May 16, 2007

Do we "coddle" the severely mentally ill? (The New Republic, free registration req'd)
  • Article (apparently) originally published here. Haven't read it all yet but paragraph one is basically asking me to accept this worldview "— before the sixties, when activist reformers discovered the notion that mentally ill patients were an oppressed people, like Negroes (as blacks preferred to be called then), women, and homosexuals (as gay men were identified then), and decided that they must be set free from their sadistic doctors and nurses (deinstitutionalized) in order to become independent (homeless) —" and I'm immediately suspicious.
  • Ah yes, here we are. Apologies for the quote mining. "The three basic values of the therapeutic culture are tolerance of aberrant behavior, a non-judgmental attitude, and a sense of understanding for the suffering patient. This is what Cho was being offered by the community at Virginia Tech." followed a few lines later by "English teachers were disturbed by his angry writings and oddness. According to the New York Times, “Lucinda Roy, then head of the English Department at Virginia Tech, began to tutor him privately. She, too, was unnerved. She brought him to the attention of the counseling service and the campus police because she thought he was so miserable he might kill himself.”" The article appears to be quite good when it isn't trying to push the "therapeutic culture" side. Taking it at face value it looks like everything pretty much worked the way it should right up until a doctor diagnosed "A doctor there wrote a cursory report: “Oriented X4. Affect is flat. Mood is depressed. He denies suicidal ideation. He does not acknowledge symptoms of a thought disorder. His insight and judgment are normal." ...either quite inexperienced or incompetent if he could not see what so many of Cho’s classmates and teachers could see.”
  • Note that the linked page comprises a discussion among several professionals rather than a single article with a single viewpoint.
  • Login: monkey pwd: filter
  • Oops...or not. Never mind
  • It's interesting to wonder whether "coddling" physically ill patients is ok when doing the same to the mentally ill is a bad thing. It may be that the main difference is that we slap seriously ill patients with physical problems into the hospital and actually treat them, while doing the same with the mentally ill brings up all sorts of issues. Until we have tests similar to those that pinpoint heart problems, diabetic coma, stoke, etc., we'll continue (in this PC world) to allow those with possibly dangerous mental problems to avoid treatment. I've lived in an environment where a person I believe is a sociopath and methamphetamine addict has threatened my well-being for the last 9 years. He's serving a prison sentence right now for forging checks on accounts which I share with my mother, but he'll be out in September. The most I'll be able to do to keep him away is to get a restraining order, but the police respond to calls on those those as secondary to more immediate problems. He's assaulted my mother(his grandmother) twice and his (now) ex-wife at least once, so far as the police know, but his degredations on his children were never reported. When he tried to drown me by holding a streaming hose up to my nose while holding my head so that I couldn't get away, the cops called it a misdemeanor. I truly believe that someday he will kill me. I'm not looking for sympathy, so please don't give me any, but wish that I could have him "coddled" in a hospital which would attempt to treat him and out of my life.
  • Path, sounds like this is someone related to you, and so you would probably hesitate to do them harm. Just remember, you are allowed to shoot first if you believe your life, or the life of someone in your family, is being threatened. My thoughts are with you.
  • Please don't mistake this for sympathy, path, but damn, that sucks. I'm really sorry that this has happened to you. Are you able to move?
  • path, you bring up an interesting angle: the physically ill rarely seem to cause a threat to us (ie, they dont "go crazy" and attack others, altho they do sometimes spread their dangerous cooties...) it seems, then, "easier" to be sympathetic to someone physically ill, perhaps? because there is some correlation between mental illness and violent/difficult/criminal/weird behavior... we have always been a society that treats the symptoms and not the cause. until that stops stories like path's will continue to be all-too-common. path, I wish you the best in your situation.
  • Path - Bad bad situation. You know he's coming back in september. Buy a gun. Protect yourself. Don't be a victim.
  • Also, the physically ill tend to recognize that they are ill and need treatment. And treatments for physical illness are generally more effective. They also tend to not make you feel worse, and if they do it's easier to take because there's the hope that when it's over you'll feel better.
