In light of yesterday's shooting in Arizona by a deranged citizen, is it time we rethink housing the mentally ill in institutions, not only for our protection and well being, but also for their own? The entire mental health system changed back in the early 1970s, when nearly all inmates were released into the community and were allowed to take charge of their own lives (and could choose to take medication and counseling, or not).

I'm reading more and more news stories about what happens when the younger mentally ill are being sent to and housed in nursing homes among vulnerable old people -- rapes, stabbings, thefts, general mayhem. Meanwhile, staff is pulling out their hair.

Should the U.S. warehouse mental patients who fail a certain litmus test that shows they cannot roam freely among us? Do we raise taxes to reopen and build new state mental institutions?

WG ;
As I commented in my posting about the assassination attempt , the global Deinstitutionalisation movement began early in the 20th century.

I don't have the facts in front of me to determine that it accelerated in the 1970s or if the primary motives were financial or just a continuation of a move towards keeping mental patients out of institutions.

In relation to the shootings yesterday ,I am wary to say that his public rants are indicitive of a mental condition warranting locking him up. In this country you have to demonstrate much more than strange musings to be considered a mental patient. It's still early ,but I see nothing that indicates past violent behavior .

Regarding deinstutionalizing mental patients --

From -- The History of Mental Illness

"Reflecting the changes in the treatment of the mentally ill brought about by drug therapy and state and federal public policies in the late 1960s', state institutions changed their procedures resembling the previous moral management revolution. There was an emphasis on protecting the human rights of the mental patients that had historically been overlooked. New employees were hired to be less hierarchical and environmentally controlling as their predecessors. Treatments were geared at the individual and proved to be more effective then group cure-alls. There also was a notable move to de-institutionalize mental patients. In 1960 there were over 500,000 patients in mental institutions in America. It had become increasingly clear that there were many inmates in asylums in custodial care who were able to function in society with adequate out-patient care. Institutions continued to provide 24-hour, long term in-patient care, but now introduced outpatient services, day and night hospitalization, diagnostic services, pre-care and after-care, and more extensive training and research.

Simultaneous with the breakthrough in medical treatment, the community mental health movement became a centerpiece of President John F. Kennedy's congressional program. There were concurrent shifts in insurance coverage for the mentally ill provided by the Comprehensive Mental Health bill in 1964, and the Medicare and Medicaid Acts in 1966. All of these national movements led to a reduction of the use of existing mental health hospitals and an explosive growth in private hospitals, general hospitals with psychiatric wings, and community mental health centers. As a result, states greatly restricted long-term, full care services in state mental institutions in the late 1960s and early 1970s."

I worked the streets for many years, in down town Atlanta. It was a revolving door for the mental health community. They would come out and be given three days medication, if they did not sell it, or if it was not stolen, they would have trouble going into the state hospital down town every day and waiting a few hours to be seen to get their daily medication. ** and they could not work, since they had to go in and get meds every day, So they stop taking it, and start getting worried about or scared of the authorities.

But the trouble even then, is who and how do you lock them up, if you "think" they need help, guess what their family will want to sue you for violating their rights to be crazy and not locked up.

There were other factors also like class action lawsuits that forced States hands.
Interesting... all my reading on deinstatutionalization claim it was for humanitarian reasons . Now we hear that the patient wasn't
1st and foremost on the mind of the state ? Hmmm . At the risk of going off topic... sounds a lot like another debate about health care in this country.

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Originally Posted by Fr_Chuck

But the trouble even then, is who and how do you lock them up, if you "think" they need help, guess what their family will want to sue you for violating their rights to be crazy and not locked up.

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Also, when the family wants to lock them up, the state says they're not ill enough.

I don't see the mentally ill in public housing/nursing homes for elderly and disabled committing much mayhem; I see mostly drug addicts being classified as mentally ill when they shouldn't be and then committing mayhem. They are the ones stealing, raping, robbing, and causing multiple problems. Some are mentally ill of course, just as some alcoholics are.
Those big old hospitals were warehouses where people who could have been leading pretty ordinary lives were warehoused, never to be seen in public again. The situation now is better than it was, despite what does happen. Blame a lot of the fact that programs such as halfway houses and outpatient clinics are the first to be cut in a recession. The money you would spend on 'institutions' would be better spent on more and better outpatient care.

