Maryland Hopes To Get The Potentially Potentially Violent Into Treatment

The U.S. government has been very successful in its effort to lay the blame for mass violence on pathology rather than individuals. The disturbed individual is no longer an individual. He or she now has a psychiatric label, whether bestowed by a doctor or a newspaper reporter, and thus belongs to a grouping of disturbed people. People with psychiatric labels aren’t their own moral agents goes the ruse.  They are adult children instead requiring full or part time professional supervision.

If violence is a matter of pathology rather than choice, fine and dandy, and this pathology is a matter of biology, alright. The thing to do is to catch violent offenders before they violently offend. When his “disease” made him (we’re talking mostly young males here) do it, after all, we’re looking at “diseases” and not individuals. Individuality is not an option. People either conform to custom and law (regardless of whether that custom and law means wearing a suit and tie or a tee-shirt, jeans and ponytail) or they are “diseased”.

The idea of pre-psychosis, although deferred from categorization as a bona fide “mental disorder” in the DSM-5, is back. The Baltimore Sun reports, New Maryland mental health initiative focuses on identifying and treating psychosis. This headline doesn’t tell you everything. Maryland is beefing up it’s mental health police state system in an effort to catch more pre-psychotic pre-killers.

Founded using a $1.2 million state appropriation approved this year, the Center for Excellence on Early Intervention for Serious Mental Illness has a goal of identifying psychosis in a fresh way: by taking notice in the earliest stages and providing support before symptoms spiral out of control.

I guess they think that by busting pre-psychotics they will be preventing psychotic mass murder in the long term. The problem I see with this plan is that you don’t have a psychotic “until symptoms spiral out of control”, and my understanding is that the majority of pre-psychotics don’t go psychotic, and so, by targeting them for treatment, one could be acting in a causative rather than a preventative fashion.

[University of Maryland child and adolescent psychiatrist, Gloria] Reeves and her colleagues say they’re working to ensure patients can live normal lives by short-circuiting the possibility of a deeper psychosis that could intensify if left untreated.

When a patient is already a patient, hey, what have you got? Shallow psychosis or pre-psychosis? In which case prevention is a matter of preventing deep, “deeper” ,or what is known in the trades as ‘full blown’, psychosis? My point is that maybe sometimes it is better to completely prevent the problem by eliminating the doctor patient relationship in its entirety first. Labeling a person “disordered” is the way you make a mental patient. Once a mental patient has been made, and is being subsidized by the state, unmaking a mental patient, unburdening the state of the financial expense, becomes a major problem in itself.

A growing body of research over the past two decades, however, has shown patients are much more responsive to treatment if they’re diagnosed early, and there are early warning signs that suggest when a person is at risk for developing psychosis.

Patients again. If we have more psychosis, but more treatment compliant psychotics, are we 1. upping the number of over all patients labeled psychotic, or 2. lessening the number of disturbed mass gunman in the nation? My feeling is that we are certainly doing # 1 while it is entirely questionable as to whether we’re getting anywhere with # 2.  Next question, do we really want a larger population of psychotics in the nation?

Before you think that the impetus for this measure is entirely medical, let it be known that the funding for this initiative was voted in by the Maryland General Assembly at the prompting of  Governor Martin O’Malley. Mental health treatment then is the state of Maryland‘s answer to massive acts of violence. Of course, this is providing that they’ve got the right suspects, uh, I mean patients, and that pre-psychosis leads to psychosis which, in turn, leads to massive acts of violence. I don’t even think that is a great theory on paper, but Maryland is not the only state that sees the answer to extreme violence in the nation as a matter of increasing the amount of oppression directed against people with psychiatric labels.

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3 Responses

  1. Yes, this is concerning. How “pre” is pre-psychotic? Is this kind of strategy along the lines of NIMH’s (thankfully doomed) Violence Initiative? Are we going to target young males who are poor and living in inner cities? Is that “pre-psychotic” enough? Or should we go further back, perhaps to toddlers diagnosed with ADHD? And I hate this “before they become violent” crap. They’re making it sound like there’s only two types of crazy people: those who have committed violent crimes and those who haven’t yet. You know, I think it’s time for hate speech legislation to be expanded to include the mentally ill as an unidentifiable group.

    • Oops. Obviously, at the end that was supposed to be “as an identifiable group.” Sorry about that.

    • I’m referring to what was proposed as psychosis risk syndrome, and is now referred to as attenuated psychosis syndrome. It essentially means, rather than full blown psychosis, psychosis risk or pre-psychosis. Attenuated psychosis syndrome made section 3 of the DSM-5, that is, insurance won’t cover it, and it is thought to need further study. Be that as it may, as in the article referred to in the above post, some researchers take the matter too seriously for comfort. Should this syndrome make it’s way into the main body of a future revision of the DSM, you should expect the rate of serious mental illness to rise correspondingly.

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