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ddeubel
Joined: 20 Jul 2005
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 Posted: Tue Sep 22, 2009 7:46 pm Post subject: The US Health Care Debate and the mentally ill |
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I've watched and read a lot on the health care debate in the US. Yet, I've never heard it once mentioned - the elephant in the room - the mentally ill.
Most mentally ill have become institutionalized as part of the criminalization of mental illness that exists in the States. Hospitals, state institutions, house only a small percentage of the mentally ill in the nation. Most mentally ill are sent to prison and don't get a hand up or even a hand out. They are just held down and drugged down. Bedlam.
Why isn't this part of the debate? What would you do to make things better instead of criminalizing an illness? Why don't hospitals do their job?
My hats off to one man who is up there with MLK Jr. His name is Bill Kleiber and he has worked for years in Houston helping released inmates. The majority he helps are mentally ill. If not that bad off when they went in, most are incapable of supporting themselves when they get out. Here's an article about Bill but he should get a Presidential Medal of Freedom. Without a doubt.
http://www.aclutx.org/article.php?aid=339
What can be done? Or is it as simple as - do the crime/pay the time? even if you are insane?
DD
http://eflclassroom.com |
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Gopher
Joined: 04 Jun 2005
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| Posted: Tue Sep 22, 2009 8:42 pm Post subject: |
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I think there might be something here to discuss, Ddeubel. After all, so did M. Foucault, no?
On the other hand, you seem to want to accuse the United States of "criminalizing mental illness" as if there were some sort of distinction to make here, as if every other country on earth was something of a utopia for the mentally ill. I doubt it is as you have just made it appear. Are you sure that is what you meant?
You also conflate "mental illness," a medical problem, with "insanity," a legal plea. I wish you would untangle these things and propose a more clear-cut problem to discuss. |
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ytuque
Joined: 29 Jan 2008
Location: I drink therefore I am!
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| Posted: Tue Sep 22, 2009 9:51 pm Post subject: Re: The US Health Care Debate and the mentally ill |
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| ddeubel wrote: |
I've watched and read a lot on the health care debate in the US. Yet, I've never heard it once mentioned - the elephant in the room - the mentally ill.
Most mentally ill have become institutionalized as part of the criminalization of mental illness that exists in the States. Hospitals, state institutions, house only a small percentage of the mentally ill in the nation. Most mentally ill are sent to prison and don't get a hand up or even a hand out. They are just held down and drugged down. Bedlam.
Why isn't this part of the debate? What would you do to make things better instead of criminalizing an illness? Why don't hospitals do their job?
My hats off to one man who is up there with MLK Jr. His name is Bill Kleiber and he has worked for years in Houston helping released inmates. The majority he helps are mentally ill. If not that bad off when they went in, most are incapable of supporting themselves when they get out. Here's an article about Bill but he should get a Presidential Medal of Freedom. Without a doubt.
http://www.aclutx.org/article.php?aid=339
What can be done? Or is it as simple as - do the crime/pay the time? even if you are insane?
DD
http://eflclassroom.com |
For a good explanation of where things went wrong:
http://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html?&pagewanted=1 |
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ddeubel
Joined: 20 Jul 2005
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| Posted: Tue Sep 22, 2009 10:45 pm Post subject: |
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Gopher,
I'm focusing on the U.S. health care debate because most of those on this messageboard know something about it / have been following it etc... I made and make no assertions about the rest of the world - that's your mind working overtime. Stick to the post at hand please.
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| You also conflate "mental illness," a medical problem, with "insanity," a legal plea. I wish you would untangle these things and propose a more clear-cut problem to discuss. |
I think you really need to learn more about the use of language and literature in general.
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| Trope- The intentional use of a word or expression figuratively, i.e., used in a different sense from its original significance in order to give vividness or emphasis to an idea. |
Please learn to look wider at issues and especially the intentions of people who write here and post. What do you think about the issue? And not just what Foucault said but what you think.
Ytuque - an excellent article. I'm digesting it right now and will respond shortly.
I find it amazing that the U.S. has less hospitalized mentally ill than the 1950s (I think at present about 44,000 as oppossed to 1-1.2 mil. in the late 50s). These people can only have been transferred to prison. Shouldn't something be done or is it just tough luck, shut the door, drug them and let the prison population beat and screw you up further? I've heard that in most major prisons, the ratio of psyciatrist to mentally ill inmate is 1- 1,000.
DD
http://eflclassroom.com |
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Joo Rip Gwa Rhhee
Joined: 25 May 2003
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| Posted: Wed Sep 23, 2009 1:21 am Post subject: |
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| The US Health Care Debate and the mentally ill |
Ah a thread about the US Health Care being debated and many of the posters on Dave's Esl Cafe. |
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ddeubel
Joined: 20 Jul 2005
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| Posted: Wed Sep 23, 2009 6:49 am Post subject: |
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The article Ytuque posted really laid out well a lot of how the problem has come about (but without touching on the result - that emptying government institutions only transferred costs and burdens onto the prison system).