Yes, I think that mental institutions should be used more. I see far too many dangerous, mentally ill people walking the streets unsupervised and many of them are even given jobs by their social workers in workplaces such as hospitals, schools and retirement homes, places where they have access to knives, boiling water, pills and vulnerable people unable to protect themselves. Society has to get over this PC nonsense. Some people are not fit to be in mainstream society unsupervised and are a danger to others. The safety of law-abiding people has to come before the so-called rights of dangerous people who will never be normal. If one of them kills or maims someone, they are often declared not criminally responsible and could be set free in a relatively short time to prey on people again. Anyone that dangerous should be put in an institution permanently.

wow . I remember the conditions that Geraldo Rivera documented when he was a legitimate reporter . Back in the day he jumped the gates of the Willowbrook facility and showed the world the horrow of warehousing the mentally ill.

There is no easy answer to this question . With the advance in pharaceuticals there is probably no need for the asylums of the past. But clearly there are weaknesses in the system that has evolved .


by the way... I am doing some interesting searches on the education 'system' that Jared Lee Loughner is the product of . The path that it's taking is very interesting and adds another equation to what makes him tick .

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Originally Posted by tomder55

btw ...I am doing some interesting searches on the education 'system' that Jared Lee Loughner is the product of . The path that it's taking is very interesting and adds another equation to what makes him tick .

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But how many thousands of students have gone through that same system and aren't "ticking"?

I'm putting my money on the fact that Jared was simply being Jared. He didn't need a reason.

You'll love the connections to Chi town .

A relevant op-ed
Pajamas Media Loughner and How America Treats Its Mentally Ill

Hello WG:

Sometimes our freedoms can come back to bite us... Like, the freedom to own a gun with extended magazines... Like the freedom to stay FREE unless you commit a crime...

I don't want to go back to where it was... YOU civilians THINK you know about mental institutions, but you know NOTHING. In South Carolina, where I visited the big house, one complete cell block was designated "state hospital". That meant that many of your relatives, who you THOUGHT were being medically ministered to, were instead in PRISON being treated like people who had committed a crime...

Do I have the answer?? You'd think I would since I know everything in the world, but I don't.

excon

Relevant op-ed by Rich Lowery

The Madness Lobby - Rich Lowry - National Review Online

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Originally Posted by tomder55

relevent op-ed by Rich Lowery

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Hello tom:

I can't think of a better argument for Obamacare..

excon

Yeah ,instead being on the streets, the mentally ill will be subject to a nurse Rachet on a death panel.

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Originally Posted by tomder55

Yeah ,instead being on the streets, the mentally ill will be subject to a nurse Rachet on a death panel.

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I would rather have my paranoid schizophrenic uncle institutionalized instead of taking his meds (or not taking them) when he felt like it, ranting at the grocery store to anyone who will listen to him, sitting on his front porch and yelling out nasty comments to passersby ("Your dog is fat and so are you."), and be at risk of getting picked up by the cops (and then I get a phone call to do something about it).

Been there, done that.

Hello again,

The idea behind closing the state institutions was the thought that the patient could stay on the streets and still be treated locally... But, the local thing didn't work out...

I suggest that Obamacare can bridge the gap between the two positions... Most of the mentally ill aren't dangerous and don't need to be institutionalized.. They DO need their meds, though. Obamacare means the sick can get local treatment.

That should make you BOTH happy.. Right?

excon

Since I was commenting related to Ex's observation that Obama care would change this ;can you say specifically how ?
It was liberal policies that emptied the institutions in the 1st place.

But ,by all accounts they were as nightmarish as Ken Kesey portrayed . Geraldo Rivera's exposes of Willowbrook confirmed that also.

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Originally Posted by excon

Hello again,

The idea behind closing the state institutions was the thought that the patient could stay on the streets and still be treated locally... But, the local thing didn't work out...

I suggest that Obamacare can bridge the gap between the two positions... Most of the mentally ill aren't dangerous and don't need to be institutionalized.. They DO need their meds, though. Obamacare means the sick can get local treatment.

That should make you BOTH happy.. Right?

excon

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Ex what provisions of Obama care suggests that? Already they are going to screw Medicare patients . If there are changes in policies dealing with mental patients I don't know them.

Hello again, tom:

I don't. I was going to insert the words "public option" instead of Obamacare. It would have been more accurate to do so...

I'm just hoping that these people WOULD be provided for under Obamacare. Maybe not. What? You think I'm going to read 2,400 pages?

excon

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Originally Posted by tomder55

Obama care would change this ;can you say specifically how ?

