The Myth of The Jail and Prison Treatment Facility

One Deinstitutionalization Is Not Two Deinstitutionalizations

Much bad ink has been spilled over calling the nation’s jails and prisons mental health facilities because of the number of people within their walls who have also been given psychiatric labels. The latest report along these lines claims there are something like 10xs more mental patients who reside in criminal justice facilities than in state hospitals. These numbers come from a study conducted by the Treatment Advocacy Center, the USA’s number one lobbyist for more forced psychiatric drugging, and the National Sheriffs Association. The culprit in this debacle is said to be deinstitutionalization.

Let me start off by saying people don’t go to jails and prisons because they are sick and because they wish to receive medical attention. People are sent to jails and prisons by the courts to receive punishments because they broke the law of the land. Second, state hospitals have traditionally been psychiatric jails and prisons. Merely trading this kind of prison for the other kind of prison doesn’t make a hospital in actual fact. I would say that, given the prison overcrowding problem that comes of three strikes laws, America has grown increasingly intolerant of difference, and law crazy itself. If your way of dealing with bizarre behavior is to outlaw it, your jails and prisons are going to fill with people behaving bizarrely. Bizarre behavior may be a crime, but it is only a disease by a wild stretch of the overactive imagination.

Statistics tell us their own story. For statistics, before we look at those coming from the recent study, let me refer to the Preface of the 2006 book crazy authored by journalist Pete Earley. Earley is another apostle of this blame deinstitutionalization religion. According to Earley, in 1955, there were 560,000 people in state mental hospitals. He speculates not about the numbers of people who might have been referred to as “mentally ill” in prison or jail at that time. Between 1955 and the year 2000, the population jumped from 166 million people to 276 million people. Given this population increase, and no change, the numbers of people in state mental hospitals would have been something like 930,000. Earley gives the present number of people, from maybe a 2002 or thereabouts survey, with “mental illnesses” in jails and prisons at 300,000. He gives the present number in state mental hospitals at 55,000.

Hmmm. Something peculiar is going on here. 500,000 people are unaccounted for. These are the people who, with the population increase figured in, would be in the state mental hospital system if we were still doing business the way we had in 1955. 500,000 people is more than half the number of people we are dealing with in the stats for a later year. You add 55,000 to 300,000 and you are still lacking 205,000 people from the 1955 figure. This is not the kind of figure that supports the contention that deinstitutionalization was a mistake, or that it was a disastrous failure. Instead it would seem to indicate that more and more people described as “mentally ill”, if not fully recovering, are being better integrated into the communities from which they came. This is a coup for least restrictive care, and least restrictive care is something that nobody receives as a prisoner on the locked ward of a state mental hospital.

According to the TAC and NSA research, there are 35,000 people in state hospitals, a 2012 stat, and 356,000 in jails and prison. Wow. We’ve got 20,000 fewer people, referencing the Earley stats, in state mental hospitals than we had 10 or so years earlier! If we’ve got more in jails and prison, too, part of that increase can be explained by population increase. What Earley gave us was something of an estimation based on statistics anyway, but we’re still minus a great number of people who would be “hospitalized” in the year 1955. All in all, I’d call deinstitutionalization a major success story. We’ve still got a lot of people in jails and prisons, given stiffer sentences and overcrowding, who don’t need to be there. One deinstitutionalization success story doesn’t justify an increased amount of institutionalization for another sort of institution.

Blaming violence on “mental illness” is the latest media and political trend. I’d like to remind people that the court of public opinion is not a court of law. We have a supply of the kind of acts, in the present climate, that the media circus demands. Should we look at the number of violent acts committed by people with no experience in the mental health treatment system, I’m sure that those crimes are not decreasing dramatically in number either. Violence is not a symptom of any “mental disorder” in the Diagnostic and Statistical Manual (DSM). When it comes down to it, death is much more likely to be a result of gun fire than it is to be a result of any psychiatric diagnostic label in a mental health professional’s repertoire. I suggest that we will have more success with the problem if we deal with the causes, and I don’t see “illness”, physical nor mental, as one of the primary causes. I would, on the other hand, do something about the climate of suspicion, hatred, and indifference that breeds crime, hardship, and troubles. Here, I think we can actually make a difference if we tried, and that is exactly what we should do.

 

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Violence Begetting Violence

Let there be no mistake about it, the violence bone is not connected to the “mental illness” bone. When we beef up our mental health police force, our mental health system, although the stated aim has something to do with quelling violence, the real aim is to make it look like we’re doing something about violence. This gesture is only cosmetic because any fool should know that 1. “illness” is not the source of violence, and 2. what is commonly referred to as “mental illness” is not literally “illness”.