I agree with many who in the article point out that there was an "overly optimistic" view of drugs and what they could do for the mentally ill. As we now know, they aren't magic and often have other debilitating consequences. As one person said at the end of the article,
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"''Drugs can help people get back to the community,'' he said, ''but they have to have medical care, a place to live and someone to relate to. They can't just float around aimlessly.'' |
However, I can't also help but think that the "money" factor wasn't the decisive thing in the minds of politicians (and too often is - witness the current health care debate over $$$ ). I'm sure many just thought the problem would disappear and all sorts of money would be freed up for their pet projects etc...
As the article also alludes, the resources weren't continually put towards community health services. They were set up and then gradually closed down and bankrupted. This too is the failure of leadership and government.
Then we have to deal with the third tip of this iceberg - homelessness. Almost 80% of the millions of homeless in the U.S. are mentally ill. This is another elephant in the room. Nobody taking up their cause.
My own thought is that a lot of homelessness, a lot of addiction and mental illness is because of inadequate social welfare in America. Not hard to assert this. Sure, if we were talking of Malawi or Liberia we could be forgiven for demanding more. But we are not.
But even worse IMO, is not the fact that the mentally ill are treated through incarceration . No. Even worse is that when there is talk about the health of the nation and who gets what - millions are kept in a shadow life and not a word is said of their mistreatment. Their "illness" doesn't count because they don't vote. Like the song, "And they call this democracy".
Obama - keep dancing to the devil's tune.
DD
http://eflclassroom.com |
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Gopher
Joined: 04 Jun 2005
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| Posted: Wed Sep 23, 2009 6:56 am Post subject: |
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Also, Ddeubel, this discussion probably cannot work because you are, typically, essentializing the entire United States when in fact individual states make their own laws re: mental health.
You cannot possibly have even begun to take that into account in your op-ed-style thinking here. |
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ontheway
Joined: 24 Aug 2005
Location: Somewhere under the rainbow...
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| Posted: Wed Sep 23, 2009 9:55 am Post subject: |
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| ddeubel wrote: |
I find it amazing that the U.S. has less hospitalized mentally ill than the 1950s (I think at present about 44,000 as oppossed to 1-1.2 mil. in the late 50s). These people can only have been transferred to prison. Shouldn't something be done or is it just tough luck, shut the door, drug them and let the prison population beat and screw you up further? I've heard that in most major prisons, the ratio of psyciatrist to mentally ill inmate is 1- 1,000.
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Over a period of several years, the hospitalized mentally ill were relocated into their communities: halfway houses, families, self supporting, or on the streets etc. This happened something like 3 or 4 decades ago. They were not moved into prisons. |
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ddeubel
Joined: 20 Jul 2005
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| Posted: Thu Sep 24, 2009 12:22 pm Post subject: |
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| Quote: |
Also, Ddeubel, this discussion probably cannot work because you are, typically, essentializing the entire United States when in fact individual states make their own laws re: mental health.
You cannot possibly have even begun to take that into account in your op-ed-style thinking here. |
Gopher,
Yes and no. Yes, individual states are responsible for much of program delivery and yes, there are differences. No, this does not stop anyone from talking about "health care in America" or "the mentally ill in America". Your arguement is false and disengenious. We both know that the Federal government significantly controls policy in this area and also controls much of the money that flows through the system and allows it to operate. Further, should we simply stop discusions of any sort because you or others believe that "it is too complicated" ? This is essentially the arguement of those counting the angels dancing on the heads of pins. Essentially an arguement of academia as it exists today, an arguement of authority holding an axe over the thoughts of "people" (forgive me if I'm sounding like Chavez - I'm listening to his speech right now). An arguement that is wrong. We can talk about these things despite the differences because the similarities are more important and great.
| Quote: |
| Over a period of several years, the hospitalized mentally ill were relocated into their communities: halfway houses, families, self supporting, or on the streets etc. This happened something like 3 or 4 decades ago. They were not moved into prisons. |
ontheway,
Yes, I realize that and the article linked above relates such. However, I'm arguing that without proper funding of community based treatment, without an appreciation of "drugs" not being an instant cure, without an understanding of the "prison industry" -- this policy was disasterous and essentially a "criminalization of the mentally ill".
Basically we have gone from 1950s and 1.2 million mentally ill institutionalized to 48,000 at present (despite the significant increase in overall population in the US.). Where have the severely mentally ill gone besides the streets and halfway houses? They have gone to prison. Now we have over 600,000 mentally ill housed in prisons with even wardens across the nation saying "We are the defacto mental institutions of the nation".
