The crime of jail

April 10, 2014 by

Psychiatric hospitalization once was the mental health system.  When it became apparent that thousands and thousands of people were basically being abandoned under the most horrific circumstances, that abuse and maltreatment were endemic, and that any chance people had of living a decent and happy life was being destroyed by their placement in an institution supposedly set up to help them a process of deinstutionalization was started.  The hospitals were closed.  It was the first seismic event of the mental health system.

The same description of what it meant to be in a psychiatric hospital is still true.  It is a description of what it means to have serious mental health issues in your life and be in jail or prison.  Nothing has changed other than the location.  Basically the same amount of people who used to be in state hospitals are now in jails and prisons for the same reason:  “mental illness.”  And once again they have basically been abandoned.  And only time will tell if this is to be the second seismic event of the mental health system.

It is the shame of all of us.  It is, I believe, the fuel behind the passion with which many people embrace the Murphy Bill.  The mental health system hasnt been part of the solution for the people they love.  Its inemptitude in reaching people with severe needs has been part of the problem.  A major part.  Talk of recovery seems empty chatter.  Perhaps useful to other people, but not to the people they care about.

The place that “helps” you should not hurt you.  It just isnt okay, justifiable or something that should be tolerated.  And despite our outrage we largely have.

Many people point to a defiency in psychiatric beds as a basic part of the problem.  Personally I think it is a lot more complex than that.  Many of the people in jail have spent time, often a lot of time in psychiatric hospitals to little or no avail.  Hospitals may provide people safe housing and stabilization but I know of little evidence they do more than that and sometimes not even that very well. 

Even if the lack of hospital beds could be proven to be part of the problem I dont see how anybody can realistically believe they will be part of the solution.  There are somewhere in the neighborhood of 300,000 people with mental illness in jail.  No where close to 300000 hospital beds are happening.  In most states little or none are happening if for no other reason the money it takes to add even one bed is unlikely to be found.  Whatever the solution a primarily hospital based solution is not going to happen.  Anyone who tells you that psychiatric hospitals are the only answer are telling you there is no answer.

Let me now say something that will be very unpopular among many people.  The “recovery movement” has largely been silent on this issue and basically conceded the playing ground to people like the Treatment Advocacy Center.  And politically as they are finding out now trying to stem the momentum of the movement towards the Murphy Bill, that was a very poor choice.  It has made it easy to tar them in the public eye as being against being at all proactive on this issue.

Over the last weeks in particular, as you may be able to tell by the links to articles on this blog, I have been more and more concerned with the issue of “mental illness” in the jails and have come up with a few conclusions:

1. The recovery movement prides itself as being about civil and human rights. Aside from the widespread psychiatric hospitalization of hundreds of thousands of people and basically leaving them for dead the single greatest assault on human rights is what is happening for people with mental health diagnoses in jails and prisons.

2. So far, little of value, little of leadership, little of even recognition of the problem has come from the recovery movement.

3. This challenge will be the real test of the staying power of the recovery model.

4. I believe that advocacy efforts that only target the dangers of coercive care to defeat the Murphy bill will in the end fail. Writing off the stories and concerns of family members who have people being tortured and abused in jails as being dupes of the Treatment Advocacy Center is not only a bad tactic, I think perhaps it is unethical. Our message has to be more than what we complain about. It must be about what we offer.

One friend put it well:

“Continually traumatizing traumatized people isnt going to help. You can use bigger and bigger sticks to manage them but eventually no stick will be big enough. I dont think I have all the answers but part of the answer is to make the trauma informed perspective a concrete and impactful part of what it means to be mentally ill and in jail.”

I think the jails and prisons are drowning in people that shouldnt have ended up there. No one answer is enough. It will take an effort of immense commitment to even scratch the surface.

But I do believe I know the starting point: We must all see the flood.

Military, Media Quick to Report Fort Hood Shooter’s Mental Health Status

April 9, 2014 by

To linda on a wednesday morning

April 9, 2014 by

Thinking of you

Mentally Ill Are Often Locked Up In Jails That Can’t Help

April 8, 2014 by

Mentally Ill Are Often Locked Up In Jails That Can’t Help : NPR
【from Next Browser】

The DSM and the Murphy Bill

April 8, 2014 by

The DSM and the Murphy Bill | LinkedIn
【from Next Browser】

The “worried well”

April 7, 2014 by

A key concept in the war on recovery being waged by the treatment advocacy center and a key focus of the Murphy Bill is the notion of the “worried well.”  Their definitions are never very clear but the “worried well” are those people who are not “seriously mentally ill” who are sucking all the money, time, energy and focus out of the mental health system.  The term “worried well” kind of implies that nothing is really that wrong, that they are robbing people who need help a lot worse than they do.   I dont know how clearly they say it but the impression I get is that everyone who is not seriously emotionally disturbed is “worried well.”

