Boeing4ever
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Should The US Start A Mental Health Policy?

Mon Jan 10, 2011 11:42 pm

In the wake of the shootings in Tuscon, we have the usual questions about gun control.

But what always gets me is how the perpetrators of these crimes showed clear signs of being unhinged, yet nothing was really done, or in this case, not enough.

A lot has been said about the closure of mental health facilities in the US. Some members in the gun control thread have even pointed out that Switzerland, with it's high rate of gun ownership, has less than a fraction of the level of gun violence in the US. The answer here lies in our national psyche.

There are a lot of people who may have serious issues and could be a threat to either themselves or others, yet we don't seem to have any sort of policy or even debate about what should be done.

I of course welcome the recent trend in denouncing political commentators on left wing and right wing organizations like MSNBC and FOX, and this should continue as they are directly responsible for the poor state of political discourse in this country.

But we shouldn't ignore the mental health component to this. Jared Laughner is quoted as having "scared the living crap" out of his fellow students and faculty at Pima Community College. He had a long history of disturbing events where everytime he opened his mouth his words were "cringe inducing". How can someone like this be out in public unsupervised to begin with?

Let the discussion begin...

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DocLightning
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RE: Should The US Start A Mental Health Policy?

Mon Jan 10, 2011 11:51 pm

You run into a real problem with civil rights and competence issues.

There are countless stories of people who were having some trouble, and wound up being committed to psych hospital by overzealous staff. On the other hand, in this young man's case, it's pretty obvious that he is a schizophrenic with paranoid-delusional ideation. It's as if he stepped right out of the page in the psychiatry textbook.

There needs to be a system for providing services to keep the public safe, and it would also drastically cut the homeless population. There are people who genuinely cannot function in (in any society) and the American policy of just leaving them to rot on the streets is not only cruel, but it's a threat to public safety. Some of them, like this young man, are actively violent. Others simply present a pure safety hazard (they wander into traffic, push dangerously overloaded shopping carts down the street, urinate and defecate on the sidewalks, etc.)

It was one of the many shames of the Reagan administration and it needs to be reversed. I sincerely hope this incident leads to the re-opening of the asylums.
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Arrow
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:05 am

The most diffiicult thing to assess (almost impossible in my opinion) is at what point does someone's mental abberration pose a threat to human health and safety. For every nut bar outed by friends and associates AFTER he's run amok -- like this guy in Arizona -- there's probably 100 who appear equally whacko and yet pose no threat to society at all. Ya can't lock 'em all up because they're a little warped; it's impossible to know where to draw the line, and civil liberties in a modern democracy ensure that the line is far enough out that the "innocent until proven guilty" philosophy holds true.

Your only hope is to keep firearms out of the hands of people like that -- and even that (given the fairly lax controls in the US in general) requires drawing lines in places that civil libertarians argue shouldn't be drawn.

Quoting Boeing4ever (Thread starter):
The answer here lies in our national psyche.

Sadly, that's the truth. It seems that gun ownership is a sacred right in the US and as long as that remains firmly entrenched in the national psyche there will continue to be sporadic acts of gun violence that kills innocent people. It happens in other places in the world, too, but apparently not at anything like the same rate. Anyone have the stats on that?
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san747
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:14 am

Mental health issues are very hard to take a solid stance on for the reasons explained above: defining what the line is, what constitutes "public danger" and civil rights issues that go along with the labels.

But another aspect is that most of the American public is uneducated as to what mental illness truly is and IMO I don't think it's a good idea to open up the public discussion on the issue until people are better educated on it. I realize that being informed on an issue has never been a requirement for Americans to pipe out their opinion on it, but I feel like this is one issue that should not be treated so flippantly.
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kiwiinoz
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:35 am

Mental health is such an underrated problem the world over. This is largely because of so many unknowns about the various illnesses and therefore the politicians reluctance to spend good money on it.

Apart from mental health, there is also not enough support for "normal" people going through a crisis. Some people wkith no apparent mental health issues can snap with the right triggers. Law enforcement in particular are not typically well trained to recognise and deal with this.

Definitely a "yes" reply to this thread title, (and the other one too!)
 
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:40 am

Quoting Boeing4ever (Thread starter):
I of course welcome the recent trend in denouncing political commentators on left wing and right wing organizations like MSNBC and FOX, and this should continue as they are directly responsible for the poor state of political discourse in this country.

Eh, I can't blame a TV network for trying to make money. You get what you pay for. If no one watched those networks, they wouldn't exist.

Quoting Boeing4ever (Thread starter):
How can someone like this be out in public unsupervised to begin with?

Who's going to stop him?

I've been scared of people before. And I'm sure I've scared people before too. But I don't think I should be in an asylum. But then again, am I really the best judge of my own mental sanity?

It's gotta be a tough call.

I'm all for having more facilities and services for those who may be mentally deficient or lacking in whatever way. But at what point does someone move from simply being "eccentric" to being "crazy"?
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Derico
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:44 am

Mental health is very frowned upon in many countries, compared to Argentina for example. Certainly in the rest of Latin America, but even in the United States.

If you say ''I'm going to the psychologist'' in Argentina, it is seen as completely normal, just like a child going to a pediatrician, or an elderly to the geriatric ward, or going to the ophtalmologist, etc, etc. In fact, I would say 50% of the people I know have gone to one at some point, or their medical coverage sent them to one. No one would say 50% of the country is mentally ill or has brain problems. Just like going to the dentist doesn't mean all your teeth are falling off. It's either preventive medicine or general welfare.