  • Look, I'm not a victim. I'll stand up to his threats as I've done in the past. But I won't get a gun, since shooting him would make me too much like him. Sorry that I derailed this toward a concern for my situation, but the mental vs. physical difference in attention strikes me as sad.
  • the physically ill rarely seem to cause a threat to us Sort of off topic, but it is worth noting that this is a relatively new notion. Those who lived through the polio epidemics would remember when those who were ill did seem to be a serious threat. This was the norm before vaccination and antibiotics.
  • Clearly then everybody who seems "weird" should be taken out and shot. Society must be protected!
  • Yes, people with entirely subjective, nebulous "illnesses" definitely need to be punished. We're far too nice to them, the bastiches.
  • He's assaulted my mother(his grandmother) twice and his (now) ex-wife at least once, so far as the police know, but his degredations on his children were never reported. When he tried to drown me by holding a streaming hose up to my nose while holding my head so that I couldn't get away, the cops called it a misdemeanor. I truly believe that someday he will kill me. Clearly then everybody who seems "weird" should be taken out and shot. Society must be protected! ----- You're driving. A truck is headed right towards you. But...you have the right of way. If you yield the right of way it means that you abandon your values. You sit in the lane because you are right. The truck runs you over. You die. Do nothing and get run over. Path, I've read your posts for years now. You're a wonderful human being. Don't let something that is out of your control end up killing you. And "Big Davey"... That's a piss poor troll. Give it another try. You can do better.
  • But I won't get a gun, since shooting him would make me too much like him. What about this is difficult to understand? Some people don't like guns. Period.
  • I like to "coddle" after wild monkey sex,,don't we all? Bonus soundtrack: You're Bound to Look Like a Monkey (When You Grow Old)
  • What about this is difficult to understand? Some people don't like guns. Period. How about a nice pointed stick instead? Sticks don't kill people. Points do.
  • Path I'll come to where you're at in September, dose the guy up with ketamine* and remove his testes. He won't feel pain, and within a couple of weeks he'll be thanking me for his new found calmness. I know very little about you, but you're always nice here so I'll do it for free!** *With Nitrous Oxide/Xenon mix maintenance. **This is a one time non-transferable offer and is subject to mutually agreed time constraints.
  • Thanks randomaction, but I've had a number of offers from good friends to take him out, and I've refused those too. Apart from the karma issues, risking being convicted of murder or other felonies is not something I'd want to subject friends to. On the other hand, I could meet you in San Francisco, and we could get royally drunk and terrorize the Bay Area.
  • Path, you are one cool kitty!
  • Wait.. wait.. he gets ketamine AND nitrous AND orchidectomy??? No fair! *cries, runs away*
  • Either I'm very unobservant, or you've been MIA for a while, nil. Either way... hi!!
  • Do we "coddle" the severely mentally ill? We didn't used to! We used to have 12x12 cells with no ventilation and straw on the floor to house 15 people. Leg irons were common. Whips were used. Ahhhhh, the good ol' days. Bring on the straitjackets and electroshock therapy, I say! Meanwhile, you leave my meds alone. I'm bipolar, not insane. Take your hands offa me. Let me alone. You'll pay for this! Oh, yes, you'll pay! *not *crazy*, just misunderstood
  • Either way... hi!! *waves back* Just been lurkish, mostly. =)
  • Look, the problem with path's relative is not that he's "severely mentally ill" but that he's DANGEROUS. Most "severely mentally ill" people that are really "weird" are NOT. The issue is really not "do we coddle the 'severely mentally ill'" but "what should we do with people who are DANGEROUS, whether they're 'severely mentally ill' or not." Would it surprise anyone to consider that most DANGEROUS people are NOT "mentally ill" and don't even strike most people as "a bit off"? This "OMG a PSYCHO!" bit is a red herring, as well as a convenient label the article writer uses to justify locking up people who are DIFFERENT. E.g., thinking I'm possessed by the spirit of Lana Turner therefore I have to ride the buses talking to myself in a faux femme way is just too damn bad for me, but knowing full well what Reality is and that it's illegal to rape and eat infants but doing it anyway just because it's fun is too damn bad for EVERYBODY. Of course, hey, the hysterias around newsworthy events like Columbine shootings and "9/11" have convinced most Americans that rights and freedoms are themselves dangerous and must be surrendered at the earliest opportunity, but they're too damn stupid to go get themselves locked up where it's safe and want to turn the whole society into a locked ward instead. And of course the Authorities are only to happy to "obey" as shown in this Metafilter post.