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Of course, not every mentally ill person would be a fit for an institution. Most of them do quite well as long as they take their meds properly and do what other maintenance is required. If they also have good support systems in the community and within their families, success is almost a sure thing. That's where your "death panels" would come in -- a team of experts to circle each wagon and work with individuals and their families to provide the best solution for them.

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But ,by all accounts they were as nightmarish as Ken Kesey portrayed . Geraldo Rivera's exposes of Willowbrook confirmed that also.

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Some, especially state ones, were, but most did the best they could. My grandmother was in a county facility and received good care back in the '40s and '50s. That particular institution still has a good rep. My uncle was in a VA mental facility off and on for years and also received good care (I had POA, so know first-hand.)

It mostly depends on the administrator/doctors whose management style determines staff behavior and attitudes. I've visited some really terrible facilities where patients feel free to disrobe in the dayroom, menacingly accost visitors, and generally have few boundaries. The administration was in shambles at the time, and the facility was eventually shut down.

The way I see it ,Laughner was not screened for ,nor did he seek mental health care . So unless Obamacare forces mental health screening on people I don't see how circumstances change . Tht was really Lowery's point. He said that of all the States, Az. Has one of the better plans .

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Originally Posted by tomder55

The way I see it ,Laughner was not screened for ,nor did he seek mental health care .

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My friend's Uncle Gerald didn't seek it either. His brother and wife made sure he was assessed by a "death panel."

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So unless Obamacare forces mental health screening on people I don't see how circumstances change .

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It wouldn't be forced. It would be required like a driver's license is required if you want to drive. Or even better, it would be required like auto insurance is in Illinois.

Most of us do the "death panel" thing now with our health care providers. When I landed in the hospital last September and ended up with two life-threatening conditions, my personal physician pulled together a team of specialists and other health care workers and met with them to get organized, and then with me, to make sure I had the best care/treatment available. At one point, I decided I didn't like one phase of the care presented. I objected, offered reasonable and legit alternatives, and my care plan was changed for that particular phase.

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It wouldn't be forced. It would be required like a driver's license is required if you want to drive. Or even better, it would be required like auto insurance is in Illinois.

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I don't think he was referred by his parents either... nor did his friends ,or the people who noticed he was wacked out at his school.

Mandatory mental screening would be a good way for the Obots to screen the Tea Partiers and right wing radio listeners and quarantene them from the general population.

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Most of us do the "death panel" thing now with our health care providers. When I landed in the hospital last September and ended up with two life-threatening conditions, my personal physician pulled together a team of specialists and other health care workers and met with them to get organized, and then with me, to make sure I had the best care/treatment available. At one point, I decided I didn't like one phase of the care presented. I objected, offered reasonable and legit alternatives, and my care plan was changed for that particular phase.

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That's not the same thing. The doctors in Obamacare are rewarded for offering end of life councilling .

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Originally Posted by tomder55

That's not the same thing. The doctors in Obamacare are rewarded for offering end of life councilling .

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I hope my doctors will be offering me end-of-life counseling. I will need expert opinions and advice. And I hope they will be properly rewarded for it too.

WHY are people having trouble understanding palliative health care and end-of-life counseling every FIVE years?

DOCTOR'S ORDERS
Obamacare for old folks: Just 'cut your life short'
Health plan provision demands 'end-of-life' counseling
Posted: July 22, 2009
8:21 pm Eastern

By Bob Unruh
© 2010 WorldNetDaily

The version of President Obama's universal health care plan pending in the U.S. House would require "end-of-life" counseling for senior citizens, and the former lieutenant governor for the state of New York is warning people to "protect their parents" from the measure.

At issue is section 1233 of the legislative proposal that deals with a government requirement for an "Advance Care Planning Consultation."

Betsy McCaughey, the former New York state officer, told former president candidate Fred Thompson during an interview on his radio program the "consultation" is no more or less than an attempt to convince seniors to die.

"One of the most shocking things is page 425, where the Congress would make it mandatory absolutely that every five years people in Medicare have a required counseling session," she said. "They will tell [them] how to end their life sooner."

The proposal specifically calls for the consultation to recommend "palliative care and hospice" for seniors in their mandatory counseling sessions. Palliative care and hospice generally focus only on pain relief until death.

The measure requires "an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title."

Hello Carol:

**greenie**

excon