I remember the first time I told this to a Brazilian girl when I was on a tour in Europe: she reacted as though I may be capable of killing someone. Hahaha, thankfully I was able to recover somewhat (with explanation and a bit of lying), but I don't think she ever saw me quite the same. It has also happened with US acquaintances or friends, and I have noticed that if you say that to people in the United States, some will immediately assume you are disturbed.

Argentina is famous for it's use of the ''shrink'' in the mass populace, it's probably overused too. But unless you grow up in a place that has more acceptance for mental health, it is hard to realize how restrictive the mindset is in other places. And that's how it seems to me, that in other countries it is a near taboo subject or otherwise if you go to a psychologist (not psychiatrist!!), you must be borderline unginged.
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san747
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:55 am

Quoting Derico (Reply 6):

Argentina is famous for it's use of the ''shrink'' in the mass populace, it's probably overused too. But unless you grow up in a place that has more acceptance for mental health, it is hard to realize how restrictive the mindset is in other places. And that's how it seems to me, that in other countries it is a near taboo subject or otherwise if you go to a psychologist (not psychiatrist!!), you must be borderline unginged.

Agreed. In a culture that equates ANY mental health issue with "CRAZY!", compassion and understanding towards someone who is say, feeling depressed, just doesn't really exist. It's a big reason why I'm going to school to become a counselor/therapist- I want to be the person that people who are suffering feel they can come to without judgment or bias.
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ltbewr
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 1:07 am

One other factor is that the USA does not have a 'single payer' or univeral right to health care and many private plans severely limit access or payment for mental/psychlogical health care. Add to that the general attitudes in the USA unlike many other countries that looks at mental/psyclogical illness as a very fearful problem to be avoided and not honestly talked about.
 
TheCommodore
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 1:32 am

Quoting DocLightning (Reply 1):
You run into a real problem with civil rights and competence issues.

Why should that pose a problem ?

Surely, the greater good of America, far outweighs one's individual civil "rights"

Quoting kiwiinoz (Reply 4):
Definitely a "yes" reply to this thread title, (and the other one too!)

I echo those sentiments.

Quoting ltbewr (Reply 8):
One other factor is that the USA does not have a 'single payer' or univeral right to health care and many private plans severely limit access or payment for mental/psychlogical health care.

Yes, America needs to address general health policy's for the everyday general public. Something that seems to be a real difficulty for American politicians to sort out. Why not just have a general health coverage for all US citizens, whether you are employed or not, rich or poor ?
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UH60FtRucker
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 1:39 am

Absolutely!!!!

It was a huge mistake to close so many mental hospitals. I would have no problem spending taxpayer money to contain these nuts.

All this pussyfooting around is just silly. Yes, I totally get it... some people have depression issues, or anxiety issues, or whatever, and that does not make them "crazy." But in this push to be so damn sensitive towards everyone's malfunctions, we tend to ignore the fact that there are indeed crazy people! I'm talking about absolute unstable nuts, who struggle/fail to integrate themselves into society. We all know some of these people, and there's no reason we should be catering to their sensitivities.

Lock 'em up!

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[Edited 2011-01-10 17:44:42]
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Boeing4ever
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 1:39 am

Quoting Arrow (Reply 2):

Gun control is a separate thread.

Quoting vikkyvik (Reply 5):
Eh, I can't blame a TV network for trying to make money. You get what you pay for. If no one watched those networks, they wouldn't exist.

And hopefully these commentators will find themselves without viewers soon.

Anyway...

A lot of good points here.

The US spends more time debating gun control, etc, but almost no attention to the root causes of violent behavior. The tool is one thing, but time and time again, the nuts who lash out showed warning signs.

A big problem is the stigma we place on mental health services. Plenty of normal individuals (however you define normal) may simply need to reach out, could be under tremendous pressure, or have a condition that doesn't lend itself to violent behavior. Yet we stigmatize those that seek such therapy.

How does one pick the nuts out of the produce section?

Another great point brought up, civil liberties, and drawing a line between "eccentric" and "crazy".

But while we all have rights, if one has twisted mental capacities and is truly a danger to themselves or others, can they really be trust with the rights given to them? While the lines may be "blurred" as some have pointed out, both the VT shooter and the one in Tuscon had already been referred to mental health professionals. At that point, it was clear both needed supervision, but they were still to be out in public.

So in those instances when the line isn't blurred, what do we do with those who are a real danger to society?

It's been pointed out that we've closed down a lot of asylums and facilities meant to hold these individuals. Now does anyone have any statistics showing the trend in violence linked to unstable individuals and the closures of these facilities?

Something is clearly broken.

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PPVRA
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 1:54 am

Quoting Boeing4ever (Reply 12):
So in those instances when the line isn't blurred, what do we do with those who are a real danger to society?

Excluding the benefit of hindsight, how do you know the line wasn't blurred? To me that's not so clear. Pushing doctors to declare people insane doesn't sound like a great idea either, just like the opposite wouldn't be good either. Maybe the system, as is, is about as good as it can be; minimizing those who get away and cause trouble, but also minimizing those who end up in some cruel institution where they shouldn't be.
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RottenRay
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:00 am

Quoting san747 (Reply 7):
compassion and understanding towards someone who is say, feeling depressed, just doesn't really exist


This is true - you only need to look at the bulk of pop entertainment as it exists today to see this.

I'm comparing "special living environment" reality shows today which pit person against person to "family" shows of the past like Leave it to Beaver, Brady Bunch, et al.

In general, civility isn't as popular as conflict - we've gone from enchantingly, nauseatingly polite to Big Brother in 3 generations.