  • And what makes y'all think castration makes men peaceful? Testosterone in adults conrols libido, not aggression. I'd think you'd want it the other way around, as in "Make Love Not War." Me, I think I'd be MORE aggressive after somebody waylaid me and hacked my nuts off, not less; if you want to keep me docile and gooey make sure I get lots of blow jobs.
  • Re (tangentially) the "coddling" of patients - in the treatment of many physical ailments, the trend seems to be away from lots of bed rest and taking it easy and toward the rapid reintroduction of physical activity. The treatment of the vast majority of muscular injuries emphasizes light exercise as essential to a proper recovery. On the article itself: the writer makes one general point - change the laws that stress the “civil rights” of the mentally ill in schools - but fails to explore it in any depth. Essentially, the writer's arguing in favour of giving somebody (I'm not sure who) sectioning powers over students who have not committed any crime but who behave oddly. To avoid painting himself/herself into a corner, the writer has avoided any detail of how this could be implemented and just made a general plea for the ability to lock people up.
  • The thing I notice about mentally ill people is their pathalogical inability to summarise. These guys just go on and on and on and on and on and on and on and on and on and on saying crazy things that could be said in a far far far far far far far far far far more concise way. It's really really really really really really really really really really annoying.
  • Thanks to my tourette's, I am fully able to say crazy things in a concise way COCKNOCKER DICKFUCK.
  • At least I can spell "pathological" correctly. And one good thing about going on and on is thst stupid people often understand eventually, while when one is terse one gets called "cryptic." To summarize: nyaah nyaah!
  • Big Davey, my comment wasn't directed against you: it was directed against me. Hence the repetition. Why did you think I was having a go at you?
  • At least I can spell correctly. And one good thing about going on and on is thst /giggle
  • when one is terse one gets called "cryptic." The moon knows.
  • Sociopathy/psychopathy are not treatable. They are not mental illnesses but cognitive and behavioural problems - possibly neurological based; only the amiable psycho would take time to be rehabbed into better cognitive skills. I carry a shitload of mental illness diagnosis (dx) that leave me with a less than desirable persona and get totally pissed off at people who immediately tune me out when I try to talk and am dismissed as a crazy. I have never noticed being coddled by any fuckin' system. ECT and hospitalizations do not count as fun. /as best as I remember
  • Has anybody seen petebest around lately?
  • At least I can spell correctly. And one good thing about going on and on is thst /giggle He never claimed to be able to spell "that" correctly, merely "pathological."
  • Big Davey makes some good points between dangerously antisocial behaviors and those *crazy*, but not dangerous, behaviors. I disagree about the testosterone/aggression reduction statement, however. MonkeyFilter: if you want to keep me docile and gooey...OH NO I JUST CAN'T DO IT... Davey, YOU JUST WISH!!
  • crap, here's the rest a#@$ tags It's pretty much a given that reducing testosterone will reduce some aggression Neuter your dog, and life becomes easier for all concerned. Of course, it's not as simplistic as it sounds. Testosterone is produced in other parts of the body; different men respond to differing amounts of testosterone; much of aggressive behavior is learned, etc, etc. I do agree that a whack-job with a seriously screwed head is going to be violent whether he's neutered or not. I still don't think it's that bad an idea. Men are pretty well attached to those "bits". *prepares to duck MonkeyFilter: if you want to keep me docile and gooey...OH NO I JUST CAN'T DO IT... Davey, YOU JUST WISH!!
