[Magdalen] Washington Post article on involuntary hospitalization of the mentally ill

James Oppenheimer-Crawford oppenheimerjw at gmail.com
Sun Feb 15 16:34:37 UTC 2015


That is why the mentally ill get pills right out of the starting gate.
It's economically cheaper to give a pill than to give other forms of
therapy.  And it's easy to say the person is getting therapy when in fact
all the research shows that the pill works a lot better (if and when it is
the indicated treatment at all!!) when combined with structured therapeutic
programs such as day hospital, counseling, work activities, vocational
rehabilitation, night hospital, etc.

Why does Johnny get such crappy mental health care.  It's your fault and
mine; we tell the cretins running the gummint that we want to cut taxes any
and every way we can.  The pressure has always been on to give the minimum
needed care for the minimum possible bucks.  and the folks deciding that
are our elected officials.

Mental health care has generally been pretty decent; it's only that the
electorate (you and me) absolutely will not pay what it costs to run it
correctly, and never really has.

We did it better in New York than anywhere else, and reckoning at the end
of the day, we did it catch-as-catch-can.  Programs worked because the
workers simply refused to allow them to fail.

I didn't know it at the time, but I lucked out in starting my emplyment
with TSONY at Harlem Valley Psychiatric Center.  It was pretty much in the
middle of nowhere. A state hospital (psychiatric center) runs on its
therapy aides and nurses. These were hired from the surrounding area.  But
the surrounding area was farms.  As a result, HVPC had mostly farmers on
its staff.  Farmers are unusual people.  Maybe it's because farmers have to
take care of their farms themselves, and if they don't do it, there's
nobody else.  Whatever the reason, these folks always, always did their
jobs.  They did more than what was expected of them.  To these folks, their
patients were like family.  They brought in special treats for the folks on
their wards.  If it was someone's birthday, chances were good a cake would
appear from someone's kitchen.  One night, shortly before I was hired, a
fire broke out in one of the buildings.  The center had a dedicated fire
department, and a loud horn would let the volunteer fire fighters in the
area know when there was a fire.  The number of blasts told which building
was effected.  That night, there were two blasts, followed by nine blasts,
repeating.

In countless homes, the response was the same. "That's my building!"
 "That's my niece's building!" "That's Mom's building!"  People arrived in
various forms of nightshirts and crawled into the building to lead the
patients out to safety. There were no injuries, but when I arrived, you
could still see the smoke-blackened bricks where the fire had been.

This and other small things over the years reminded me of the traditions I
was stepping into there.  I thought I would be gone very shortly, but I
ended up staying in the field for over thirty years.

It's the people and their ethical standards that makes good care.  The
policies from the central offices? Not so much.

James W. Oppenheimer-Crawford
*“If you have a chance to accomplish something that will make things better
for people coming behind you, and you don’t do it, you're wasting your time
on this Earth.”  -- *Roberto Clemente

On Sun, Feb 15, 2015 at 9:55 AM, Jay Weigel <jay.weigel at gmail.com> wrote:

> The problem, Jim, is there is in most places no such thing as "real
> community care". Mental health services are among the first cuts made to
> any budget, often before it's even submitted for consideration to whatever
> outfit is charged with dealing with budgets. On top of that, once it's
> submitted for consideration to whatever budget committee exists, anything
> left for mental health services is then cut, and cut again. And shall we
> talk about the nonexistent training given to police on how to deal with
> mentally ill persons?
>
> On Sun, Feb 15, 2015 at 1:32 AM, James Oppenheimer-Crawford <
> oppenheimerjw at gmail.com> wrote:
>
> > This varies greatly depending on where you live.  When I started in the
> > field in 1975, we were just breaking down the long term asylum model, and
> > real community care was coming into existence.  Even then, a person would
> > only be hospitalized (New York State, mind you) if they were found to be
> a
> > danger to self or others. So just because a person is very unpleasant to
> > others was not grounds for admission.  Mind you, I'm not talking about
> > involuntary commitment; I'm talking about even voluntary commitment.  If
> > someone volunteers to be admitted, this does not mean they will be.
> > Likewise, a person with suicidal thoughts is not necessarily going to be
> > admitted. There are large differences in suicidal tendencies.  Folks
> think
> > that if there "seems to be reason to be concerned," that a person can
> just
> > get committed, and that's simply not true.  There are standards that have
> > to be met.  It's not about someone being worrisome; it's about there
> being
> > demonstrable reason to suspect the person is a danger to self (or others)
> > The days when someone can be admitted "just because" are gone, and
> rightly
> > so.
> >
> > Yes, if someone was admitted, there generally are good, solid reasons for
> > it.
> >
> > James W. Oppenheimer-Crawford
> > *“If you have a chance to accomplish something that will make things
> better
> > for people coming behind you, and you don’t do it, you're wasting your
> time
> > on this Earth.”  -- *Roberto Clemente
> >
> > On Sat, Feb 14, 2015 at 3:18 PM, Susan Hagen <susanvhagen at gmail.com>
> > wrote:
> >
> > > I forgot suicide and self-harm.  People try over and over again to
> > > kill themselves and come very close to succeeding.
> > >
> > >
> > > On Sat, Feb 14, 2015 at 3:16 PM, Susan Hagen <susanvhagen at gmail.com>
> > > wrote:
> > > > Kate, whatever model you believe in as the cause, people are almost
> > > > always considered for involuntary confinement because their outward
> > > > behavior has become troubling.  It may be disorderly conduct, petty
> > > > crime, family members or neighbors reporting that they are isolating
> > > > themselves and not eating or taking care of their hygiene.  They
> > > > themselves may call the police to report that family or neighbors are
> > > > trying to kill them.  They may assault family or emergency responders
> > > > who try to help them.  There are a thousand things that may trigger
> an
> > > > intervention.   I listen to people who have been stabilized and
> > > > according to their self report they were just fine, minding their own
> > > > business when the jack booted storm troopers broke in and hauled them
> > > > away.  Their history documents very different circumstances.  What is
> > > > supposed to happen?  Do they belong in jail?  Should they starve?
> > > > Threaten people?
> > > >
> > > > I don't know the answers to any of these questions.  I do think that
> > > > sometimes people need to be in a secure place where they can get care
> > > > and I don't think that jail is the right place.
> > > >
> > > > Susan
> > > >
> > > >
> > > >
> > > > On Fri, Feb 13, 2015 at 10:18 PM, Kate Conant <kate.conant at gmail.com
> >
> > > wrote:
> > > >> I know the details, but that doesn't make it right.  I don't know
> what
> > > >> other diseases make one "eligible" for involuntary confinement.
> This
> > > just
> > > >> highlights the societal prejudice (and that is just as true among
> the
> > > >> medical community--at least around here).
> > > >>
> > > >> "What does the Lord require of you, but to do justice, love mercy,
> and
> > > walk
> > > >> humbly with your God?"
> > > >> Micah 6:8
> > > >>
> > > >> On Fri, Feb 13, 2015 at 7:12 PM, James Oppenheimer-Crawford <
> > > >> oppenheimerjw at gmail.com> wrote:
> > > >>
> > > >>> In most situations, the standard is two physicians (generally
> > > >>> psychiatrists) sign off on the patient being dangerous to himself
> or
> > to
> > > >>> others.  The patient is held for a period of 72 hours, during which
> > the
> > > >>> professionals decide whether or not to apply for a court
> commitment.
> > At
> > > >>> both of those junctures, the patient often simply elects to become
> a
> > > >>> voluntary commitment.  The court can commit for up to 90 days, I
> > > believe.
> > > >>> The State pays attorneys to represent the patients, and yes, they
> > > sometimes
> > > >>> do in fact get the patient released when the State pros would have
> > > >>> preferred to keep them, but generally everyone tries very hard to
> > have
> > > a
> > > >>> meeting of the minds.
> > > >>>
> > > >>> The time when the patient really truly is trying to be released and
> > the
> > > >>> State is resisting, there is usually a very debilitating mental
> > illness
> > > >>> making the patient unable to discern their need for care and
> > > protection.
> > > >>> Generally the patient is a danger to themselves, not to others. I
> > wish
> > > Mr.
> > > >>> Hopkins would publicly acknowledge that his role is utterly
> > fictitious.
> > > >>> Some folks think his character is typical. It's not.  At all, at
> all.
> > > >>>
> > > >>> James W. Oppenheimer-Crawford
> > > >>> *"If you have a chance to accomplish something that will make
> things
> > > better
> > > >>> for people coming behind you, and you don't do it, you're wasting
> > your
> > > time
> > > >>> on this Earth."  -- *Roberto Clemente
> > > >>>
> > > >>> On Fri, Feb 13, 2015 at 12:51 PM, Kate Conant <
> kate.conant at gmail.com
> > >
> > > >>> wrote:
> > > >>>
> > > >>> > The biggest problem I see with commitment laws is that they are
> > > >>> > discriminate treatment of the so-called "mentally ill".  They
> have
> > > the
> > > >>> > court system deciding what someone's "diagnosis" is and then
> > shafting
> > > >>> them
> > > >>> > for it.  Brain disorders are medical disorders.
> > > >>> >
> > > >>> > Kate
> > > >>> >
> > > >>> > "What does the Lord require of you, but to do justice, love
> mercy,
> > > and
> > > >>> walk
> > > >>> > humbly with your God?"
> > > >>> > Micah 6:8
> > > >>> >
> > > >>> > On Wed, Feb 4, 2015 at 8:04 PM, James Oppenheimer-Crawford <
> > > >>> > oppenheimerjw at gmail.com> wrote:
> > > >>> >
> > > >>> > > "...no good can come out of the Iowa Writers' Workshop
> > > >>> > > "
> > > >>> > > .
> > > >>> > >
> > > >>> > > Might be a short story in there struggling to get out.
> > > >>> > >
> > > >>> > > James W. Oppenheimer-Crawford
> > > >>> > > *"If you have a chance to accomplish something that will make
> > > things
> > > >>> > better
> > > >>> > > for people coming behind you, and you don't do it, you're
> wasting
> > > your
> > > >>> > time
> > > >>> > > on this Earth."  -- *Roberto Clemente
> > > >>> > >
> > > >>> >
> > > >>>
> > > >
> > > >
> > > >
> > > > --
> > > > Before enlightenment pay bills, do laundry.  After enlightenment pay
> > > > bills, do laundry.
> > >
> > >
> > >
> > > --
> > > Before enlightenment pay bills, do laundry.  After enlightenment pay
> > > bills, do laundry.
> > >
> >
>


More information about the Magdalen mailing list