Does art imitate life, or is life imitating art?



Quoting Boeing4ever (Reply 11):

The US spends more time debating gun control, etc, but almost no attention to the root causes of violent behavior


Again true, and I think at least a part of the reason for this is that gun control is a hot political issue while research into violent behavior is rather boring and research in general has been painted as wasteful of taxpayer money by many political action committees.

It's all research into the mating of fruit flies, and so forth.



Quoting PPVRA (Reply 12):
Excluding the benefit of hindsight, how do you know the line wasn't blurred?


Loughner doesn't appear to have documented his plans to the great level of detail which Harris and Klebold (Columbine) did, but even in the Columbine instance there was a large body of evidence before the fact that the boys were unhealthy. Harris was already under psychiatric care at the time of their killing spree.

This pretty much went ignored - using the standards of "the bad old days," both of these kids would most likely have been committed before they went on their killing spree.



Quoting UH60FtRucker (Reply 10):
It was a huge mistake to close so many mental hospitals.


The only folks who are truly happy about this are the urban exploration hobbyists - there are lots of neat moldy old hospitals which are easy to break into and photograph.



Cheers!

(corrected spelling)

[Edited 2011-01-10 19:10:18]
 
Boeing4ever
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:02 am

The point on hindsight, while valid, seems to be losing relevance IMO.

Columbine, VT, Tuscon, workplace shootings, etc. Often times, yes through hindsight, these wackos have shown clear signs.

It just seems disturbing to me that we often see these signs and do little about them. And I'm not talking about a quirk or two, I'm talking documented threatening or violent behavior. In the case of Jared Loughner, I'm afraid it wasn't really hindsight. He was kicked out of his community college with his return conditioned on his ability to get a mental health professional to certify he wasn't a danger to himself or others. At this point it was clear how far over the line he was. This never happened, and Loughner just floated away, rambling on Youtube before he finally lashed out.

In the case of the other shootings I listed above, it also wasn't hindsight. Manifestos, hit lists, etc where all created by the perpetrators. These are not simple eccentricities where it would be "wrong" to have these people committed.

I'm not sure the line is as blurry as we make it out to be. I think part of it is a fear of backlash should we do something. Back in HS, I was threatened by someone who had a hit list. He already had a documented past of making threats and exhibiting violent behavior. I'm sorry, but that is not eccentric behavior by any stretch of the imagination. BTW, I reported this student and after an investigation into the matter to verify the claims, the student was dealt with. I think it worked out for everyone involved as who knows what could have happened had I done nothing, especially knowing about his past.

I'm not saying everyone with a mental issue should be locked up. In fact, quite the contrary, many with mental issues can still function in society.

We need to take a hard look at how we approach the issue of mental health. I think this country has a seriously flawed policy in place.

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[Edited 2011-01-10 19:06:21]
 
TheCommodore
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:09 am

Quoting Boeing4ever (Reply 11):
The US spends more time debating gun control, etc, but almost no attention to the root causes of violent behavior. The tool is one thing, but time and time again, the nuts who lash out showed warning signs.

Wow. Here's an example.

I just learned that the state of California spends more on Jails and inmates, than they do on schooling !
Maybe its an overreaction on my part, but I find that VERY disturbing indeed. If the scales are out of whack that much, then I wouldn't even begin to imagine how America is going to address that problem, let alone have a sensible debate about gun control.

That's unbelievable, what has gone wrong over there.

[Edited 2011-01-10 19:11:12]
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Boeing4ever
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:18 am

Quoting TheCommodore (Reply 15):

The gun control debate is a separate thread. You've been warned.

In fact, with such attempts to derail on a topic that isn't as "hot" or as "politically active" as gun control, it's no surprise we have had no real debate on mental health in the US.

In fact, I find your whole tone that my thread is somehow representative of some sort of a skewed priority highly offensive and agenda ridden, but unfortunately typical of what happens after such acts of violence. A lot of people are actually afraid to deal with the real root cause.

Just how long as we going to keep our heads in the sand? When someone starts scrawling hit lists, the issue isn't his access to any sort of weapons, but why he isn't under some sort of supervision at all!

Again, has any hard look been taken at the closure of mental health facilities, asylums, etc, and the rise of violent acts by unstable individuals? Has anyone bothered, or is this too boring for everyone?

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TheCommodore
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:38 am

Quoting Boeing4ever (Reply 16):
The gun control debate is a separate thread. You've been warned.

You are the one who mentioned gun control in first sentence of your opening thread !

And not only that, it has been mentioned by several other posters in this thread

So drop the attitude please of "warning people off"

Quoting Boeing4ever (Reply 16):
In fact, I find your whole tone that my thread is somehow representative of some sort of a skewed priority highly offensive and agenda ridden, but unfortunately typical of what happens after such acts of violence. A lot of people are actually afraid to deal with the real root cause.

No idea of what you on about with this.

I simply replied to something you wrote. There is no tone in my reply to you what so ever.
Mental health is a problem all over the world, better dealt with in some countries than others. maybe America could look at how other nations cope with this problem and learn from this. Just a thought.
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Boeing4ever
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:47 am

Quoting TheCommodore (Reply 17):
You are the one who mentioned gun control in first sentence of your opening thread !

And not only that, it has been mentioned by several other posters in this thread

So drop the attitude please of "warning people off"

The point of my mentioning it was that it wasn't the main issue behind violent behavior, and that as a whole we don't do a good job of keeping those who harm themselves and others from actually doing so.

Quoting TheCommodore (Reply 17):
No idea of what you on about with this.