  • How the HELL can you diagnose a two year old with bipolar?!?!?!?? That's just stupid. First thing to do is look at the child's environment and see what's going on there, whether it be parenting, nutrition, whatever. Then monitor. Look at behavioral modification around age six or seven. Maybe at age ten or so you can start talking seriously about bipolar. How about taking care of a kid that seems to have problems, rather than drugging them and shutting the closet door. I think the set-up on this article is sensationalism, but the basic question is a good one, and deserves to be addressed in a rational manner. It seems to be a fad to diagnose kids with bipolar, and to do it waaaay young, but, nevertheless, something seems to be going on with our kids. Whether you consider it a psychological issue or a behavioral issue, something isn't right. Of course, it couldn't be the water they drink contains measurable levels of Prozac and other drugs, or that the meat they eat contains hormones and antibiotics, or that their school diets consist of fats and fructose, could it? Naa, all these are within "tolerable" levels and couldn't POSSIBLY have a cumulative effect. I see a lot of these kids in school having a hellish time, and compared to my own (sucky but normal) school years, only two, perhaps three, kids were like this. Are they bipolar? Well one bipolar can sometimes recognize another, so I'd say some are, but some of them are just not quite...right. It's like their nerves are on the surface of their skin. Mentally, they seem to really want to try--to focus on an assignment, to not be squiggling around, to not be so emotional, but they simply can't stop what they're doing. Bad parenting, lack of social/study skills, typical younger child or onset of adolescent hormones? I'm sure all that plays into it, but it just seems to be a bit more than that. I think calling them bipolar simply smacks a label on a larger problem and obscures what we need to be looking for.
  • But big pharma likes to see folks start young on their products. Helps spread the insanity. I suspect many parents prefer meds to providing proper care. Docile kids are easier to ignore.
  • Sadly, that's very true. I've met lot's of mothers-who-shouldn't-be-mothers dose their kids up with nighttime cold medicine just to shut them up and make them sleep, day or night. Or, they keep taking them to the doctor with a shopping list of issues that they want their kids medicated for. These same kids have few skills by which to cope with life. Their not given the chance to cope. They get medicated before they learn those skills. The older they get, the worse their problems become and their own parents are oblivious to of the fact that they caused it, from poor parenting and enforced drug use. What's odd to me, aside from all of the above, is that these parents readily admit what they are doing for their kids.....they seem to think they're doing what's best. Somehow, keeping their kids completely docile is akin to keeping them calm, mellow and happy. They forget that at some point, you have to come down. As for the main point of the post, I'm certain my point of view is not at all popular; it seems to me that severly, mentally ill people, those who are incapable of operating under the basic "right versus wrong" principles, should be put somewhere where they will be observed at all times and not out in society harming others or themselves. Those who would say that these peoples' rights are being taken away by doing that don't realize that they (the mentally ill) aren't even aware that they have "rights".
  • Then 'Catch 22' comes into play. Patient is hospitalized/medicated/treated/assessed/released on demand by now stabilized patient. Who proceeds to go off meds and decompensate again. Which leads to new misadventures and a revolving door of Rx and release. Mental health now prefers more accomodating patients to their ministratons. Society seems now to be dealing with the fall out of The Myth of Mental Illness and "One Flew Over the Cuckoo's Nest" days. i hope to miss the rebound effect.
  • Unfortunately, mental illness is a handy hook to hang all sorts of things on--different problems, different drugs, societally determined 'unacceptable' behaviors, ways to exclude certain persons from society or deprive them of their rights. There IS a central core of problems, the majority of them, IMHO, most likely physical in the sense that there is some type of chemical imbalance or 'mis-wiring'. Some mental illness is probably perceptual, and it's tough to chance someone's worldview. ...mental illnesses are genuine brain diseases, although their precise etiologies have not been figured out yet. If mental illness is a myth, they note, so is physical illness, because both categories have fuzzy boundaries and are to a large extent culturally determined. ... Critics, ..., also contend that the distinction between mental and physical disease is misleading, since (as the American Psychiatric Association puts it) 'there is much that is "physical" in mental disorders and much 'mental' in "physical" disorders." In some societies, you're not crazy, you occupy a special place as a shaman or an oracle. Unfortunately, not in this one--unless you can get online and sell a particular mess of bull to the gullible. In which case, you're not insane, because you're functioning within the parameters of our society as a good moneymaker should. The bottom line for mentally disturbed boils down to this: can a person function in society in a (happy and) productive manner. A lot of people don't feel the happy part is necessary--but it's not real functional if you're miserable and suicide because of it, or can't get out of bed, or strangle your kids. In this case, happy is able to work within the framework of one's life in a more or less contented manner, versus *happy* or ecstatic all the time. Unfortunately, there's a lot of people out there that are looking for *happy* to escape a dysfunctional life, be it with a legal/illegal drug or a bottle. There's a time and a place for drugs, just like there's a time and a place for bandades. You wouldn't put bandade on a broken leg, and that's what we're doing with many of these drug prescriptions. Something is wrong in our society, and instead of looking to fix the problem, whether it be social or environmental, we keep putting on a bandade. My daughter says the best advice I gave her was to take her toddler and move out of her lower-priced, but upscale, 450 ft apartment in a fancy part of town to a more-expensive, run-down 950 ft apartment with a small, fenced patio, that's just a short 3-minute walk away from the park. She was beginning to worry her daughter needed Ritalin, but all they both needed was more room. How many kids get too many drugs and not enough exercise? I raised four, and the best estimate I can give you is that you need twenty+ acres per kid, in addition to sneakers, bikes, wagons, balls, mud, rocks, and trees, and 3 hours a day physical activity. Mom's sane; kids sleep well; everybody's happy.
