Homelessness, Hospitalization and “Compliance”

Jonathan Keyes
86
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“Whitaker clearly believes that schizophrenia should be treated without medication if at all possible. However he fails to focus any attention on the fact that on any given day in the United States half of all individuals with schizophrenia, or about one million people, are not being treated. This is a huge natural experiment to test his thesis. Many of these individuals are found in public shelters, sleeping under bridges, in jails, and in prisons. If Whitaker had spent more time in these settings observing the outcome of this natural experiment, instead of delivering lectures on his vision of the impending antipsychotic apocalypse, he would have written a very different book.”

 — From E. Fuller Torrey’s review of Anatomy of an Epidemic

As most of you know, E. Fuller Torrey is a psychiatrist, one of the strongest proponents of involuntary treatment, and a supporter of outpatient commitment — the process of mandating that individuals take psychiatric drugs for extended periods of time after being released from a hospital setting.  In the quote above, he accuses Robert Whitaker of ignoring the plight of the homeless “mentally ill” who he believes would be better served by the modern mental health system and forced psychiatric drug treatment.

But before getting to Torrey’s argument, let’s first take a look at how those who are poor and homeless and suffering severe emotional distress are generally treated in the community.  Often those who are suffering distress will be brought to a hospital setting by police or community members, or come in of their own accord voluntarily.  Once hospitalized, they are almost invariably prescribed psychiatric drugs and often are prescribed antipsychotics.

They then follow one of two tracks.  A large portion of this population returns to the streets within a week with a prescription or a short-term supply of these drugs.  It is estimated that upwards of 50% of people who are prescribed antipsychotics stop taking them.  There is no survey for homeless individuals but I would guess that the rate of “non-compliance” is significantly higher among them.  Folks like E. Fuller Torrey would suggest that anosognosia — damage to the brain caused by mental illness leading to a lack of understanding that one is ill — is the primary cause of non-compliance.  In essence, Torrey suggests that homeless people stop taking their meds because their illness makes them believe they don’t need them.  He believes that if they only knew what was good for them, they would happily take these drugs.

However, there are numerous more understandable reasons why the homeless population stops taking these drugs.  For one, the drugs all have serious side effects such as akathisiadystonia, constipation, loss of libido, sedation, confusion and weight gain.  The homeless population are also generally uninsured.  Even if they are insured, they need to still come up with co-pays for these drugs when they have limited — or no — money.  Finally, many come to disagree that taking routine doses of major tranquilizers will help them feel better.

In essence, this segment of homeless people who come to the hospital are started on potent psychiatric drugs and then quickly returned to the street — where they more than likely stop taking them.  The stopping and starting of these powerful neuroleptics can lead  to serious withdrawal symptoms that include severe anxiety, agitation, insomnia and psychosis that can be mistaken for underlying mental illness.

A percentage of the second group of homeless individuals who appear more severely emotionally distressed, with signs of severe psychosis and mania, will go before a judge in a civil commitment hearing and then will be involuntarily committed if they are deemed a danger to themselves or others.  At this point, a decision can be made to force the homeless individual to take antipsychotics and mood stabilizers even if they don’t want to.

Forced compliance.  The term is loaded with ethical issues and also presents a serious challenge to the constitutional right of individuals to choose how they live their lives as long as they are not harming others.  These are not criminals, and yet we treat them worse than criminals by suggesting that they may in the future commit violence and therefore we must protect against them by keeping them in a permanent state of government sanctioned sedation.

Torrey makes the argument that he is acting humanely because the State is also protecting these individuals from themselves.  But as evidence mounts that the long-term use of neuroleptics damages the brain and causes long-term health problems, the State is not actively protecting these individuals; it is complicit in causing these people long-term harm.

So: two avenues.  One is the hospitalization merry-go-round in which homeless folks are started on strong drugs and then discharged to the street where the lion’s share stops taking them, leading to severe withdrawals.

The other avenue is being involuntarily committed for a prolonged period, and made to take neuroleptics if the individual will not take them willingly.  Many states also have assisted outpatient treatment (AOT) laws, wherein an individual who is released from a hospital setting is usually forced to take a long-acting antipsychotic shot every week or two out in the community.  This is  something Torrey and his organization the Treatment Advocacy Center strongly promote.