I simply replied to something you wrote. There is no tone in my reply to you what so ever.
Mental health is a problem all over the world, better dealt with in some countries than others. maybe America could look at how other nations cope with this problem and learn from this. Just a thought.

Your reply first went on about prisons, for whatever reason. You then stated that "how can the US be expected to have a sensible debate on gun control" with "these scales out of whack", which you can see how I took as a statement that my assertion that we spend more time debating gun control then how we deal with mental health was "out of whack". I may be misinterpreting your intent. I'm sorry, but this thread is a debate about mental health. There's another thread about the gun control debate.

Now here's a question... How does Australia deal with mental health issues, specifically with those who present themselves as a danger to others? I'm not slagging off Australia, I'm actually interested. After all this is a world wide problem, but clearly policies in the US are letting a lot of violent people out into society. Does Australia have any sort of asylum system where unhinged and potentially violent individuals are committed and monitored?

How about other countries?

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TheCommodore
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:59 am

Ok, now we got that sorted.
 
Quoting Boeing4ever (Reply 18):
Now here's a question... How does Australia deal with mental health issues, specifically with those who present themselves as a danger to others? I'm not slagging off Australia,

We have our issues here too, don't you worry.

Australia is plagued with mental health issues, its not one of our "good points" I don't think. And very few Governments have the will to do too much about it.

Below is the latest Aust Gov report on "mental health for 2010.

http://www.health.gov.au/internet/me...alth/publishing.nsf/content/home-1

I think we have one of the highest youth rates of suicide in the western world, no one seems to know why that is, just one of life's little mysteries perhaps.
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lowrider
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 4:01 am

Quoting Arrow (Reply 2):
The most diffiicult thing to assess (almost impossible in my opinion) is at what point does someone's mental abberration pose a threat to human health and safety.

I think that is the core of the problem? There is no bright line that a person crosses from being a little eccentric to an actual threat? Also, what behavior are we going to deem criminal? And there is also the issue of locking people up who haven't yet committed any offense. Google "Definition of Mental Health", and you will get over 15 million entries. There is no consensus on what mentally healthy is. It is one of those things that seems to defy quantification.

Quoting Arrow (Reply 2):
Ya can't lock 'em all up because they're a little warped

If they did, most of us would be posting from asylums.
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n229nw
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 4:12 am

There is debate to be had--but there are certainly no simple answers.

Quoting UH60FtRucker (Reply 10):
All this pussyfooting around is just silly. Yes, I totally get it... some people have depression issues, or anxiety issues, or whatever, and that does not make them "crazy." But in this push to be so damn sensitive towards everyone's malfunctions, we tend to ignore the fact that there are indeed crazy people! I'm talking about absolute unstable nuts, who struggle/fail to integrate themselves into society. We all know some of these people, and there's no reason we should be catering to their sensitivities.

I find that idea really disturbing. I mean on one level, it would be a comfort to think that anyone who might hurt you was locked away. But there are HUGE problems with that, moral and practical.

1.) In many cases it is difficult or impossible to determine who is potentially dangerous and who is not, however out of touch they may be with reality.

2.) Any system that seems to "punish" people for being mentally ill stigmatizes and discourages others from seeking mental health counseling and care when they need it, which can have the effect of increasing the amount of mental anguish and mental illness in society.

3.) Detaining against their will large numbers of people who have not committed any crimes is a VERY slippery slope in terms of rights, a slippery slope that can be exploited by people looking for vengeance or power, by corrupt medical systems, and by governments. In fact, it is an easy tool of totalitarianism and can easily reach a state where it has much more detrimental effects of society as a whole than an occasional, unpredictable murder.

Not easy reading, but have a look at books such as Madness and Civilization (and also related Discipline and Punish) both by Michel Foucault, about the history of mental illness and the way society has defined it in different times and places.

No matter what, you can't make the world safe. The number of random murders by deranged people is tiny compared to drunk driving deaths for example. I'd rather punish more drunk drivers...

Quoting TheCommodore (Reply 15):
I just learned that the state of California spends more on Jails and inmates, than they do on schooling !
Maybe its an overreaction on my part, but I find that VERY disturbing indeed.
Quoting Boeing4ever (Reply 16):

In fact, I find your whole tone that my thread is somehow representative of some sort of a skewed priority highly offensive and agenda ridden, but unfortunately typical of what happens after such acts of violence. A lot of people are actually afraid to deal with the real root cause.

I don't think that is really a thread hijack, though it seems to go against what the same poster himself wrote earlier in the thread. The amount of money spent on prisons, and the number of people locked up, in this country, must have something to do with this debate. We lock up way more people than other countries which in spite of that fact end up with much lower crime rates, and the question of whether locking people away helps or hurts society in the long run is a valid part of this discussion. The answers probably aren't simple. But if you want to discuss this issue in a way that goes beyond populism and sound bites, I think it is a dimension that will certainly come into play.

Quoting Derico (Reply 6):
Mental health is very frowned upon in many countries, compared to Argentina for example. Certainly in the rest of Latin America, but even in the United States.

I don't know if that's still the case in the US. I believe nearly 40% of university students in this country for example are taking anti-depressant/anti-anxiety medication, and counseling certainly isn't frowned on in many circles.
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san747
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 4:14 am

Here's an interesting article on how the media and our culture overall views mental illness and its relationship to violent acts like this:

http://www.slate.com/id/2280619/

As much as the problem of adequately dealing with severe mental illness in this country is, the problem of automatically labeling someone who commits an act like this as mentally ill is just as bad. No one labelled Nidal Malik Hasan insane when he shot up Fort Hood because his motives were obviously political, so why do we all assume Jared Loughner is insane, despite clear evidence of political motives behind his act as well?
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Superfly
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 8:39 am

The book and movie; 'One Flew Over The Cookoo's' next was part of the movement to shut down these facilities.