  • Man, BlueHorse, soooo true! The flack I get because I am so pro-physical activity yet am surrounded by people who just want to shove the kids in front of a screen, plug them with food and call it good. I want my kids to physically express themselves, to get all the frustration of the day out of their system. Somehow I am now seen as a mom who spoils her kids. I am always having to defend my position. It's so fucking stupid. And pisses me off. I'm particularly angry today. Sorry.
  • Accuse you of spoiling your kids? Hell, I got accused of neglect and putting my kids in harm's way. Yeah, there were afternoons when I wasn't exactly sure WHICH part of the back 40 they were playing on, but I could get out and walk around and find them within 3-5 minutes. (we're talking eight and ten-year-olds) And yeah, they occasionally fell out of trees, fell off bikes, fell off horses, cut feet and fingers, got hideously muddy, banged and scraped knees on rocks, hit each other with sticks, threw rocks and had baseball sized-lumps on a heads--male learning experiences. Yup, I was neglectful. Although I did lose my youngest one summer afternoon when she was a toddler. Was panicked, looked EVERYWHERE. Called the neighbors. Was ready to call Mr. BlueHorse at work and the police. Went into the back yard one last time and stood right next to, and looked down INTO, the tractor tire we had converted into a sandbox, where I'd seen her just 2 minutes before she'd disappeared, and there she was asleep, curled under the rim in the shade. Doh!
  • Mud is important to a child's healthy development. I can't stress that enough. I think back to my happiest times as a child, and 99.9% of them involved mud.
  • I'm with you both. I didn't allow the television on until the news started after supper. Any viewing fit between what we might be doing, watching and her bedtime. She's in her thirties now but still prefers to read than watch boring old t.v. I've always been a food purist: she still won't drink soda as "coke! yuck!"was her first sentence. She also trained and worked as a chef. At age 14 she chose to row a boat across the lake to a summer job rather than drive with me - 1 1/2 hours earlier in the morning. Great for her posture and she ended up standing proud, shoulders back. She made the choices and I simply shuffled with the options. she still loves me, honest. /and I loved making mud pies with flowers on top.
  • I loved cramming mud down the craw of my Baby Alive until her gears all siezed up.
  • I am very pro-mud! I have the all-time best pictures of my kids, fully clothed, covered from head to toe in thick mud, with giant smiles on their faces!! God, I love them.
  • My Bobo's (grandma) best friend had a farm, and when we'd go visit her they'd give me a two liter bottle of water, a big spoon, a bowl, and direct me to go make mud pies. When I was done they'd admire my work then hose me down! That way, they got to visit and I was ecstatic with joy and mud.
  • Two liters? Pffft! Give the kid the hose on trickle, and let them sit on the ground. You ain't seen mud until you peel off their clothes and they have mud in their butt crack. One rolls around in it, one makes mud pies and gets somewhat dirty, and one can't hardly stand to touch it without GramMa's rubber gloves. Go figger.