea what kind of experiences I've had. "Yes, briefly" refers to hands on experience - there is also education, training, and outside reading.

And as far as Constitutional, civil, and human rights are concerned, you don't need any particular kind of experience to have opinions on those.

12:09 AM, May 23, 2007  
Anonymous Anonymous said...

Tennwriter-

You loosen the controls, and you get more criminals abusing the system. Tighten the controls, and you get less criminal abuse, but more nuts wandering the streets endangering themselves and others.

And as the founding fathers opined, its better to let 10 of the guilty go free than to falsely convict one of the innocent. I feel its better to side with them.

And lastly, I've been the victim of persecution by secret report (although we beat it off successfully, with considerable strain on my equanamity.)

This is interesting. Can you go into more detail - what happened, how you beat it, what resources you used, etc.?

I'm not a Libertarian, and this is one of the reasons why. I prefer Reality with its complexities to a simplistic ideology. This is not to say, I don't like Libertarianism...its a good place to start, and a bad place to end. Coercion is neccessary at times, at certain extremes.

Libertarianism is perhaps the most realistic political philosophy, so your comment seems sort of odd. And libertarianism doesn't preclude coercion.

Sometimes injustice, negligence, outright cruelty, and gross examples of moral stupidity occur in the pshcyological professions. One might argue that this profession was founded in organized cruelty as they used electroshock to cure shellshock in WW1.

I agree. And what makes them dangerous is that often they can violate someone's Constitutional, civil, and human rights unilaterally, without facing all the protections the founding fathers built into the criminal and civil justice systems.

If you see a man living on a street corner because the Voices won't leave him alone, and he screeches like a monkey at anyone who tries to help him, and you know that a few pills would take him out of his terror and pain and misery and maybe let him smile just a little bit because he might never be truly happy, then do you not have an obligation as well?

Of course if he's a normal person and the reason he is screaming at those trying to "help" is because they seem to be enabling whatever is responsible for him waking up bleeding out the rectum that tends to indicate that he isn't crazy. Something tells me stopping those trying to "help" him, sueing them into the ground, and locking them up will get him a lot closer to true happiness. Because the drugs just cause side effects for normal people. (And waste money for some while making money for others.)

12:25 AM, May 23, 2007  
Anonymous TMink said...

Anon wrote: "We seem to be partly talking past each other."

I am sorry about that. I love engaging in thoughtful discussion with people on the blog. And I am sorry we are having trouble doing that. One reason is your using anon instead of some convienent and secure screen name. I can't keep track of the various people posting under the same name. Please select and post under an assumed name. I would like to communicate more easily with you, and that would help us a lot.

Having said that, you wrote: "If someone can't feed themselves or rudimentarily clean themselves or is in danger of dying from exposure it is probably warranted."

If I could delete "probably" I would have been proud to write that sentence.

(Note the goal is to look for extreme incompetence, not some anal type checking to see if everyone's eating their brussel sprouts.)

I would have been proud to write that sentence verbatim. You were correct, we were missing each other's point. Good catch.

Part of ths miss I think is that I come at the problem from a treatment perspective while you may not. And another part of the problem likely lies in the conduct of some of my colleagues who have provided poor, greedy, or incompetent services.

Psychology, Social Work, and related fields are funny professions. Funny peculiar. We are selected for graduate school based on our expressed interest, grades in college, research abilities, and GRE scores. Then we are let loose in a field that is rife with snags for people with power issues.

The people that come to see us are vulnerable and easily abused. I sit in a small room with a closed door talking to children, teens, and adults about their sexual abuse for a good part of most days. Talk about vulnerability.

Because of this, as well as the issues of liberty, strong accountability is demanded of our professions. But we also get an inside picture of the way lives are devastated by not getting the treatment, and sometimes, very rarely, coerced treatment they need to survive.

So I think you and I agree almost completely, we just come to the agreement from different perspectives carrying differing concerns.

Trey

10:36 AM, May 23, 2007  
Anonymous Anonymous said...

Anon,
I too would prefer a screen name.

Lakeshore went from 2200 to 180. Thats more than 10 to 1. There's always going to be some innocent who gets abused. You have to weigh that against some innocent who needs help. I think we've gone way too far one way, beyond the Founder's stance on criminals even. Its a matter of judgement.