Quoting Boeing4ever (Reply 11):
Another great point brought up, civil liberties, and drawing a line between "eccentric" and "crazy".


Since I'm a chubby-chaser, does that make me "eccentric" or "crazy"?


I am in favor of bringing back the Nuthouses for the common good of all. In the old days, did the the family of the crazy person have any say?

Quoting vikkyvik (Reply 5):
And I'm sure I've scared people before too. But I don't think I should be in an asylum. But then again, am I really the best judge of my own mental sanity?


Yes, you scared me when I met you and yes you should be in an asylum because you like Vapor Trails and Snakes & Arrows over Caress Of Steel and Hemispheres!  

(that is a Rush reference folks)


You I wonder if there was a guy in 1961 that insisted on driving a 1927 Lincoln if he would be considered crazy and put away in a nuthouse.

Quoting DocLightning (Reply 1):
It was one of the many shames of the Reagan administration and it needs to be reversed.


  
It's mindblowing that people put Reagan on a pedestal.

Quoting n229nw (Reply 21):
I believe nearly 40% of university students in this country for example are taking anti-depressant/anti-anxiety medication, and counseling certainly isn't frowned on in many circles.


Many college professors are on meds too and I can think of few that should be put in an asylum. I never forget having a professor throw a temper tantrum in class because no one volunteered to give her a ride to the nearest BART station. No joke!
She was a statistics professor too.
I also have a physics professor that never showered or brushed his teeth. I think the university had to step in and address this problem. He made a student vomit just by walking past his desk. Oh my gosh he smelled horrible!
These were all tenured professors mind you. None of these professors could ever survive in a business setting with this sort of behavior.

Quoting san747 (Reply 22):
No one labelled Nidal Malik Hasan insane when he shot up Fort Hood because his motives were obviously political,


....and religious.
Nidal Malik Hasan's actions were consistent with his fellow Islamic terrorist. He even shouted out while he was shooting what his killings was all about.
Of course that didn't stop pundits in the media and the President from jumping out and saying not to 'jump to conclusions'.  
Quoting san747 (Reply 22):
so why do we all assume Jared Loughner is insane, despite clear evidence of political motives behind his act as well?


Simple. There is no movement or organization that is out to kill Congress members and constituents to speak off. I haven't heard Obama and the media warning us to not jump to conclusions on this case.
Members of Congress are already using this trajedy as an excuse to pass more authoritarian laws. Never mind the fact that laws already on the books would have prevented Loughner from legally purchasing a gun.
The FBI failed to enforce laws already on the books.
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jessbp
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 10:38 am

THis debate is fascinating and a little scary. I'll admit right here that I suffer from mental health issues. I have Bi-Polar disorder type 2. What does this mean, well It means that my low swinging moods are worse than my hi swinging moods. Both can be dangerous, but only to me. For example. When I'm on an upcycle, I'm fun loving, free flowing and I can spend money like it's water. When I'm down though, I can find it hard to get up and can and have harm myself. That said, I'm a active member of my community, and I cope well out in the world. A lot of this comes from understanding my condition and knowing my limits. If I'm at a point where I'm likely to not 'Know my limits' then my partner will make sure I'm safe.

I only mention this as it's possible under some of the proposals here would see locked away based solely on my diagnoses and not on my ability to function. It's not that I don't understand the sentiment. Three times in the last 13 years I've been referred to secure mental health units for assessment, and believe me, there are some scary people there. I'm fortunate that I've never had to stay there.

Asylums are a good idea though, I'm not against the idea. releasing the severely mentally ill, the paranoid schizophrenic back into the general population with no idea where to go or support will result in the problems we see today with homelessness and mental health. But when it comes to asylums, you need to ensure that staff are well trained, and not little more than bullies, that doctors are there to help, not see the asylum as their personal plaything to test weird and disturbing treatments. These places should be run to a national standard, with the same, recognized treatments used in each. That insures the poor patients, who, no matter what a lot of people think, didn't ask to be struck down with these horrible conditions are looked after well, whist the rest of us on the outside are protected.

But even reopening the asylums isn't the whole answer. There has to be a good level of mental health clinics in communities to ensure that those who, through proper treatment and therapy can be returned to society, and helped reintegrate with the kind of support that's missing.

that's just my 2cents worth.
 
ltbewr
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 12:29 pm

It is impossible and not desirable in many ways to return to the government run 'asylums' for those with manageable mental/psychological health problems. In the USA, many asylums and large facilities to detain the mentally/psychologically ill were shut down for a number of reasons.

New drugs and treatments were developed that meant many didn't have to be institutionalized. The stigma of ever being in such institutions was devastating, limiting employment and social activities, making their conditions worse. In the late 1960's and early 1970's, many stories were published in newspapers and magazines about the horrible and inhumane conditions, the financial corruption of managers stealing the money for themselves and not their patient's use. Too many poorly paid and trained workers who only believed they were there to babysit and collect a paycheck. Many structures were functionally and practically obsolete, needed extensive and very expensive renovations. Then led to many governments and politicians who wanted to shut down these facilities to reduce the costs of government or shift monies to more jails, social programs that were more financially efficient and meant more positive publicity to them.

I would note that many our prison system have considerable mental/psychological illness, often compounded by illegal drug use and alcohol abuse and not getting the proper treatment; indeed their incarceration may make their problems far worse.