There are a lot of problems with this concept, but if you take it even half way serious it takes you to some interesting places:

Since only 4-7% of the emotionally disturbed population is seriously emotionally disturbed does that mean that 95% of the people receiving mental health services should either be eliminated from services or get greatly reduced services.  Torrey and crowd are very clear tbat a lot of money is being wasted on people who dont need help that bad.  Who decides who gets help and according to what criteria???  Does anybody really think this is even close to a realistic idea??  Can you put the genie back in the bottle??

Over 30000 people a year commit suicide- one every 16 minutes.  Someone attempts every minute.  Although suicide is a much higher risk with people with serious mental illness I dont think anyone would claim that the seriously mentally ill make up the bulk of suicides.  Most people who committ suicide under the Torrey system would be diagnosed as “worried well” at best.  Are people with suicidal issues not worthy or qualified to get help?

Millions of Americans are victims of trauma each year.  Our veterans are only part of that population.  Are veterans, abuse victims of all sorts who probably are not going to meet the qualifications of serious emotional illness not qualified to get help?? Are they simply the worried well?  Is anyone starting to recognize the absurdity of this concept??

Many people with labels of serious mental illness have experienced some degree, some form of recovery in their lives.  There are too many witnesses.  Are they all to be written off as mistaken diagnoses.  And if they are, if there are that many mistakes, why should anyone believe any diagnosis?

Where I live co-occuring disorders (mental health and substance abuse at same time) are a major issue, perhaps the major issue. Yet many of those people would fall under the diagnosis of “worried well” probably.

Depression has massive effects on the lives of millions of people, their jobs, their families, their children, their communities. Yet many of them would qualify as “worried well.”

The point of all this is simple. The idea that helping only those with bipolar disorder or schizophrenia should be or even could be the sole purpose and aim of the mental health system is unrealistic, distorted, unfair, simple-minded and simply

The term “worried well” is as stigma laden, as prejudicial as any other term. Its only real meaning is a way to call people names in an effort to find political advantage.

The attack on Recovery

April 7, 2014 by

The attack on Recovery | LinkedIn
【from Next Browser)

I have recently been asked to write a new blog on Linkedin and this post is the first post on that blog.  If you would like to follow this blog more closely I hope you will consider connecting with me on Linkedin.

Shooting Unfairly Links Violence With Mental Illness — Again

April 7, 2014 by

The Mentally Ill, Behind Bars

April 6, 2014 by

The myth of the hospital as protective fortress

April 6, 2014 by

The post below is a couple of years old.   Lakesore has closed.  While the situation has changed many of the arguments are still very relevant to current concerns.

I went to a meeting today with the East Tennessee legislative delegation about mental health in Tennessee. Among the other people there was the commissioner of mental health and many people associated in one way or another to the mental health system.  The upcoming closure of Lakeshore Mental Health Institute was the central topic. 

One theme seemed to predominate.  It was brought up in several different ways but the message was the same throughout.  They talked about public concerns and questions, but it came back to one subject.  “If Lakeshore is closed who is going to protect from the violent crazy people?”

The question was asked in all kind of different ways.  One administrator of another hospital asked whether or not there was a plan to deal with the disruptions in the emergency rooms caused by violent acting out people who were defecating on themselves that they would be unable to find placement for.  What he didnt seem to know was that there would be no sudden surge of violent defecating people in the ER.  Whether or not Lakeshore is open or not is irrelevant to the violent, defecating problem.

  The ER is the entrance point for many people in to the mental health system.  It has been that way for a long time.  It will remain that way.

There is no horde about to be unleashed though.  There are a little over 1 million people in East Tennessee.  If you have any faith at all in current predictions about the frequency of  mental illness 306,000 of them will need mental health treatment in any one year.  Lakeshore has about 75 patients most of the time.  90% of them are released within 7-9 days.  They are the same people in and of other psychiatric hospitals.  The only difference is that they are poor.  They have no insurance.  They are not more severe.  They are not more violent.  The are much more poor.

There are about 40-45  people who Lakeshore has been home for.  They have been there many of them for years and there is no place in the community for them.  The superintendent of Lakeshore spoke in the meeting to that issue.  All we need he said is money.  About 38 of these people can make it in the community with support and help.  “There are about 8 people we are not sure of,” he said.  There are currently 7 other people who are forensic patients who are guilty of violent crimes and may be dangerous.  There are about 1100 admissions a year at Lakeshore.  The deeds of 15 have tarred the picture of all.

What I wanted to say to the hospital administrator was that if the mental health system of the poor and uninsured actually included enough community resources and supports to help them maybe his emergency room wouldnt be so full.

  I confess to being extraordinarily cynical on the subject to but I had to wonder whether or not violent defecating people with private insurance had different results than those without insurance.Another very nice lady wondered whether or not all the violent people might spoil the atmosphere on the psychiatric wards for the depressed people.  The commissioner pointed out that perhaps an inpatient psychiatric ward was not the best place to treat someone with depression, but I am not sure whether she heard that or not.

  I know you can ask anyone who has ever been on a psychiatric unit and he will tell you one of the first things you learn is that the staff expects you to be “good.”  Rather it spoils things or not for “the depressed” it makes it much more difficult for the staff when people are troublesome.