I won't drone on. You can read the articles on the net - about funding problems (especially California's rejections of fed. funding and many states just failing to recognize there is a huge problem), about numbers, about the prison industry, about how you are almost assured to become a criminal if you are mentally ill and poor. About how expensive it is to keep the mentally ill in prison and how they stay in prison much longer than others. About how there is no support. I won't drone on (but have) - here are my questions if anyone cares to answer;
What can be done to stop the mentally ill being "criminalized"?
Why, since this is such a huge budget issue for health care, why has this not been spoken of, during the present debate?
Is it enough to let "the community" look after the mentally ill and how does profit based health care and "prison care" help or hinder the problem?
Is it not wrong to incarcerate someone who is mentally ill and "unfit"?
This video is really amazing - I highly recommend it.
http://www.jennackerman.com/trapped/feature/
Also, though old, this radioworks program offers everything for a primer on the issue.
http://americanradioworks.publicradio.org/features/mentally_ill/index.html
Once more, thank god for people like Bill Kleiber in Houston. Shining lights in a lot of darkness.
This year 700,000 inmates across the country will be released and almost half of them will have significant mental health problems. Without caring people on the streets - most are headed back to prison and homelessness and addiction on the streets.
DD
http://eflclassroom.com |
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ddeubel
Joined: 20 Jul 2005
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| Posted: Sun Oct 04, 2009 3:33 pm Post subject: |
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My New York Review of Books finally arrived by post and in it is an incredibly lucid article by Oliver Sacks, - " "The Lost Virtues of the Asylum". (I'd also recommend his review, available online , A Summer of Madness. http://www.nybooks.com/articles/21774)
He really calls it as it is (though unlike me, without wondering why this isn't part of any health care debate or put into the realm of "national emergency".
Besides a good overview on the process of deinstitutionalization and the failure of government to look after those that "can't" (the ensuing homelessness, crime, drug use, death) he lays out how antipsychotic medications are an abysmal failure by only treating half the disease.
He writes...
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| "the millions of mentally ill remain the least supported, the most disenfranchised and the most excluded people in our society today. " |
I for one have been in the dark about this, in denial. It really is an epidemic and something America should have on the agenda when it comes to "health care reform".
DD
http://eflclassroom.com |
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mises
Joined: 05 Nov 2007
Location: retired
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| Posted: Sun Oct 04, 2009 4:57 pm Post subject: |
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| Deinstitutionalization has been a disaster. Institutionalization wasn't much better. |
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young_clinton
Joined: 09 Sep 2009
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| Posted: Tue Oct 13, 2009 6:24 pm Post subject: |
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| For the most part the mentally ill are better off not in institutions. Although there was always the assumption that the institutions were there to help patients, I think really people were institutionalized for purposes of control and putting away undesirables. There is still a huge debate whether or not psyciatry and psyciatric drugs in general actually help the mentally ill. In some few cases the drugs are magic bullets, but whether or not they help the general population of mentally ill people as a whole is questionable. Psyciatrists may actually do more harm to thier patients by giving them a diagnosis that is poorly defined and superficial, and that provides little understanding to what is actually occuring. |
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rollo
Joined: 10 May 2006
Location: China
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| Posted: Thu Oct 15, 2009 2:31 pm Post subject: |
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| The patients rights movement led by very well intentioned people were the prime force in deinstitulisation. Professionals in the field warned that this policy would be disaster. No one was transferred to prison. |
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TheUrbanMyth
Joined: 28 Jan 2003
Location: Retired
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| Posted: Thu Oct 15, 2009 7:06 pm Post subject: Re: The US Health Care Debate and the mentally ill |
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| ddeubel wrote: |
I've watched and read a lot on the health care debate in the US. Yet, I've never heard it once mentioned - the elephant in the room - the mentally ill.
Most mentally ill have become institutionalized as part of the criminalization of mental illness that exists in the States. Hospitals, state institutions, house only a small percentage of the mentally ill in the nation. Most mentally ill are sent to prison and don't get a hand up or even a hand out. They are just held down and drugged down. Bedlam.
?
DD
http://eflclassroom.com |
Actually most mentally ill people are not imprisoned or for that matter institutionalized. |
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Reggie
Joined: 21 Sep 2009
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| Posted: Thu Oct 15, 2009 9:07 pm Post subject: |
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I'm sure anyone who has been to Washington D.C. has noticed the large number of homeless, mentally ill war veterans sleeping barefoot on benches. These men have been highly visible to politicians of all political parties for decades but have been ignored. The people who drive vehicles with "We Support Our Troops" magnets have never done anything for these men. Neither have religious organizations or anyone else.
When our combat veterans suffering from PTSD get treated like that in our nation's capital, one can only imagine the contempt we have for people who go crazy from smoking dope in Smalltown, USA. With drug use becoming rampant, wars continuing, and economic hardships to add to the stress, mental health issues are going to be an ongoing issue.
I don't know what the solution is, but I guess if we took a moment to actually give a damn, it might be a nice start. |
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