Beyond the Cusp

March 2, 2018

The Left Denies Mental Problems


This is not another article claiming that people on the left or far left are mentally challenged or lacking in sanity, as tempting as such might be. That does not mean that the left will be free from all blame. We may of done that back on December 19, 2012, with our article Gun Ban Whiplash Coming from Anti-Gun Progressives. There was a movement starting in the mid to late 1950’s which gained speed through the 1960’s finally taking full sweeping change throughout the 1970’s with the closing of many state and private institutes which treated the mentally challenged and mentally ill patients. The watershed moment came under President John F. Kennedy with the passage in 1963 of the Community Mental Health Act which posited that providing federal funding for community mental health centers and research facilities in the United States would then replace the State Hospitals and place the institutionalized patients out into the general public to be treated by clinics. This was then to facilitate the transition of the less mentally ill to treatment by these community mental health centers allowing them to reside in the real world where they would have examples of proper behavior which could become role models. It was posited by Dr. Henry N. Pratt, director of New York Hospital in Manhattan whose testimony is reported in the New York Times article How Release of Mental Patients Began. He told the subcommittee “striking proof of the advantages of local short-term intensive care of the mentally ill was brought out’” in a Missouri study. This Missouri study, which compared a group of 412 patients in two intensive treatment centers with patients admitted to five mental hospitals, showed that the average stays for patients in the large hospitals were two-hundred-thirty-seven days longer than for similarly diagnosed patients at the treatment centers. Dr. George A. Ulett of St. Louis, the psychiatrist who directed the study as head of Missouri’s Division of Mental Diseases, now says the numbers cited, though correct, were misinterpreted. This would become one of the quotes demanding more Federal dollars to fund the community mental health centers to pay for more psychiatrists and support staff. This would become the perpetual mantra from the left and even some centrists on the right despite further statements from Dr. Ulett and other psychiatrists that the system was misguided and overestimated the numbers which could be readily and properly treated by local mental health centers and did not require institutionalization. Dr. Frank R. Lipton and Dr. Albert Sabatini of Bellevue Psychiatric Hospital in Manhattan were also quoted as decrying that research on the problems of the homeless, saying one of the major flaws in the concept of deinstitutionalization was the notion that serious, chronic mental disorders could be minimized, if not totally prevented, through care provided within the local community. Their exact words were, “This philosophical and ideological shift in thinking was not adequately validated, yet it became one of the major conceptual bases for moving the locus of care.”


The Sounds in My Head Will Not Stop

The Sounds in My Head Will Not Stop


The other problem is that initially the psychiatric specialists came to believe that the new drugs, especially psychotropic drugs, would be the panacea of cures for numerous mental disorders including some of the most serious disorders. This reliance on the new drugs and promise of even bigger and better drugs on the horizon actual success rates were grossly overestimated. There eventually became two obvious shortcomings of drug therapy. The first was that these drugs would work with little or no side-effects which proved to be dead wrong as prolonged use of many of these drugs proved to be disadvantageous and some even dangerous. The other is that you could expect that the patient would take care and religiously take their prescriptions in the correct doses and at the right time. Too many patients simply were not sufficiently and mentally capable of remembering to take their medications, operating within society, interacting with people or following the simple protocols of society such as laws, prevailing morals, personal interactions and, for some, any knowledge required to fit in or act as required in almost any situation, even the most ordinary and common daily interaction. Many of the problems associated with the homeless have come as a direct result of the deinstitutionalized mentally ill. The problem which has been created is one which will be a greater challenge to repair than it would have been to simply finance the existing system which deinstitutionalizing of the mentally challenged was presumed to be a repair and an improvement. The great idea has most definitely come home to roost, and it roosts largely in our city streets, under bridges, in emergency rooms and living wherever they can find a piece of dry where they can place their cardboard homes if they are fortunate to live where they can do so without running afoul of the legal systems.


This was recently covered in an article by Walter Williams titled Another Liberal-Created Failure. Professor Williams pointed out research that, “according to professor William Gronfein at Indiana University-Purdue University Indianapolis, by 1955 there were nearly 560,000 patients housed in state mental institutions across the nation. By 1977, the population of mental institutions had dropped to about 160,000 patients.” But how did we get to the point where there were so many institutionalized mentally challenged patients. What was the initial reasoning behind the state institutions? These mental health state institutions were established to address an actual and real problem, the mentally ill were a sizeable percentage of the lawbreakers and when placed in prisons, they were mistreated, thus the state homes became the remedy to prevent further mistreatment of the mentally ill incarcerated in the prison system. The mental institutions were designed to provide the necessary treatment as well as separation from the normative society thus decreasing the problematic interactions between the mentally challenged and normative populations. State institutions, as noted by Dr. Williams, were initially founded in 1773 in Williamsburg, Virginia, as Eastern State Hospital became the first public hospital in America for the care and treatment of the mentally ill. They were followed by more state treatment hospitals throughout the United States as this was recognized as a much necessary and required solution to the obvious problem of the mistreatment of the mentally ill within the prison system. These systems continued as the best solution in a system where every solution is whatever is the least disadvantaging and least damaging to the people placed in these hospitals. What probably became lost with time is that the institutions for the mentally ill were not simply a prison for the mentally ill but hospitals where treatment and therapies could proceed under the supervision of licensed psychologists, psychiatrists and other mental health professional. Were there problems at some of these hospitals with certain staff members mistreating the patients? Yes, there were, but still the treatment generally was professional and caring and a far cry from what these unfortunates would have received if incarcerated in the prison systems.


