Who Says You're Crazy?

Locking up loonies means giving government the power to lock you up.

The New York Times pointed out that the gun control debate has brought about a bipartisan moment in Washington - both Democrats and Republicans agree that we need better care for crazy people, a.k.a. "mentally ill."  It's been known for a long time that many homeless people are sufficiently mentally ill that they can't cope with the complexities of modern life.

In the late 1800s to the mid-1900s, many American cities and states set up asylums to care for crazy people.  As with most well-meaning government programs, costs got out of control and inmates suffered terrible abuse.

Beginning in the 1960s, most public mental institutions were closed.  Advocates expected that local health care centers would care for the now-released mental patients, but such centers never materialized.  Many of the people who were released from mental institutions ended up among the homeless street people, harassing taxpayers for funds directly instead of indirectly as before.

Hope for the Homeless?

Mental health advocates are hoping that the Newton massacre will bring the funding they've been demanding for many years:

While the Senate has been consumed with a divisive debate over expanded background checks for gun buyers, lawmakers have been quietly working across party lines on legislation that advocates say could help prevent killers like Adam Lanza, the gunman in the Newton, Conn., massacre, from slipping through the cracks.

... Unlike the bitter disagreements that have characterized efforts to limit access to guns, the idea of improving mental health unites Republicans and Democrats, urban and rural, blue state and red state.

Voting in favor of better mental health allows politicians who oppose gun control to avoid criticism from the families of the kids who were killed in Newton, Conn.  It's likely that Washington will "finance the construction of more community mental health centers, provide grants to train teachers to spot early signs of mental illness and make more Medicaid dollars available for mental health care."

The 400-Pound Mental-Health Gorilla

Those who want government to spend more on mental health welcome the money, but they warn that the new system won't be perfect:

Though more stringent reporting standards into the nation's background check system will undoubtedly help, he [Ronald S. Honberg, legal director for the National Alliance on Mental Illness] added, there will always be holes.

"It's very difficult to come up with a system that's foolproof," he said. "The bigger point is if you really want to improve mental health care in this country, then let's improve mental health care."  [emphasis added]

The 400-pound gorilla of a "hole" Mr. Honberg didn't mention is what to do if a mental patient doesn't want to take the medicine doctors recommend.

This is a difficult issue.  One of my friends suffered from some sort of mental illness.  When he took his medicine, he acted more or less normal.  When he didn't take it, he lost it to the point that he'd beat up his wife and children among other anti-social acts.

The medicine had undesirable effects that gave him good reason to not want to take it: it made his head hurt very badly and made him impotent.

When in the depths of his illness, he could sometimes be persuaded to start taking the medicine.  He'd act better after a few weeks, but then the undesirable effects would kick in and he'd kick the pills again, restarting the cycle.  What should we do in such cases?  Send the cops 'round to force him to swallow medicine he hates?

Police complain that they can't do anything about homeless people who don't want shelter.  Should police have the power to force homeless street people to move to places they don't want to go?  There have been a number of notorious cases where odoriferous and ill-behaved bums basically ruined the enjoyment of public spaces for countless upstanding citizens, but who were able to win lawsuits to the effect that they had just as much right to be stinking up the library as anyone else.

In years gone by, police would execute the "bum's rush," sometimes even loading vagrants up into trucks and dumping them over the edge of the state line far out of town.  The Supreme Court has put an end to this practice, which seems like an improvement in civil rights on its face - until you have to actually go downtown and trip over filthy, threatening, bug-infested loonies.

Locking Up "Crazy" Grandpa

And that's with people that truly do have serious mental problems.  What about those whose only problem is being inconvenient to somebody powerful?

Unscrupulous heirs have always tried to get elderly relatives certified as crazy so they could take over their money; powerful men used similar methods to dispose of an inconvenient wife.  In the past, it was pretty easy to get someone committed, which is one reason why there were so many mental patients.  From the hospital's point of view, a patient was a source of money, so they were reluctant to let anyone go.  People who knew they weren't insane tended not to cooperate with the staff, which contributed to abuse in mental hospitals.

At the same time mental institutions were shut down, many state laws were changed to make it a lot harder to commit people.  Again, this seems like a victory for personal rights and individual liberty - but it's why the police can't force street people into shelters no matter how messy they make the place look.

What do we do about this?  Set up a committee?

Think about this for a moment.  We forcibly drug school kids whose behavior we don't like, ordinarily with the permission of the parents.  Should we be equally free to forcibly drug adults whose behavior we don't like - or, more precisely, which irritates those with power?