Still we need to expand well structured residential mental health facilities, to be part of our communities, to not have the stigma of the old institutions, to help those that need it and perhaps prevent them causing harm to themselves and others.
 
kiwiinoz
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 2:01 pm

Quoting jessbp (Reply 24):
that's just my 2cents worth.

Well, considering your perspective, your contribution is probably worth a little more than 2 cents, (at least compared to our contribution anyway)

I have lost a couple of people to mental illness, and I think it's tougher than any other, (physical) affliction, as so many people close to the victims question their own actions and support, believing that they could have helped more. They probably could, but very few people know how, or they are just scared.

I also believe that there are some beautiful "damaged" people out there that have made incredible contributions to society/humanity, in spite of their illness, and sometimes, amazingly as a result of their illness. I would love to see a world without these afflictions but I still believe we are far better as humans for embracing these people rather than wholesale, "send them to the loony bin"
 
oly720man
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 2:05 pm

Quoting ltbewr (Reply 25):
In the late 1960's and early 1970's, many stories were published in newspapers and magazines about the horrible and inhumane conditions, the financial corruption of managers stealing the money for themselves and not their patient's use. Too many poorly paid and trained workers who only believed they were there to babysit and collect a paycheck.

You can say that today about quite a few care homes for the elderly (in the UK at least) that are run as profit making businesses with seemingly little regard for what they're actually meant to be doing.

http://www.timesonline.co.uk/tol/news/politics/article2260659.ece
http://www.telegraph.co.uk/news/ukne...-elderly-abused-in-care-homes.html


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Dreadnought
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 2:22 pm

Quoting lowrider (Reply 20):
Also, what behavior are we going to deem criminal? And there is also the issue of locking people up who haven't yet committed any offense.

That's the Big Question. The difference between someone who is looney toons but harmless and someone who could really hurt you is completely subjective. Who makes that choice? Political appointees are easily corrupted. Psychiatrists might well be qualified but they will tend to commit simply because it represents more business for his profession. Panels of psychiatrists will do no different. You could do a full court but that would be outrageously expensive, and you'd be putting the decision into the hands of a non-expert.

Quoting n229nw (Reply 21):
I believe nearly 40% of university students in this country for example are taking anti-depressant/anti-anxiety medication, and counseling certainly isn't frowned on in many circles.

For that I blame the medical/pharmaceutical industry. There is no reason to believe that people are more depressed/anxious than they were 200 years ago. We've been sold a bill of goods that there is a pill for just about anything that ails you.

I was once diagnosed as clinically depressed. No sh&t - I had lost my job and was having trouble finding another and I was eating up my savings. That's not a medical condition, that's life! They wanted to give me pills for it. Bunch of BS - I needed to get a job, not take pills. And I did eventually.

University students on medication for anxiety? Well, you have exams and the realization that you are fast approaching the date where you cease to be a child sucking on your parents' teat and have to go out in the real world and support yourself. Of course you're going to be anxious! That's called life - it's not a medical condition.

Don't compare these things with true mental illness - people who don't know where/who/what they are, schizoids etc.
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AM744
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 3:40 pm

Quoting ltbewr (Reply 8):
One other factor is that the USA does not have a 'single payer' or univeral right to health care and many private plans severely limit access or payment for mental/psychlogical health care.

That's the case in my neck of the woods. Regular private insurance policies explicitly precludes mental issues. Even if a facial paralysis is deemed to stem from stress, insurance won't cover it, let alone more serious conditions. There needs to be an economic incentive to deal with this.
 
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DocLightning
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 5:58 pm

Quoting lowrider (Reply 20):
There is no bright line that a person crosses from being a little eccentric to an actual threat? Also, what behavior are we going to deem criminal?

No, but when people start speaking incoherently and babble in this manner, it's pretty unambiguous that they need medication. The vast majority of paranoid-delusional schizophrenics are harmless, but that doesn't mean that they shouldn't get treatment. There are a number of very good antipsychotic medications out there that don't have the horrible side-effects that the originals had.

BTW, Electroconvulsive therapy (shown very inaccurately in "one flew over the Cuckoo's nest") is worthless in schizophrenia. It is good for one thing and one thing only: major depressive disorder. It is far more effective than antidepressant medication and has far fewer side-effects. The downside is cost. ECT is *ALWAYS* done under general anesthesia and that makes it expensive.
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lowrider
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 6:21 pm

Quoting DocLightning (Reply 30):
but that doesn't mean that they shouldn't get treatment.

There are vast gulfs between what people should do, and what they can be forced by law to do. It is not to far in the past that it was thought that homosexuals should get treatment, too. There is also a vast difference between providing resources for people who want treatment, and mandating that people must get treatment. In in any sort of national mental health policy, I fear the likelihood of the latter, because I think it is where the government will tend to go. Of course some people might say that makes me paranoid, and therefore in need of treatment.
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Aaron747
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 6:43 pm

Quoting n229nw (Reply 21):
I believe nearly 40% of university students in this country for example are taking anti-depressant/anti-anxiety medication

Is this supposed to be a good thing? Long-term effects of SSRI medications are still relatively unstudied and kids popping benzos like Xanax or Valium left and right become habitual users with terrible withdrawal syndromes later. As other posters have alluded to, all this indicates is successful Big Pharma initiatives coupled with complacent (or worse, lazy) psychiatrists.
If you need someone to blame / throw a rock in the air / you'll hit someone guilty
 
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DocLightning
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 6:48 pm

Quoting lowrider (Reply 31):

There are vast gulfs between what people should do, and what they can be forced by law to do. It is not to far in the past that it was thought that homosexuals should get treatment, too.