As to my personal horror story, I'd rather not go into details. We pointed out the absolute idiocy of some of the charges, clarified misrepresentations, I called the investigator a 'Stalinist' since they wouldn't let me know who accused us, and eventually I pointed out someone who was a potential real problem. Mostly we endured.

Libertarianism tends to preclude coercion in the case of someone who is actively dangerous to themselves. It also precludes coercion in the case of someone who genuinely needs help, but because of paranoia refuses it.

I refuse your contention that Libertarianism is the most realistic ideology. If that was true, then yes, my view would seem odd. But since Social Conservatism, a mish-mash of sometimes conflicting ideas, is more realistic.

Or we could just say "Are not" "Are too".

Indeed, there are abuses, but I and the others point out actual problems happening now or in our recent history. Real problems. Not hypothetical. I, me, personally know someone who would have refused meds, and been absolutely miserable and messed up for the rest of their life, and been a danger to others.

I'm eccentric at times. I'm not advocating for people who are a bit weird getting tossed in the asylum. No one is advocating for that. We're advocating that people with real, dead obvious problems get the help they need, even if they don't want it, at least at first.

Tennwriter

2:35 PM, May 23, 2007  
Anonymous Cousin Dave said...

To the various anons: Oliver Sacks, to name one, has repeatedly demonstrated that there exist a considerable number of "right brain" injuries and dysfunctions which, among other things, render the sufferer incapable of recognizing that he has a problem. Libertarianism is based on the premise that all adults know more or less what's best for them, and will act out of (more or less enlightened) self-interest. However, in the case of a person who suffers from a problem that makes them both self-destructive and incapable of realizing that they are so, the fundemental assumption of Libertarianism is broken. Then what do you do? More often then not, a person who is self-destructive will eventually also become destructive to others. There isn't an easy answer. Just stating that no such person should ever be involuntarily subject to treatment is an attempt to find an easy answer. Further, it's an answer that we have been conducing a three-decade-long experiment on now, and it isn't working. At some point you have to yeild to the evidence.

I've just found a Surgeon General's report from 2001 that estimates that, on average, in any given year 3% of the American population suffers from both a mental illness and a drug addiction simultaneously. If one accepts the premise that this group constitutes most of the ones who require extended in-patient treatment to have any hope of improving, then we can use this as a rule of thumb to estimate the number of mental patient treatment beds required in a given area. I'm going to assume, because I can't find any data right now, that the population of the Knoxville metro area is around 900K (it appears to be similar in population to Birmingham, which numbers a bit over a million in the 2000 census). 3% of 900K is 3000. That would be in line with the Lakeshore facility having had 2000 beds in 1970, assuming that the percentage of the population we're discussing has remained at around 3% since that time. I do not know if there are other mental treatment facilities in Knoxville now, but Lakeshore's current 180 beds would appear to be woefully inadequate.

3:48 PM, May 23, 2007  
Blogger Helen said...

Cousin Dave,

The Knoxville metro area is 616,079 as of 2000, probably more now--good guess.

5:28 PM, May 23, 2007  
Anonymous Anonymous said...

Tennwriter-

There's always going to be some innocent who gets abused. You have to weigh that against some innocent who needs help.

That's no excuse for making it easier for innocents to be abused.

As to my personal horror story, I'd rather not go into details. We pointed out the absolute idiocy of some of the charges, clarified misrepresentations, I called the investigator a 'Stalinist' since they wouldn't let me know who accused us, and eventually I pointed out someone who was a potential real problem. Mostly we endured.

That's unfortunate, I would like to hear about it. Were there any resources on-line or anywhere else that were particularly helpful? Or any resources you've seen since that would have helped you when you were in the thick of things?

Libertarianism tends to preclude coercion in the case of someone who is actively dangerous to themselves.

Where do you get this? Libertarians may be against loose involuntary commitment laws, but they do recognize a need when someone is in danger of dying from exposure, for instance.

It also precludes coercion in the case of someone who genuinely needs help, but because of paranoia refuses it.

Well I can see this because it is easily abused as a vehicle for fraud. Calling someone "paranoid" is argument by definition. Like "denial". Since one can't prove a negative, it can be used for all kinds of malfeasance.