The Soviet Union was famous for its use of mental institutions to abuse political prisoners.  Communism was so obviously the only right way to run a society that anyone who disagreed with communism was by definition crazy; many dissidents were treated for that particular "mental illness" with horrendous effects.

As conservatives, we think that lots of liberals are delusional; should we be permitted to drug them, or better yet, lock them up to keep them from harming society?  But that's a dangerous road: whom in government or anywhere else would you trust to decide that you are crazy enough to lock you up and physically force you take medicine you don't want?  Eric Holder?  Your parents?  Some doctor?  Sarah Palin?

If the government can force you to take medicine you don't want, can they force you to have an abortion you don't want?  The Chinese government claims the power to do that and has used it with a vengeance for many decades.

Remember the hooraw about mammograms?  The committee wasn't saying that younger women couldn't have mammograms, they said merely that insurance shouldn't pay for them and that slow-growing cancers in the elderly shouldn't be treated because the cure was worse than the disease.  From all the yelling and screaming, you'd have thought they were saying that breast cancer shouldn't be treated at all.  The right to lock people up should bring about even more controversy once people realize how easily it can be abused.

The Obama administration has declared that it's OK for the military to kill American citizens on the President's sole say-so.  We at Scragged don't trust the government to declare someone crazy enough to be locked up, and we certainly don't think any government official should have the ability to decree death for someone without the assent of "twelve good men and true" in a court of law.

Without that kind of direct bureaucratic power over life and death, however, how do we handle crazy folks who don't want to be treated?  Maybe filthy bums on the street and the occasional mass murder is the price we pay for not worrying about being whisked off to the re-education camps.

Will Offensicht is a staff writer for Scragged.com and an internationally published author by a different name.  Read other Scragged.com articles by Will Offensicht or other articles on Law.
Reader Comments

Very interesting and thought provoking column, as usual. A smelly bum on the streets is one thing, but when you are the victim of a mass murder, that is another. Yes, life is full of risks of all kinds but we look to government to protect and defend us. There must or should be some happy medium (median?). I don't believe it is always an "either-or" thing, and I suspect you don't believe it as well. The larger question is how do we protect the individual from both being the victim of a shooting and from being unjustly restrained in acting on our free will. I am afraid I don't have the answer to that at this time.

April 16, 2013 12:15 PM

The sole job; the sole duty; the sole responsibility of the government(s) of the United States of America is to protect the individual, inherent natural rights of the people. Protecting the borders of the nation and the territories is part of the protection of our rights. We have the right to our property and freedom
If one reads carefully and understands the original seven article of the Constitution for the United States, along with the first twelve amendments one will learn that the Federal Government that was empowered by We The People, had no power to address the social ills, or what is perceived to be the social ills, of the society.
The general welfare clause, "...promote the general welfare..." and the clause in Article I section 8 "The Congress shall have the Power To...provide for the common defence and the general Welfare of the United States;..." have been misconstrued to mean that the various government(s) can assume the power to take the money from one segment of society, those who actually work and produce, and give the money, after a share is taken to pay for the activity, to those who don't produce.
In all of the history of mankind, is there one instance of the government successfully carrying out a project that done more good than harm? Of course we can except killing and maiming during wartime. Governments are very good at that activity.
Peace, Robert Walker

April 16, 2013 12:30 PM

It seems to me that I am more threatened by malevolent government bureaucrats who profoundly disagree with my political and religious beliefs, than I am by stinky bums and mass-murdering wackos. You can always kick a bum who is harassing you, and mass-murdering wackos are extraordinarily rare so can be statistically disregarded. History proves that government-run men in white coats are far more dangerous and difficult to resist.

As far as a middle ground, I'm not really sure how to do that. We all agree that when a court rules you incompetent, that's acceptable - and we still have this process today, it's just really hard and expensive thus rare. As it SHOULD be!

But if you want to lock somebody up **before** they commit a crime, you know it's going to be Tea Partiers thrown in the dungeon, not guys named Mohammed.

April 16, 2013 12:34 PM

Mentally challenged people have always been around. To suggest that they can't adjust to the complexities of modern life is incorrect in my viewpoint. Modern life life is what it is regardless of the year, be it 1813 or 2013. The question is what to do with these folks. Do you trample the rights of a few for the protection of many or do you allow bums in the streets. In my viewpoint the SCOTUS hurt our society in more ways than one when they allowed the people in institutions to be set free. Yes, I am sure that there was the abuse of a few but this is not a perfect world. I don't think that one has to have a PhD in physchiatry to figure out that a person mentally challenged. If we would allow common sense to enter the picture rather than allow a bunch of lawyers writing the rules to protect everyone in every way we would be much better off not only in this topic but many others. Conclusion: bring back the mental institutions.