The difference is competence. I think that being unable to complete a sentence is a bit different than the prejudice that lead to the "treatment of homosexuals."

The problem with mental illness is that it affects competence and there is no single unambiguous standard for competence. But while I think that competent people should have the right to do what they like, people who are not competent (like children) cannot have that freedom.

We already have systems in place by which someone's competence is determined inadequate. It takes a physician and a judge. My 18yo patient with Down's Syndrome is one such example.

Is it abusable? Yes. It will never be immune to that. But one hopes that by requiring multiple professionals who are not personally linked to the patient to attest that the patient is incompetent, we can reduce the number of competent people who are forcibly treated.

One classical symptom of paranoid-delusional ideation is the idea that an external force (in this country usually the Government... in other societies, aliens or deities) is directly inserting thoughts into your brain.
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"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
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hka098
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 6:50 pm

No. I don't want anyone coming after me...
 
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n229nw
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 8:24 pm

It's funny that several posters have responded to the statistic about college kids on SSRIs in my post (which I mainly used as evidence that I don't think seeing a counselor or psychiatrist is stigmatized in this country as much as it used to be), in response to Derico.

I think, however, that my much more important points were the other part of the post (post 21).

Quoting Aaron747 (Reply 32):
Is this supposed to be a good thing? Long-term effects of SSRI medications are still relatively unstudied

It's probably not a good thing in the long term, though it really isn't one of the great problems facing the world either. One small positive effect it may have is that kids who need help do not feel embarassed or stigmatized if they seek it.

Quoting Aaron747 (Reply 32):
all this indicates is successful Big Pharma initiatives coupled with complacent (or worse, lazy) psychiatrists.

The downside, as you and others suggest, is the quality of a lot of the help they get. There is a lot of poor, lazy, complacent care, and there is indeed (as in all medicine) the downside of the Big Pharma lobby. That is not unrelated to the debate in this thread either...
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san747
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 8:44 pm

Quoting Dreadnought (Reply 28):

I was once diagnosed as clinically depressed. No sh&t - I had lost my job and was having trouble finding another and I was eating up my savings. That's not a medical condition, that's life! They wanted to give me pills for it. Bunch of BS - I needed to get a job, not take pills. And I did eventually.

University students on medication for anxiety? Well, you have exams and the realization that you are fast approaching the date where you cease to be a child sucking on your parents' teat and have to go out in the real world and support yourself. Of course you're going to be anxious! That's called life - it's not a medical condition.

I hope you understand the difference between what you experienced and true clinical depression- to me, you seem like a classic misdiagnosis. People fallaciously equate depression with sadness- I can't tell you how many people have told me, "You have depression? I know exactly what that's like, my dog died last year and I was really depressed."

The truth of the matter is true clinical depression is nothing like that. It's a chemical imbalance in the brain and it's not something one can just "get over" or "suck up" (despite what just about everyone else in my life, none of whom have depression themselves, have told me). This isn't even to mention the myriad of people who don't even believe I'm truly depressed because I'm not "sad" 100% of the time.

Medication along with therapy and doing positive things in your daily life (establishing a strong support network of friends and family, working towards concrete goals and accomplishments) are the ways you treat and eventually cure yourself of depression.

It's a good sign you noticed that you weren't truly depressed, because most people either think any time they're sad, they're depressed or they don't even acknowledge that depression is a true condition, both of which are harmful to those of us who do actually live with the condition.

Quoting Aaron747 (Reply 32):

Is this supposed to be a good thing? Long-term effects of SSRI medications are still relatively unstudied and kids popping benzos like Xanax or Valium left and right become habitual users with terrible withdrawal syndromes later.

Medication has done myself and many others a lot of good, and I've seen the negative effects of people who clearly have clinical depression and anxiety who don't take meds for it. There is nothing that makes my blood boil more than people who blindly question the validity of anti-depressants/anti-anxiety meds, especially from people who have personally called me stupid or a sucker for "drugging" myself.
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jessbp
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RE: Should The US Start A Mental Health Policy?

Tue Jan 11, 2011 11:24 pm

Quoting san747 (Reply 36):
The truth of the matter is true clinical depression is nothing like that. It's a chemical imbalance in the brain and it's not something one can just "get over" or "suck up" (despite what just about everyone else in my life, none of whom have depression themselves, have told me). This isn't even to mention the myriad of people who don't even believe I'm truly depressed because I'm not "sad" 100% of the time.

I couldn't agree more. True depression has the ability to floor anyone. I know that the worst periods of depression I've experienced in my life have simply left me unable to do anything. There's no reasoning with it. and worst of all, your whole perception changes. But with treatment and support I got through it, and I'll get through it next time.

Quoting san747 (Reply 36):
Medication has done myself and many others a lot of good, and I've seen the negative effects of people who clearly have clinical depression and anxiety who don't take meds for it. There is nothing that makes my blood boil more than people who blindly question the validity of anti-depressants/anti-anxiety meds, especially from people who have personally called me stupid or a sucker for "drugging" myself

At the moment I'm off meds, mostly because I'm stable. But I have a back up of meds for when my moods turn sour. But I do see Aaron747's point. I've had to swap meds periodically and the withdrawal was a bitch. Anti anxiety meds were the worst, but that was the doctors error. He left me on them for three months when 28 days should be the maximum amount of time allowed. After that they actually cause anxiety than prevent. Another doctor left me on a anti depressant for 3 years that left me with a tachycardia!