Discontent is not “illness” officially until the guy with the medical degree gets around to calling it so, and this still doesn’t make it so. Rebellion and disobedience are now official diseases, but that doesn’t make them real diseases either. The big three, schizophrenia, bipolar disorder, and depressive disorder are, when it comes to medical practice, actually three nonsense terms. Deviate from the straight and narrow, and you will be classified as diseased. Believe in the jargon, and you’ve found your religion. Science itself is a little more  skeptical and open minded.

Mental health treatment is actually about social control. The interests of the individual must be suppressed in favor of the interests of the state, according to the state anyway. Politicians, and the robber barons who own them, must always practice vigilance when it comes to preserving their precious status quo. Misfits, non-conformists, and eccentrics are not to be tolerated as they represent a threat to the way things are, and the way things have been. Authenticity itself, exposing a world beyond the uniform, also must be expelled from the life of the community. “Acting out” is only “acting out” where inauthentic “acting in” is the rule.

Pre-schizophrenic disorder (attenuated psychosis risk syndrome), as it is listed in the DSM-5 section 2, is now an official disorder to be covered by insurance. Anyone not schizophrenic already could be suffering from it. Catching the “disease” early is our new answer to massive acts of gun violence in our nation. Understated problem: If you’re doing a sweep for pre-schizophrenics a heck of a lot of potentially violent people are going to slip through your net. Catching people earlier is likely to result in 2 things. 1. You will increase the number of prisoners you’ve got. 2. The violence perpetuated by people who slip through the cracks so to speak in your prison walls will increase.

Technically this presents us with the ongoing dilemma we started with before we started trying to do something about our problem. Technically everybody in the nation is a pre-schizophrenic. If 1 in 4 people get shuttled into a head doctors office in the course of a year, that makes 1 in 4 people “sick”. Keep dreaming. Just because somebody has been caught by the mental health system, or even if somebody has sought “help” so to speak, this doesn’t automatically mean that that person is violent.

3 in 4 people in this country are not “mentally ill” in any given year because 3 in 4 people have not tried to engage in multiple acts of murder. Should he or she kill numerous people,  every armchair shrink in the nation will have this or that person pegged “coo-coo”.  The media, as it has of late, will be having a field day with the amateur, and professional, diagnoses being made. The obvious problem is that we are trying to call violence the result of “sickness”, and averse circumstance “disease”. Neither interpretation is particularly honest.

Dishonesty is the problem, and that hotbed of pure deception, the mental health movement, is the cause. Trading one bad circumstance for another doesn’t accomplish a great deal in the way of producing positive circumstances. Negative circumstances are more likely to provoke violence than positive ones.  Attributing negative circumstances to people with defective genetic material is simply avoiding the facts of the matter. We are all in this world together, even those of us the rest of us would try to shuttle off into the proverbial community closet. Someday, like maybe today, those  “statistics” are going to come back to haunt us.

Mental Health Treatment Is Not Violence Prevention

According to an article in Politico, Sandy Hook spurs states’ mental health push, some states have acted following President Barrack Obama’s call for renewed national focus on mental health.

At least 37 states have increased spending on mental health in the year since Adam Lanza shot dead 20 children, six school employees and his mother in Newtown, Conn. It’s not just about money, either. States are experimenting with new — and sometimes controversial — ways to raise awareness about psychological distress, to make treatment more accessible for children and adults and to keep firearms away from those struggling with mental illness.


Let’s see.

a. Raise awareness about psychological distress…Is that like advertising “mental illness” and its “treatment”?

b. Make treatment more accessible for children and adults…Are we selling mental health services here, and Expanding Those Services (i.e. increasing the numbers of people labeled “mentally ill” and, thereby, as it is put, “served”) of which it is comprised?

c. Keep firearms away from those struggling with mental illness…We have three entities that we have to contend with here.

                    i. people

                    ii. firearms

                    iii. “mental illness”

Although without a known physical presence, theory has it that the third entity, “mental illness”, exists, and that it leads, in turn, when in combination with people and firearms to massive acts of violence against humanity. Problem is, what do we mean by this term, “mental illness”, and when fully one forth of the residents of the United States are thought to have it, does it really have any valid meaning whatsoever?

Schools are screening students, teachers and school employees are being educated on recognizing the signs of “mental illness”, and seminars are being held. I just have a conceptual problem with turning schools into mental health police departments busting more people, and here when we say people we’re talking CHILDREN, for alleged “mental illness”, on the presumption that doing so has anything to do with the rate of violence in this nation.

The most contentious measures are laws passed in more than a dozen states that require some reporting of mental health status as part of background checks for firearms purchases.