April 16, 2013 12:46 PM

Bassboat,
Before we jump on the bandwagon to bring back the mental institutions, we might want to take a look at www.cchr.org and their reports on what psychiatrists have done in the past, and what they are doing now.
Prefrontal lobotomies, electroshock therapy, ice baths, sterilization and worse, were the orders of the day.
I am of the opinion that if the government got out of the way, and let things take their natural course, we would have fewer social ills, and a lot more peace.
Your statement on modern life, no matter the year, is exactly right.

Patience,
The malevolent government is the biggest threat to our peace and prosperity. As I sit here pondering the imponderable, and pounding the keyboard, I can watch members of the Las Vegas Metropolitan Police Department practicing their trick riding on my motorcycles, while burning up my gasoline, and while collecting a paycheck. They practice quite frequently in the back parking lot of a defunct Government Motors dealership.
Peace, Robert Walker

April 16, 2013 1:11 PM

RW,
Let's not forget that the doctors of the past used leeches, bled people when they were sick and numerous other what we consider today to be insane things. Medicine has always been a practice and you leard by your mistakes. How many people are alive today because of what at the time was an experimental procedure so let's not be too hard on the aforementioned doctors.
As for your government statement I agree that government is not nor will ever be the answer. What is causing problems today is that the government turned out the loonies to the streets. It hurt the loonies and the rest of society. I doubt that in today's world that you would see people locked up who were not a touch off. Would some get screwed? Of course but it's the lesser of two evils.

April 16, 2013 5:48 PM

Bassboat,
Don't get psychiatrists mixed up with MD's.
Let me give you the gruesome details of a prefrontal lobotomy. The patient is put to sleep using some form of anasthesia, /then one eyelid is lifted and an ice pick, yes an ice pick is inserted under the skull bone over the eye, and then moved back and forth to destroy the brain tissue in the pre-frontal lobe. The procedure is repeated on the other side of the nose to ensure total destruction. This makes the patient more docile.
Electro shock therapy consists of electrodes placed on the temples and as much as 90,000 volts of electricity at a low amperage is shot through the brain. Many patients were killed by these insane activities.
The ice baths: A patient is placed in a tub of hot water, hot enough to turn the skin red, and after a few minutes, taken from the hot water and put into a tub of ice water. The shock can and did kill.
Need I describe sterilization and what it does?
There is no sane defense for the activity described above.
Peace, Robert Walker

April 16, 2013 6:17 PM

RW,
It is gruesome but what if it had worked? Do you think they were trying to hurt the patients? I think you are confusing what we know today with the past.

April 16, 2013 7:38 PM

The doctors who bled George Washington killed him, but they were doing what was state of the art at the time.

Bleeding people was always bad, of course. We can't necessarily fault the individual practitioners, but we CAN criticize the profession for not collecting data and figuring out that it didn't work.

OOH, modern doctors keep doing what make them money regardless of whether it works or not.

April 16, 2013 8:46 PM

Nate, you are correct in that many times patients are given unneeded tests and the bills go through the roof. Don't forget why they do this many times. Lawyers have a field day in court if a doctor has not run every test imaginable. This is where 90+% of the problem lies, at the feet of the lawyers. I am not ignoring that there are some bad doctors out there but the vast majority of them don't have much of a choice.

April 17, 2013 2:17 AM

Bassboat,
You're good, but you need more practice. The left wing tactic of changing the dialogue only works some of the time, and not at all on those of us who recognize the tactic.
You haven't been quite successful in getting the dialogue changed to one about MD's.
You wrote "what if it had worked?" What if it had been one of your children that was being used for the butchering experiments? Would that have been okay? Or you. Would you volunteer for the experiments? How about a brother or sister, would you give one of them up?