But I know without the pills, I'd have died several years ago. So San747, I know exactly what you mean, and what you've gone through.
 
lowrider
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RE: Should The US Start A Mental Health Policy?

Wed Jan 12, 2011 3:48 am

Quoting DocLightning (Reply 33):
Yes. It will never be immune to that. But one hopes that by requiring multiple professionals who are not personally linked to the patient to attest that the patient is incompetent, we can reduce the number of competent people who are forcibly treated.

It would also require a certain degree of immunity for th participating professionals. Can you imagine the liability in some states if a person was judged competent, then slipped a gear and went on a killing spree, or found to be a pedophile? Without that protection it is easy to envision a number of people being involuntarily committed as a form of risk mitigation. By the time you finish jumping though all these hoops, how many people are going to be helped and at what cost?
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Aesma
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RE: Should The US Start A Mental Health Policy?

Mon Jan 17, 2011 12:46 pm

Quoting Superfly (Reply 23):
I am in favor of bringing back the Nuthouses for the common good of all. In the old days, did the the family of the crazy person have any say?

Yes, and that's part of the problem, for at least two reasons : someone who should be committed, at least temporarily, but the family won't allow it. Or worse, someone who should not be committed, but the family want to get rid of them for whatever reason (money being on top of the list of course).

Quoting lowrider (Reply 31):
There are vast gulfs between what people should do, and what they can be forced by law to do. It is not to far in the past that it was thought that homosexuals should get treatment, too. There is also a vast difference between providing resources for people who want treatment, and mandating that people must get treatment. In in any sort of national mental health policy, I fear the likelihood of the latter, because I think it is where the government will tend to go. Of course some people might say that makes me paranoid, and therefore in need of treatment.

Well, the premise of the topic is about dealing with the recent shooter before he did it, so if there is no way to force someone to get treatment, then what's the point ?

My father is bipolar so I have that perspective on the issue. He won't harm anybody, and has never been suicidal either, when on the "low wave" he just stays bedded for weeks, and on the "high wave" he buys a lot of stuff (like, 3 engines for his small sailboat, said sailboat, a car...). He has been to the psych clinic several times, I have been there, it's a nice facility with a wooded park with deer and all. It's not for crazy people, mostly depressed people, anorexic etc. Already the ambiance is disturbing.

Now, I love my father, but when he has been "high" for a long time like currently, it's starting to be very difficult to bear. He has restricted access to the money so at least he can't buy expensive stuff anymore, but there are a lot of other little things of life that are annoying. So sometimes I wish he was "low" again, or at the clinic. Not nice I know, and I don't feel good about it. So, imagine if I didn't love him, or if I could get money from his internment !
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lowrider
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RE: Should The US Start A Mental Health Policy?

Mon Jan 17, 2011 8:39 pm

Quoting Aesma (Reply 39):
so if there is no way to force someone to get treatment, then what's the point ?

Indeed. That is what I was heading toward. By your own admission, your father is not a threat to himself or other people. So what grounds are there to force him to get treatment. Having cared for an elderly relative with end stage Alzhiemers, I have some idea of what your struggles might be like. Before we could get power of attorney, we had to convince her to do a lot of things she didn't want to. Every try to reason with someone like that? We cannot force people to get treatment because they are difficult or inconveinent. That is a power just begging to be abused.
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allrite
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RE: Should The US Start A Mental Health Policy?

Tue Jan 18, 2011 12:46 pm

Quoting jessbp (Reply 24):
you need to ensure that staff are well trained, and not little more than bullies, that doctors are there to help, not see the asylum as their personal plaything to test weird and disturbing treatments.

My father worked in psych hospitals and lectured in psych nursing. He remarked, and I have observed this in interviews, that many who study psychiatry are themselves sufferers of psychiatric disorders. I'm not aware of him suffering any himself and his hospital time was before me, but I gather that the work as very difficult and stressful. It's probably difficult to get the best people to work in these facilities, though I'm sure many amazing individuals do.

I doubt if old fashioned asylums are the answer, especially as many psychiatric disorders can be treated now through medication, but there seems to be a great need for services where the mental illness sufferers who pose a threat to themselves or others can be properly and compassionately cared for. At the moment, at least in Australia, the burden falls mainly to the victim's families and the legal system, neither of which are adequately prepared to cope. However, community care is cheap (from the government perspective, though it costs in other ways) and governments are always falling over themselves to show how tough they are with regards to gaoling people.
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hka098
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RE: Should The US Start A Mental Health Policy?

Tue Jan 18, 2011 1:04 pm

Society is never going to stop the crazies that are determined to hurt people. The availability of guns makes no difference. Banning guns, or even making them difficult to obtain only hurts those playing by the rules. Placing a social stigma on those that may have emotional stability issues will force them underground. Even today, mental illness is quietly frowned upon by the establishment or by those that just don't understand it. It's a punch-line. "Has he taken his meds today?" People that need "meds" to function every day are not proud of that fact and often have to deal with irritating side-effects.

Where is the money going to come from, to treat those without the means to obtain proper mental health care? America's medical establishment is based on profit, not treating people. Is the answer to that question, throwing people into state hospitals? Those resources are drying up across the U.S. and the ones that exist may be closer to a prison or human warehouse than a hospital.

A scary piece of rhetoric is the idea of placing a medical decision into the hands of those not qualified to make it. Committal should only be done after a careful evaluation by a certified, practicing physician. How long would it be before not agreeing with a police officer, or the party line makes one insane? That may sound paranoid, but it is a real possibility given that scenario.

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