This was lost sight when new drugs became available for the treatment of the mentally ill and many became somewhat overly optimistic over the results that these medications would in theory provide. The new and progressive idea for the treatment of the mentally challenged was that they could not really get better within the mental institutions as they had few examples of normative adult behavior. Should the mentally challenged be placed into an outpatient treatment center and placed into normal society, then they would recover more readily and adjust to regular life and improve. Also stated in Walter Williams article was, “Several studies summarized by the Treatment Advocacy Center show that untreated mentally ill are responsible for 10 percent of homicides (and a higher percentage of the mass killings). They are 20 percent of jail and prison inmates and more than 30 percent of the homeless.” One has to look at these numbers and one should stick out as an extremely counter productive result of treating them outside institutions, the system being pursued since the 1963 Community Mental Health Act. The twenty percent of jail and prison inmates should be shocking as the initial reason for programs for the treatment of the mentally ill was to take them from the prison systems as they suffered from mistreatment and lack of proper medication, therapy, treatment and other required needs of the mentally challenged. Apparently, the treatment of the mentally challenged is becoming full circle, to where the problem was first addressed when their mistreatment in the prisons was the driving force. From mistreatment in prisons we went to institutions dedicated to the proper, sensible and compassionate treatment of the mentally challenged providing them with a combination of drug treatment, individual or group therapy, counselling and separation from the general public for mutual protection we went to out patient clinics with a high reliance on drug treatments with minimal counselling and supervision which has now led society back to incarcerating far too many people with mental illness. There is also the problem of the increased criminal behavior caused by placing these mentally challenged patients into the general public. Additionally, too many of the mentally challenged patients placed into a self-care environment where they are responsible for assuring they take their medications as prescribed results in medications not being taken or being used improperly. Further, patients can often forget or skip their sessions for treatment and therapy and if they skip too many in succession, these outpatient treatment clinics being strapped for funds will often simply drop the patient from their schedules as their funding is dependent on patients treated and every missed session results in lost revenues. This allows for too many patients falling through the cracks and this eventually results in tragedy either for the individual mentally challenged individual or to society when they commit a violent act.


Dr. Williams also linked to another article from the Wall Street Journal titled Fifty Years of Failing America’s Mentally Ill. This article takes in more statistics and failings of the system of outpatient treatment using community mental-health centers, or CMHC’s. The results of this new treatment system has been simply a tragedy which is thusfar continuing with little if anything being done. What would be preferable would be for the Federal Government to take the funds currently being spent on mental health directly for specific treatment systems and programs or specified in any way for treatment, housing, therapy, drugs or counselling and other treatments be repurposed as a block grant to the individual states to use as they feel is the most productive and best treatments for their mentally challenged individuals. The government might even consider partially paying for the construction, revitalization or refurbishing of institutions for the mentally ill who should be required to be kept in a whole treatment center where they are assured that their medications will be taken and they appear for their treatment sessions. Mentally ill patients who miss a set number of treatment sessions or are found to be skipping taking their medications should be reinstitutionalized for their own good and for the safety of the citizens as well. The state institutions were given a bad rap with their failings blown out of proportion in order to carry out the great experiment for the treatment of the mentally ill where placing them in the general public was to be the cure-all and end-all of mental illness. Well, the results of the grand experiment are in and have been fully examined and have been determined to be largely a failure. The experiment has cost us the health of many mental patients while also costing the public lives from homicides including over ten percent of the mass killings committed. These include the mass shooting at Sandy Hook Elementary School in Newtown, Connecticut, Century 16 movie theater in Aurora, Colorado, and the Safeway food store shooting of U.S. Representative Gabrielle Giffords constituent meeting in Tucson, Arizona mass killings which took twenty-eight innocent lives including the shooter’s mother, twelve innocent lives and six respectively. These three shootings resulted in nearly fifty deaths and approaching one-hundred injuries which might have been avoided were there proper facilities in existence where people observed with mental challenges could be sent for observation and treatment and be kept for more treatment if so determined necessary. This would include families placing a troubled relative into treatment, police being able to bring before a court the need to place a troubled individual into such a facility for treatment, for a physician to advise for a patient be observed and treated if so determined, for courts to place somebody into an institution for determinations and treatment or for self-placement into such an institution for observation and treatment if necessary. The one item we can all be assured about is that the current system has some large holes through which treatments and societal safety are leaking forth and both the mentally challenged and the normative society are hurting from these problems. Perhaps it is time to turn everything back to the fifty states and allow each state to find their own particular solutions. Over time, some states will perform far better and others will fail catastrophically leading to the states desiring to perform better, they will have numerous proven solutions from which to choose. Eventually, the various fifty states will find a solution set from which a best system may soon emerge and over time, as new ideas and treatments present themselves, they will be tried in their many varied forms and ideas with the predictable range of results allowing each state to adopt that they find advantageous. Allowing the individual states to take their own paths in treating the mentally different, the potential for a near perfect set of policies and use of funds is far more likely to be found through fifty separate programs than in one directed from Washington D.C. Now all that need be achieved is getting Washington D.C. to agree to allow the states to be what they should be, the test laboratories of the numerous and varied approaches to a problem eventually seeking to optimize for the best results for the lowest cost.


Beyond the Cusp


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