Monday, April 23, 2007

Why violent psychotics are not locked up

When I lived in San Francisco, I worked in the security business for 12 years. I remember having to deal with a lot of mentally disturbed people, many of them homeless.

Most of them were harmless to others, but clearly not able to take care of themselves properly or make good decisions without help. A few were obviously dangerous, to themselves and others.

Many on the left gleefully called it the Reagan legacy. And it's true, he did indeed play his part; yet Reagan was just one component. There was a coalition of liberal groups forming a "liberation movement" that had been pushing for release of mental patients from hospitals for many years. In the 1970's, this movement joined forces with fiscal conservatives to empty state run mental hospitals. This movement succeeded in other states as well.

Outpatient centers were supposed to replace the hospitals, at reduced cost. The left said this was more humane; the right said it would save money. When the outpatient centers failed miserably, funding for them was cut. The result is what we have today; chaos.

There is an excellent article by Dr. Jonathan Kellerman in the Opinion Journal that goes into this and much more:

Bedlam Revisited:
Why the Virginia Tech shooter was not committed.


An excerpt about the V-Tech shooting:

[...] Diagnosis from afar is the purview of talk-shows hosts and other charlatans, and I will not attempt to detail the psyche of the Virginia Tech slaughterer. But I will hazard that much of what has been reported about his pre-massacre behavior--prolonged periods of asocial mutism and withdrawal, irrational anger and hatred, bizarre writing and speech--is not at odds with the picture of a fulminating, serious mental disease. And his age falls squarely within the most common period when psychosis blossoms.

No one who knew him seems surprised by what he did. On the contrary, dorm chatter characterized him explicitly as a future school-shooter. One of his professors, the poet Nikki Giovanni, saw him as a disruptive bully and kicked him out of her class. Other teachers viewed him as disturbed and referred him for the ubiquitous "counseling"--an outcome that is ambiguous to the point of meaninglessness and akin to "treatment" for a patient with metastasized cancer.

But even that minimal care wasn't given. The shooter didn't want it and no one tried to force him to get it. While it's been reported that he was involuntarily committed to a "Behavioral Health Center" in December 2005, those reports also say he was released the very next morning. Even if the will to segregate an obvious menace had been in place, the legal mechanisms to provide even temporary "warehousing" were absent. The rest is terrible history.

That is not to say that anyone who pens violence-laden poetry or lets slip the occasional hostile remark should be protectively incarcerated. But when the level of threat rises to college freshmen and faculty prophesying accurately, perhaps we should err on the side of public safety rather than protect individual liberty at all costs.

If the Virginia Tech shooter had been locked up for careful observation in a humane mental hospital, the worst-case scenario would've been a minor league civil liberties goof: an unpleasant semester break for an odd and hostile young misanthrope who might've even have learned to be more polite. Yes, it's possible confinement would've been futile or even stoked his rage. But a third outcome is also possible: Simply getting a patient through a crisis point can prevent disaster, as happens with suicidal people restrained from self-destruction who lose their enthusiasm for repeat performances.

At the very least, in a better world, time spent on psychiatric watch could've been used to justify placing the Virginia killer on a no-buy gun list. I'm not naïve enough to believe that illegal firearms aren't within reach for anyone who really wants them, but just as loud dogs deter burglars and crime rates drop during harsh weather, sometimes making life difficult for a would-be criminal is enough. [...]

(bold emphasis mine) He goes on to explain why it has become impossible to intervene in cases such as this, and how we can expect more of the same, unless we become willing to deal with the facts that face us. This is a must-read for anyone who wants to understand how we have ended up with things the way they are, and what we might now consider doing about it.
     

4 comments:

Anonymous said...

Guess they'd say Humane is in the "eye of the beholder!" or something clever! I worked alone in downtown D.C. in the middle of the night on I street. I would go out for a soda in the middle of the night - the parking garage across the street - and buy a soda for people sleeping next to the machine! There was an old couple who slept in a jewelry alcove every night because medical problems took everything away. Yep - although most of the people I know would never attempt such a position. They also never get to know how harmless these people really are and how afraid they are to be in shelters. The streets in the business area are safer than the "burbs" and they all have something lacking in the mental area. If they didn't - they'd be in jail for "three hots and a cot!"

Every night (3 AM) as you pass the Vietnam Memorial - near the Lincoln Memorial - there would STILL and ALWAYS be tourists. Even in winter. In the winter you would also notice an entire crowd sleeping on steam grates.

NONE of these were dangerous, nor were they committing crimes.

Walker said...

If people reject state housing and health options, they can be on the street, even if they are 'sane.' (And in some ways, being taken care of by the state is indeed an insane state of affairs.)

But these personal anecdotes like those of Chrys designed to make us think that we are all one step away from the streets because of a health problem -- just stupid and false. Sorry Chrys, you are either a liar or a naive dope. Probably both.

Damn near EVERYONE has some kind of government income these days. In Indiana, there isn't a single soul under age 18 that is not getting free government insurance and no one over the age of 55 who isn't insured by the government. In point of fact, if you don't fall into one of those categories, you absolutely DO get government disability and everyone, and I mean everyone, does.

There is free housing, free food, free medical care. I suspect the only reason unemployment is so low is because everyone is on the dole.

Chas said...

Walker,

Please refrain from the insults, that's uncalled for.

Some of homeless are mentally ill people who are incapable of making even basic rational decisions required to take advantage of what help is available. Dr. Kellerman touched on that in his article; people who are genuinely mentally ill can't make good choices.

Many others of the homeless, mentally ill or not, choose to live on the streets so they can spend their welfare money on booze and drugs instead of rent and food.

I can't speak specifically about the people Chrys mentioned because I didn't know them. I think in most places there is lots of help to get people off the streets, but the homeless have to make an effort to work with the help available. Many do. The others, they can't or won't.

Anonymous said...

Whatever you want to believe Walker. I've had an interesting life - lived and worked in the D.C. area for 18 years or so - worked in INSCOM while in the U.S. Army for 4 1/2 years. These people are really here and there are even people who work full time in D.C. who can not afford places to live. There needs to be a place for people living this way to obtain security.

It's a huge problem in Ohio too - all of the people living on the dole - where do they think this all comes from. Anger shows it's head when I can't afford to go to the doctors, get my teeth fixed, etc. while deadbeats (not the street people) get these serves free! Chaz has seen some of the people who REALLY NEED this help while he worked in security.

Had to look ya up Walker - pretty good scrap booking - see you like Sopranos?! I've KNOWN these people and worked for them.

When you reach your 50s - you'll have experiences that people don't believe in your life. Unless you're one of those people who never serve, never travel or never take risks.

None of us have the right to call others liars - unless you've traveled the same newspaper route. OH - By the way - I too have worked for newspapers - actually single handedly built several! AND I've been self employed. I would NEVER consider being "low" enough to insult people I know nothing about silly surface child - look me up first. THEN say why you believe this way.

Nice to know there are adults available - Thanks Chaz