Among these ‘contentious measures’ aimed at violating the second amendments rights of citizens who have experienced the mental health system, names have been added to a national criminal database of people deprived of those rights, additionally violating privacy rights and, in New York state, mental health workers are encouraged to report people in therapy in the mental health system, thought potentially dangerous, to the police. Meanwhile, if one scans the news, police officers are shooting unarmed civilians, often thought “mentally ill”, every day of the week, for behaviors perceived as threatening. Were these police officers demented? Not an issue. The person dispatched has to be the one deranged.

“If someone, anyone who interacted with Adam Lanza could have said, ‘There’s something very wrong here’ and gotten him the help he needed …” [Andrewe] Sperling [NAMI’s director of legislative affairs] said.


The presumption here is that Adam Lanza would have thought he needed some kind of help getting on with his affairs rather than that these particular members of society feel they need some kind of help keeping people like Adam Lanza from doing serious harm to large numbers of the American public. I would say that somebody is speaking out of both sides of his mouth, that is, practicing deception. Why deception? People intuitively know better than to expect beefing up the mental health system, on however small a scale, to have a real effective on violence.

Mental health treatment outcomes in this country are, in many cases, dismally bad. Putting more money into ineffective programs are not going to improve those bad outcomes. Although stress is put on the importance of early detection, when it comes to treatment results, once a “mental illness” label has been applied those results are going to worse than they would have been where the person, child or adult, was never labeled in the first place.

A few comments on the recent commitment to dialogue on mental health as a violence prevention measure.

1. I think America does have a problem.

2. I think there are many questions as to whether the national solution won’t actually make matters worse

We need a more tolerant loving country. We need to raise children to grow up to be good people. Blaming the problem on people with “mental illness” is a red herring. People in the mental health system are simply not more inherently violent than people outside of that system and, if anything, studies show them to be less violent. They do face a lot of discrimination and prejudice though. Witness this matter of them, as a block, being blamed for massive acts of violence in this country. This is ignoring the fact that they are us. We’ve got an arrogant gun toting populace, and to get back to the habitable nation we once knew, we are going to have to expend more of the love we lavish on guns, and other material possessions, on people, and people beyond the confines of one’s own immediate nuclear family, however threatened we may feel we may be by this beyond.

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.

Light Reflected Off The Expanding Bubble of Mindless Brain Research

A seminar in New York, at Fordham University School of Law of all places, is “symptomatic”, to use the  wrong word, of what’s wrong in brain research today. Somehow  it is believed that by studying the brains of people thought to be abnormal we are going to figure out how the brain works. If we do so, this line of reasoning presumes, we can end massive acts of violence taking place in the world today. You think?

The story in the New York Times is entitled The Day When Neurons Go on Trial.

Neurons are the new superstars in today’s brain research world. We’ve got neurologists, neuro-scientists, neuro-researchers, neuro-psychiatrists, neuro-philosophers, etc, etc. Who knows? Maybe neuro-attorneys are the next wave. The latest trend is neuro, but neuro with a twist, as nothing in the brain, and especially nothing in brain research, seems to proceed in a straight line.

Over and over, they put questions to a guest speaker, Joshua R. Sanes, director of the Center for Brain Science at Harvard, about the implications for society if and when brain science can identify with confidence a propensity for violence, or for lying.

Dr. Sanes answer was he wished he knew.

It is now believed that diseased circuits caused diseased brains, which we experience as psychiatric disorders, Dr. Sanes said. A student, Brittany Taylor, asked what such broken structures would mean if they cause somebody to commit a crime. “Are we going to look at that as a mitigating circumstance, or are we going to have to change our culpability standards completely?” she asked. What if other parts of the brain were involved, or if environmental factors were influencing the neurons? Could someone say with confidence that the neurons made him do it?

Stupid is as stupid does. If diseased brains are brains with diseased circuits, isn’t it a bit disingenuous to say that diseased circuits cause diseased brains? The cause, it would appear, is still X, and X is basically unknown.

Dr. Sanes reply seemed to be expect a lot of useless information. Following this plea of overwhelming informational overload, Dr. Sanes goes onto make a few predictions, the kind of predictions that could earn him a spot on my projected future column, Psychiatrists Say The Darndest Things.

“Fifteen years from now, somebody is going to say it’s the 489th neuron from the back of your ear that made you do it,” along with a mutant gene, Dr. Sanes said. “That’s going to be hard to dismiss.”

I suspect Dr. Sanes could not imagine himself, as a neuro-science-freak, being the person to have such a couple of willfully rebellious neurons. My own prediction is much more modest. I predict that this Decade of the Brain is likely to be as much of a vacuous bubble, a dud, as the last Decade of the Brain. We still have to make that little leap to consider what many neuro-science-types refuse to consider, namely, that maybe obnoxious and aberrant behavior isn’t entirely determined by biology.