John Volk,
Each one of us is responsible for our own condition. Further, it is not the responsibility of the government to protect us from each other. How many of the smelly bums were once successful, and fell down because they couldn't comply with all of the government regulations? Regulations that are far outside the parameters of any authorization to promulgate. When we start looking to someone else to take care of us, we are then lost.
Peace, Robert Walker

April 17, 2013 3:12 AM

JW,
You are using a rear view mirror for your argument which incidentally is what medicine, CEO's, and anyone who wants to learn. Did they call Columbus crazy when he took off for the New World? Yes, the experiments were crazy since they didn't work. what would have happened to all of the people who have received stents, bypasses and heart transplants if it had not been for Dr. Chriatian Bernard when he tore a man's heart out of his chest and put in a mechanical heart? Does that sound gruesome enough for you? You totally missed my point and may be incapable of understanding it.You may have the last word as this is an obvious exercise in futility.

April 17, 2013 9:54 AM

I think we're missing an important point here, and that is the granting of consent.

I believe in the maximum personal freedom. Some people believe their diseases can be cured by taking herbs; occasionally they are right. It's not the government's business to tell them they can't have that treatment. Same thing for chiropracty, acupuncture, and various other treatments that were long pooh-poohed but have more recently been proven to have at least some good effects.

The same goes for major experimental surgery. If you have a wonky ticker and are going to die anyway, you might as well let some mad scientist try to give you an artificial heart - worst case you die, and you were going to die anyway. But that should be the patient's decision.

The trouble with the insane is that they are not competent to make their own decisions. So some other authority or procedure has to exist to decide that an individual person is incompetent.

Currently this is done before a judge in a court of law, and I think that's best. An independent judiciary and, if necessary, a jury provides the greatest possible protection for civil liberties. No it's not perfect, but every time it has been shortcut, bad things ensue.

April 17, 2013 11:10 AM

Patience,
You hit the nail on the head. It is personal freedom above all. It was not the MD's that were doing the experimental psychology operations, it was and still is, the psychologists.
If you access www.cchr.org as I suggested earlier, they have a video posted wherein a number of psychiatrists are interviewed, and none could say that psychiatry had ever cured anyone.
None of the people who were subjected to the psychologists experiments had given their consent to the experiment.
There are those amongst us who thing the 'gun control' issue is about gun control, but it is about people control. Overeducated fools can't see the difference.
Peace, Robert Walker

April 20, 2013 1:36 PM

The NYT understands that it's very hard to determine when someone is going to go postal. Very few media have pointed out that Bill Clinton was the one who decreed that military personnel, who've been trained in gun use at great expense, couldn't carry guns at work:

http://www.nytimes.com/2013/10/05/us/supervisors-of-navy-yard-gunman-were-told-of-issues.html

The mother of Aaron Alexis, the military contractor who killed 12 people at the Washington Navy Yard last month, told his bosses one month before the shootings that he had a history of paranoid episodes and most likely needed therapy. But Mr. Alexis’ managers at the Experts Inc., an information technology firm, decided to keep him on the job and did not require him to seek treatment, an internal company investigation has found.

The investigation by Hewlett-Packard, which oversaw the Experts’ subcontract at the navy yard and other military bases, concluded that the Experts mishandled Mr. Alexis and knew more about his mental problems than the company has disclosed, a person with knowledge of the inquiry said. As a result, Hewlett-Packard last week canceled its business relationship with the firm, saying it had lost confidence in its work.

“It is HP’s understanding that the Experts made their decision to return Mr. Alexis to duty without consulting a medical professional about his behavior, without determining whether he had seen a therapist as his mother suggested he might need to do, and without taking any other action to ensure that any mental health issues had been treated and resolved,” the person said. The person spoke on the condition of anonymity because he was not authorized to discuss the case publicly.

The Experts did not dispute most of the findings of the investigation, including that Mr. Alexis’ mother had made them aware of his history of paranoia. But in a statement, the Experts said that Hewlett-Packard was “fully aware” of problems Mr. Alexis was having in early August in Rhode Island, “and any claim to the contrary is baseless.” Over all, according to the statement, Hewlett-Packard supervisors consistently gave Mr. Alexis satisfactory or better ratings in the weeks before the shootings.

Mr. Alexis, 34, a former Navy reservist, was killed in a shootout with the police at the navy yard.

Since the Sept. 16 rampage, many questions have arisen about what the government and Mr. Alexis’ supervisors knew about his mental stability. Over the past decade, Mr. Alexis had been arrested three times in three states, including once after shooting out the tires of a car in what he told the police was an anger-induced “blackout.” But the government issued him a security clearance in 2008 and renewed the clearance this year when the Experts hired him to service computers on military bases.

In the aftermath of the navy yard rampage, President Obama ordered a review of how security clearances and background checks are conducted for all federal government employees and contractors.

October 5, 2013 11:51 AM
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