I refuse your contention that Libertarianism is the most realistic ideology. If that was true, then yes, my view would seem odd. But since Social Conservatism, a mish-mash of sometimes conflicting ideas, is more realistic.

Strongly disagree here. Social Conservativism rests on trying to legislate morality and taste, and pushing your opinions on others through force. All wasting a lot of taxpayer money and creating a lot of unnecessary strife and degradation. It's also a vehicle for hypocrisy, blackmail, secrecy, and corruption. Libertarianism is much more realistic in this area. But you are right, discussions of this do tend to degenerate into "is too", "is not" sessions.

I, me, personally know someone who would have refused meds, and been absolutely miserable and messed up for the rest of their life, and been a danger to others.

And there are also numerous stories of people having their lives destroyed and sometimes taken through abusive, coercive, involuntary psychiatric/psychological intervention.

I'm eccentric at times. I'm not advocating for people who are a bit weird getting tossed in the asylum. No one is advocating for that. We're advocating that people with real, dead obvious problems get the help they need, even if they don't want it, at least at first.

That's what you say, but the devil is in the details. There are screw-ups, crimes, and atrocities happening now, with our supposedly rigid involuntary commitment laws. Loosening them would just result in even more abuse.

1:48 AM, May 24, 2007  
Anonymous Anonymous said...

cousin dave-

To the various anons: Oliver Sacks, to name one, has repeatedly demonstrated that there exist a considerable number of "right brain" injuries and dysfunctions which, among other things, render the sufferer incapable of recognizing that he has a problem.

And this is more argument by definition. If you want to discredit someone, have a corrupt, degreed parrot claim they are "self-destructive". Since one can't prove a negative, the corrupt mouthpiece always wins.

Libertarianism is based on the premise that all adults know more or less what's best for them, and will act out of (more or less enlightened) self-interest. However, in the case of a person who suffers from a problem that makes them both self-destructive and incapable of realizing that they are so, the fundemental assumption of Libertarianism is broken.

Again, this is nearly all assumption and argument by definition. The Founding Fathers were probably some of the most libertarian figures in American politics, and one could call them "self-destructive". Same for a lot of artists, inventors, writers, revolutionaries, etc. The world would be a duller, drabber, more oppressive place if the busybodies and tyrants that they encountered could have easily grabbed them, threw them in a padded room, and rotted their brains with expensive brain candy.

More often then not, a person who is self-destructive will eventually also become destructive to others. There isn't an easy answer.

That doesn't necessarily follow. And more assumption and argument by definition...

Just stating that no such person should ever be involuntarily subject to treatment is an attempt to find an easy answer.

That wasn't said. I don't think most libertarians would disagree with involuntarily committing someone who couldn't passably feed and clean themselves, or was in danger of dying from exposure. (And again, this doesn't mean some anal type looking over your shoulder to make sure your bed is made and you don't stay up past your bedtime.)

Further, it's an answer that we have been conducing a three-decade-long experiment on now, and it isn't working. At some point you have to yeild to the evidence.

What do you mean? Aside from a slight recent uptick, which I'm suspicious of, violent crime has been declining steadily for much of the recent part of those thirty years. If one was yielding to the evidence one would be saying "don't fix what isn't broken", especially when you're proposing rolling back rights and freedoms and spending lots of money.

2:10 AM, May 24, 2007  
Anonymous TMink said...

Anon wrote about Oliver Sachs: "If you want to discredit someone, have a corrupt, degreed parrot claim they are "self-destructive".

Well, I agree with your point in general about using an appeal to authority, but I must disagree about the insinuation that Oliver Sachs is a corrupt, degreed parrot.

Anyone reading some of his writing would see that it is not the case.

Trey

11:58 AM, May 24, 2007  
Anonymous Anonymous said...

tmink-

Well, I agree with your point in general about using an appeal to authority, but I must disagree about the insinuation that Oliver Sachs is a corrupt, degreed parrot.

I wasn't referring to Oliver Sachs in particular. I don't know much about him. I was referring to the practice of setting up people who are accused of being mentally ill, incompetent, dangerous, etc. by using argument by definition, appeals to authority, etc. to force them into the impossible situation of trying to prove a negative. Terms like "denial" and "paranoid" can be used for this, and given the right situation, "brain injured" probably can be too.

2:12 PM, May 24, 2007  
Anonymous Bugs said...