To my knowledge every psychiatric hospital in this area has had at least an informal “do not admit list.”  One almost certain result of Lakeshore closing will be the death of the “do not admit list.”There are neighborhoods in Knoxville that are much more dangerous than Lakeshore even on its worst days.  Study after study has shown the idea of violence and mental illness being closely related are a myth.   People with mental illness are far more likely to be the victim of violence rather than the source of it. 

The myth of the mentally ill violent person and of the psychiatric hospital that acts as a protective fortress for the larger community is one of the greatest injustices done in the entire mental health system.Someone in the meeting used the phrase “Not in my back yard.”  It is time for segregation to be a thing of the past for everyone.

There was a police officer there listening to the meeting.  I talked to him after the meeting and asked his opinion.  He shook his head.  “The real problem is not those people at Lakeshore.  I dont worry about them.  The real problem is the people out here.  Those are the dangerous ones.”

Albuquerque. If you say people with “mental illness” are being shot because of lack of “appropriate treatment” it is you who lives in a fantasy world

April 6, 2014 by

You almost wonder if it is open season on “mental illness”- once again someone has been shot by police “just doing their job.”  The story below tells the story.  It is a story worth screaming about.

Their is a campaign in this country to villify those with mental health issues in their life as being unpredictably violent and dangerous. 

The simply awful disgusting mean stupid thing is when you read that somehow these awful incidents happen because the victims were not involved in “appropriate” treatment and proof of the need for more coercive treatment.  It is made to seem that the police are the victim of the people they hurt. 

According to the article below 37 people with “mental illness” have been shot by police in this town in last 4 years.  37.  I wonder how many people have been shot by supposedly “mentally ill” offenders?

Who is really the most dangerous?

Video Of Albuquerque Police Shooting Homeless Man
【from Next Browser】

How Many People Are American Police Killing?

April 5, 2014 by

How Many People Are American Police Killing?
【from Next Browser】


April 5, 2014 by

Bad things happen faster than they should and last longer than seems right.

Good things happen slower than they should and never last as long as we feel like they should.

We never have a problem coming up with good reasons to do things that are often not good ideas.

We normally think finding out whose fault it is is the best explanation for everything.

We dont appreciate the momentum of life enough.  The better things are going the more likely it is that better things will happen.

Figure out the difference between what you do on good days and what you do on bad days.  Do more good day things.

Tell people thank you for things you wish they would tell you thank you for.

Be aggressively kind.

No matter what you think the sky is seldom falling.

Dont treat unimportant things importantly.

Celebrate small things.

Part of wisdom is knowing what you are not wise about.

Look for people who give you reasons to do better instead of excuses for doing worse.

Accomplices are not the same thing as friends regardless of what they tell you.

The things that you try to live up define the way you live.

How you do things are as important as why you do them.   Being good at things matters.

Feeling good and doing good are not the same thing.

It is possible to feel bad while you are doing well.

Dont mistake urgency for importance.

Things are frequently more than they sound like they are.

It is not realistic to believe you have to accept things as they are.

Be prepared for deep water.  Dont forget where the boat is.

Tolerate success well.

Dont be loyal to bad times.

Ask questions.  Listen to the answers.

If you know all you need to know you dont know much.

How scared you feel has little to do with how much courage you have.

Share.  It doesnt belong to you anyway.

Are We Torturing The Mentally Ill?

April 5, 2014 by

Are We Torturing The Mentally Ill? –

If you had a passionate addiction…

April 5, 2014 by

If you had a passionate addiction to doing what is good for you:

You would find something to look forward to each day.

You would know that all things that taste good are not good for you.

Your day would be defined, not by what you hope happens, but by what you plan to have happen.

You would know that what makes you more able to do things makes it more likely more things will get done.

You would be part of something worth being part of.

You would know that if there were no bad times there would be no good times.

You would know that being grateful for small things makes it more likely you will have something big to be grateful for.

You would know that helping others to find a better life helps you to find a better life.

You would know that what helps you to deal with what you cant control helps you to learn what you can control.

You would know that a life less about you is a life more for you.

You would spend more time practicing becoming what you want to become.

You would know the biggest failure is refusing to fail.

You would know the meaning of everything is what you learn from it.

You would find the seeds to success in every failure.

You would know nothing lasts forever.  And find good reason to be grateful for good things coming and bad things leaving.

You would never be afraid to laugh.

You would know there may be no music if you dont sing.

You would know the secret to going where you go is knowing where you are.

You would know that no step is too small to step.

You would know it is easier to find what you give away.

You would know that if most people do what they are used to doing it matters what you get used to doing.

You would know that being human is both your greatest strength and your greatest weakness.

You would know that being kind to others is the greatest kindness we can show ourselves.

You would know to forgive others because you deserve it even if they dont.

You would know life is what you do with other people not what you do to them or what they do to you.

You would know everything is not a matter of opinion.  Some things are more important than others and you will have some idea of how to tell the difference.

You will know that being an expert on you makes it more likely you will be an expert on other things.

You will know you can be more than the bad news in your life.

You will know you are more than what people describe you as being.


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