Mental patient forswears hospitalization for punishment in prison

If anybody thinks the horrors of forced psychiatric treatment over blown, Las Vegas Channel 13 ABC News has a story about a man who prefers prison. In fact, so chagrined at his treatment was he that he confessed to murder. I imagine if this man had had a little more patience, he would have been released back into society, eventually, no questions  asked.

The heading to the story reads, Man confesses to murder to get out of psychiatric hospital.

On July 9, a detective with the Las Vegas Metropolitan Police Department received a phone call from [Henry] Perez.

Calls to police stations are fairly common.

Perez told the detective that he wanted to confess to a murder that had occurred several years ago on Calcaterra Circle.

Phone confessions of murder, not so much.

Perez also told the detective that he wanted to confess to the murder because jail was better than being in a mental facility.

There, you’ve heard it straight from the horses mouth. If he has any reason for lying, it isn’t because life is a breeze in the mental hospital.

Perez was being held at Rawson-Neal Psychiatric Hospital. This is the same Rawson-Neal Hospital that received a lot of bad press recently for dumping, via bus ticket, discharged patients in the neighboring state of California. Rawson-Neal actually lost its accreditation over patient dumping incidents.

The under story here is that in the psychiatric hospital, where forensic cases are concerned, that is, where somebody pleaded Not Guilty by Reason of Insanity, the lengths of stay are usually longer than if the prisoner went into a jail, or than if a patient were admitted by the commitment hearing. Cruel and unusual punishment has not become the issue it should be where that cruel and unusual punishment is interpreted ‘treatment for diseases of the mind’.

Apparently, somebody has their civil and human rights work cut out for them.

Mental Health Treatment Is Not Gun Control

The drug industry mental health system propaganda machine is working overtime churning out statistics such as only 40 % of the people in need of mental health treatment are receiving it. These randomized stats beg a number of questions: how much of that treatment is forced, how is need determined,  how many of those people want treatment, do you mean “mental illness” or problems in everyday life, etc., etc., etc.

The government has decided the problem is a mental health problem and not a criminal activities problem. If we pump money into mental health treatment, if we beef up the mental health system, theory goes, we are doing something about massive acts of violence. I, for one, question the complete illogic of this absurd endeavor. The ghosts who commit atrocious acts of violence are not those sore thumbs who are going to get picked up by the mental health cops.

Excuse me, the real reason the government is beefing up the mental health system is to look like the government is doing something to deal with the problem after a series of massive acts of violence in this country. This is a cosmetic matter.  This is an political reputation strategy and a complete diversion. People in the mental health system are not responsible for violence in this country. In a word, they are innocent. They simply didn’t do it.

Mental health treatment, until very recently, has been mostly a matter of treating people who didn’t want to be treated completely against their will and wishes. If 60 % of them didn’t pursue this treatment, the only wonder is that the statistic is not larger. Criminals don’t have this problem. They are assumed to be friendly, unlike mental patients, with liberty from the beginning.

Murder is a criminal offense. “Mental illness” is a sensibility offense. We lock people up who have broken no official laws, but have displayed erratic behavior, because they offend our sense of propriety.  Also, it is thought that if we don’t lock them up, they will either manage to get somebody so offended as to do them violence, or they will manage, wittingly or unwittingly, to do violence to themselves.

The problem is that people are not really locked up because they are violent. Violent acts are criminal offenses. You’ve got people in both systems, that is, people who have been put in the mental health system by the criminal courts rather than by the civil courts. These patients are said to be forensic. They are not the rule, they are the exception. You could call them either “mentally ill” criminals, or, alternately, as is more conventional, the criminally “mentally ill”. Again, for people in the system, they are the exception, they are not the rule.

Beefing up the mental health system because of these few exceptions is not a good idea. Questions of conscious intent are not always resolved sufficiently by the courts. If a so-called “socio” or “psychopath” is a good anything, a so-called “socio” or “psychopath” is a good actor. One thing good actors are very good at playing is bad actors. People characterized as “mentally ill” are bad actors, otherwise they wouldn’t have gotten caught. They would have “slipped through the cracks” as the ruse goes.

Real gun control is a matter of seriously dealing with a culture of violence and reducing the proliferation of weapons of war. It is not a matter of blaming people in the mental health system any more than it is a matter of blaming people who belong to different races, religions or ethnic groups.  Curtailing the gun ownership rights of people in the mental health system is not going end massive acts of gun violence, nor is beefing up the mental health system. The problem is not “mental illness”, and pretending it is, is not the solution; the problem is violence.