Speaking of paranoid...

5:34 PM, May 24, 2007  
Anonymous Anonymous said...

Anon.
1)Door one-Innocents get abused. Door Two-innocents get abused. There is no Door Three.

You try to minimize the harm done, but there will be harm done.

I hope you're engaging in rhetorical excess when you say 'no excuse for an innocent to be abused'. Reality is tragic. If you can find a way to avoid this, I'll hail you as a great benefactor of humanity. However, insisting on jury trials for insanity is not a feasible cure. If you say, we need to revisit the procedures to increase justice then fine. I have no issue with trying to find better procedures. However, face this fact, it is likely that an increase in justice would require more people being put away.

Tennwriter

2)Will Davis in Collapsium argues that it is immoral to refuse to let a person engage in a procedure which is known to make them retarded.

I had a Libertarian boss who advocated legalizing cocaine for a weekend so that the drug users could OD themselves and 'raise the level of society'.

Some of the people on this forum sound pretty resistant to helping people, wanting to put the limit way past reasonable.

Libertarians tend to advocate for a right to suicide.

While, yes, there is a spectrum of Libertarian thought, my statement is unfortunately not completely outre'.

3)Unreality.

A) A political program is unrealisic if significant problems are not addressed by it.

B)A pol. prg. is unr. if following it would result in destruction of the nation and/or the community.

C)A pol. prg. is unr. if it has no real chance of succeeding as it is against human nature.

But keep in mind this: I think Ayn Rand was a nut, but without her, we might have been saluting the hammer and sickle this morning....so Libertarians are beneficial as long as they are reigned in.

5:38 PM, May 24, 2007  
Anonymous Anonymous said...

Bugs,
They say brevity is the soul of wit. You're a much wittier, and to the point person than moi.

Tennwriter

5:52 PM, May 24, 2007  
Anonymous Anonymous said...

anonymous 5:38-

1)Door one-Innocents get abused. Door Two-innocents get abused. There is no Door Three.

But one set of abuses involves government carrying out the abuse, government rolling back civil and Constitutional rights, and government spending taxpayer money to do so. It also goes against the principles on which this country was founded. Couple that with a crime rate that has been declining anyway and that door is pretty thoroughly discredited.

I hope you're engaging in rhetorical excess when you say 'no excuse for an innocent to be abused'. Reality is tragic.

Some realities are, but that's no excuse for letting government carry out the abuse, or handing criminals the means to steal and abuse more.

However, insisting on jury trials for insanity is not a feasible cure.

Says you. Many states already require some kind of proceeding when they're following the rules and not corrupted.

I have no issue with trying to find better procedures. However, face this fact, it is likely that an increase in justice would require more people being put away.

Really? How?

7:56 PM, May 24, 2007  
Anonymous Anonymous said...

bugs-

Speaking of paranoid...

Ah yes, I am "paranoid" because I want to prevent psychologists and psychologists - who can be just as corrupt, crazy, greedy, biased, vindictive, cowardly, etc. as the rest of humanity - from being able to violate peoples' civil and Constitutional rights using cheap logical games.

I think you're in denial, bugs. And remember, you can't refute the label I just placed on you because any efforts you make to prove that negative are assumed to be evidence that my assumption is correct - you are just "deeper" in denial. Circular logic at its finest.

8:03 PM, May 24, 2007  
Anonymous Anonymous said...

Correction, should be "cheap logic games" above.

8:04 PM, May 24, 2007  
Anonymous Bugs said...

That makes no sense, and so do I.

8:12 PM, May 24, 2007  
Anonymous Anonymous said...

Anon.

I've already pointed out that we have more than the 10-1 stance you wanted for criminals for the insane with Lakeshore's shrinking.

Mental heath professionals,and ordinary citizens have testified of real, actual events to you. Events they know of from a personal basis, and not hypothetical maybe-ifs.

Unless you're claiming that 90% of the people at Lakeshore in the 70's were there unjustly, then some of the people wandering Knoxville today need to be there. But you're too afraid to help them, besides it might cost you a few bucks.

You are demanding that government never make a mistake. This is adolescent in attitude, which is something I associate with Libertarians. Adolescents think that all the world's problems are easily solved with the right will, and doing the obvious answer.

And our Founders weren't Libertarians, not even close. They loved freedom and liberty as do most Americans, but you look at the Constitution and you see a complicated mish-mash of conflicting ideas. Here's a bit of aristocracy, a little democracy, some dictatorship...a little of this, and a little of that in a profound stew made to a deep understanding of human nature that was far deeper than the surface understanding of a Libertarian. Fact is, I think I said a mish-mash of conflicting ideas was the Socons....seems we're in good company.

Someone is going to die from abuse. Your path makes it more likely to be lots of someones, but at least your hands will be clean because the gov't didn't do anything. It just let it happen. But I was taught that Acts of Ommission could be sins just as Acts of Commission can be.

We already are balanced toward letting the needy die because we didn't do something. How much further should we go? What reforms should we make that would make it okay to help people who desperately need it?

Tennwriter

11:32 PM, May 24, 2007  
Anonymous Anonymous said...

Anon.

Let me say one last thing, and then I at least will quit responding.

As I said, I've been abused by the system. I feel from your attitude that you have been as well, but yours was the mental health system. Now, I know my system has flaws, and I know at least one reform I'd like to make that would clear up a lot of those flaws. I can explain my reform, and the reason behind it.

I also can say the system that abused me has a useful, and even noble purpose, and it should not be disbanded.

You need to gain that sense of perspective. See things in a whole, balanced fashion, and not just see what injustice was done to you, if my speculation is correct.

BTW, Socons are kewl, Libertarians drool...:/

Tennwriter

11:39 PM, May 24, 2007  
Blogger Chris G said...

Just dipping my big toe into the Dr. Helen pool of consciousness here, but the water feels great. I'm going to have to be a regular reader.

Being involved in the Home and Community Based Services waiver, I have to agree that discharging from institutional settings to community based is fine as long as the appropriate supports are available, funded and in place. Unfortunately, there recently seems to be a trend of "patient dumping" from one system to another to make INDIVIDUALS someone else's budget problem, disregared the actual care needed.

Chris
My Blog

1:34 AM, May 25, 2007  
Anonymous Bugs said...

Chris,

Sounds like what possibly happened to Cho, the VT shooter. Bureaucracy at its best.

P.S. - Apologies to anonymous.

9:57 AM, May 25, 2007  
Anonymous Bugs said...

P.P.S. - Weekly Standard article discusses exactly this issue:

http://www.weeklystandard.com/Content/Public/Articles/000/000/013/679vkrbg.asp

1:00 PM, May 25, 2007  
Blogger Helen said...

Bugs,

Thanks, interesting article by Sally Satel. I will post it as an update.

1:58 PM, May 25, 2007  
Anonymous Anonymous said...

bugs-

That makes no sense, and so do I.

Sure it does. This is how "mental health professionals" use argument by definition: I label you as "paranoid", "in denial", or "brain injured" and claim you have some kind of mental illness. If you claim that you aren't mentally ill, I say that your claims that you aren't mentally ill are actually symptoms that you are - "you're too sick to realize you need help", "you're deep in denial", "you're too paranoid to get the help you need". It's circular logic - I interpret whatever happens as support for my argument:

- You agree you are mentally ill - I was right

- You just ignore me - you're in denial, I was right

- You claim you aren't mentally ill - you're in denial or "too paranoid" to get help, I'm still right

Do you see how this is circular logic? Do you see how using these self-serving arguments I can never be wrong - that I'm implying infallibility, omniscience, etc.?

4:32 PM, May 25, 2007  
Anonymous Anonymous said...

Tennwriter-

I've already pointed out that we have more than the 10-1 stance you wanted for criminals for the insane with Lakeshore's shrinking.

Actually we don't, the criminal justice process and the mental health system aren't exact comparisons.

Unless you're claiming that 90% of the people at Lakeshore in the 70's were there unjustly, then some of the people wandering Knoxville today need to be there. But you're too afraid to help them, besides it might cost you a few bucks.

The trend in Knoxville was similar to the trend across the country. By your logic there should have been an immense crime wave and Ghostbusters-style chaos and lawlessness - where is it? Crime has actually trended down, so apparently a lot of those people didn't need to be imprisoned and have their rights violated.

I realize some will say that all those people are all languishing away because they are not getting "treatment", but that doesn't stop people from charitable contributions and trying to use persuasion rather than coercion to help these people get "treatment", if that's what you believe they need.

And the money taken for those kinds of things doesn't hurt just me, it hurts society and future generations, because capital investment is depleted.

You are demanding that government never make a mistake. This is adolescent in attitude, which is something I associate with Libertarians. Adolescents think that all the world's problems are easily solved with the right will, and doing the obvious answer.

Ah, yes. When our arguments fall short we resort to the snide, indirect ad hominem attack of infantilization. Unfortunately what you're engaging in is projection. Your views are actually the infantile ones - its children, the insecure, and the immature that want to force their opinions and tastes on others. The immaturity of the spoiled tyrant.

Adults realize that it is wrong to force their opinions, tastes, and choices on others. And to violate the rights of others. That's why libertarianism is realistic, mature, and adult.

And our Founders weren't Libertarians, not even close. They loved freedom and liberty as do most Americans, but you look at the Constitution and you see a complicated mish-mash of conflicting ideas. Here's a bit of aristocracy, a little democracy, some dictatorship...a little of this, and a little of that in a profound stew made to a deep understanding of human nature that was far deeper than the surface understanding of a Libertarian. Fact is, I think I said a mish-mash of conflicting ideas was the Socons....seems we're in good company.

I don't know where you're getting this, the founding fathers were quite libertarian. Distrustful of government power. Distrustful of executive power. Distrustful of standing armies. Distrustful of money not backed by stable commodities. Distrustful of majority rule and the possibility of majority oppression. Distrustful of state-backed religion. Etc, etc, etc... All very libertarian.

Someone is going to die from abuse. Your path makes it more likely to be lots of someones, but at least your hands will be clean because the gov't didn't do anything. It just let it happen. But I was taught that Acts of Ommission could be sins just as Acts of Commission can be.

Your reasoning doesn't follow. It doesn't follow that using the current rules will result in "lots of someone's" dying of abuse. In fact, the statistics show the opposite. All the people freed in the 70s and 80s didn't cause this huge crime wave, so your "lots of someones" dying didn't appear. So your reasoning has been proven wrong.

We already are balanced toward letting the needy die because we didn't do something.

Where are you getting this?

What reforms should we make that would make it okay to help people who desperately need it?

The crime statistics have been declining, so there doesn't appear to be major problems with the current rules. If you believe there are people who need help, charitable outreach using persuasion rather than coercion would be the way to go. (Charitable as in using your own money or money freely given to you, not money stolen from others.)

5:18 PM, May 25, 2007  
Blogger Helen said...

anonymous 5:18:

You state: "The crime statistics have been declining, so there doesn't appear to be major problems with the current rules. If you believe there are people who need help, charitable outreach using persuasion rather than coercion would be the way to go."

What you don't mention is that prisons and jails are the new asylums for the mentally ill--many of the severely mentally ill are not out in the community--they are behind bars. There are around 500,000 mentally ill people serving time in prisons and jails and only 55,000 in mental hosptitals. We are paying for the mentally ill anyway, whether you like it or not.

Before the 1970's and deinstitutionalization, the trend was just the opposite. I don't see how the mentally ill being in prison is a step in the right direction toward the "freedom" you seem to be so interested in for the severely mentally ill. A jail cell hardly seems like freedom and many prisons and jails have no clue as to how to deal with the mentally ill.

7:14 PM, May 25, 2007  
Anonymous Anonymous said...

helen-

What you don't mention is that prisons and jails are the new asylums for the mentally ill--many of the severely mentally ill are not out in the community--they are behind bars. There are around 500,000 mentally ill people serving time in prisons and jails and only 55,000 in mental hosptitals. We are paying for the mentally ill anyway, whether you like it or not.

Before the 1970's and deinstitutionalization, the trend was just the opposite. I don't see how the mentally ill being in prison is a step in the right direction toward the "freedom" you seem to be so interested in for the severely mentally ill. A jail cell hardly seems like freedom and many prisons and jails have no clue as to how to deal with the mentally ill.


What you're saying is true to an extent. If you want to change it loosen the insanity defense, add some screening, and take the prison money to fund some inpatient facilities. All that can be done without changing the involuntary commitment laws.

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8:59 PM, April 13, 2009  
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2:45 AM, April 21, 2009  
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2:43 AM, June 08, 2009  

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