On his website, Torrey makes some powerful arguments for assisted outpatient treatment.

He says that in studies AOT has reduced hospitalization, homelessness, incarceration, violence,  “treatment noncompliance”, and  caregiver stress.  Let’s take him for his word that these statements are true.

But, let’s look at it this way; I bet I could get the same statistics if I physically restrained someone for months at a time.  They wouldn’t be hospitalized, or incarcerated, or stress out the caregiver, because they would be restrained.  I could also get the same results if I lobotomized these individuals.  No need to worry about them being violent, because they have been surgically altered.

The act of long-term involuntary “treatment” is a form of chemical restraint that causes long-term brain damage.  It is a severe threat to a person’s health and well-being.  No matter what sort of “humane” results you get from AOT, it is completely negated by the implications of the State injuring people in the process.

Recently, Representative Tim Murphy introduced legislation that would sharply increase outpatient mandatory treatment, even for people who did not pose a  threat to self or others.

As we move further into this Orwellian world, if this law passes, the State will be able to force drugs on individuals who may be suffering severely from emotional distress who present no inherent danger.

Every year 7.6 million people go through inpatient psychiatric hospitalization.  A significant percentage of these folks are impoverished and homeless.  For many of these individuals, they have experienced a high level of trauma due to their socio-economic condition.  Instead of being served by the medical establishment, they are often traumatized further.  We spend an enormous amount of money on the process of hospitalization.  The average cost of each visit is about $5,700.  The average length of stay is 8 days.

As a therapist working part time in an inpatient setting, I often joke about the cost of care with patients.  When they find out their stay will cost many thousands of dollars I offer them a fantasy alternative;  I say, “Hey, instead of coming here, we could have flown to Hawaii and stayed in a hotel, ate at gourmet restaurants and gone scuba diving and surfing all day.”  They say,  “Yeah, I bet I wouldn’t feel nearly as depressed if I did that.”  It seems funny until you realize the massive misallocation of resources going towards paying for very expensive medical care instead of examining alternatives.

For the homeless population, my hope is that at some point we shift from spending such an enormous amount of money on emergency “care” and shunt more of those resources towards long-term assistance and services for the homeless.  One of the best social programs to develop over the last two decades is the policy of “Housing First.”  In this program, people who are homeless are offered an apartment first before addressing other concerns such  as their mental health.  Recently in Vancouver, this model was developed with good success.  From an article in The Vancouver Sun,

“The Housing First philosophy rethinks the traditional model of addressing homelessness among people with mental illness, which first treated the illness, getting the patients ready to go into the community and then finding a place for them to live.  Workers were often surprised and disappointed when the individuals were back in the hospital a few months later.  “It was a revolving door,” Bradley said. “With Housing First we don’t make unrealistic demands on people.”

The new model provides them with a safe place to live and “after a while people begin to think about their substance-abuse issues and their mental-health problems when they don’t have to worry about being warm,” she said.”

I also think it is key that we turn away from medicalizing economic disadvantage and trauma.  When someone is homeless, they are under an enormous amount of daily pressure to get enough food to eat, find a place to sleep at night, remain warm and dry in changing weather conditions and stay safe from people who would harm them on the streets.  These are stressors that often lead to symptoms of severe distress such as depression, prolonged anxiety, and for some, spiraling symptoms of confusion and disorganized thoughts.  For an in-depth look, Social worker Jack Carney gives a detailed explanation of the intertwining of poverty and people who are labeled with a mental illness.  Activist and survivor advocate Will Hall also talks extensively about how those who are poor are more easily labeled mentally ill in this interview here.

Pathologizing these symptoms of distress and labeling them as an underlying untreatable illness further traumatizes many of these individuals.  When they interact with health professionals, they are then offered “medications” to “treat” their illness.  Instead of offering drugs to these folks, let’s offer what they really want, and need; access to better shelter, food and safety.

86 COMMENTS

  1. Jonathan,

    IMO, this is not a bad post you’re offering here; really, it’s good, I think, in many ways.

    (Surely, it’s much better than your first post, IMHO — as you’ve done better fact-checking, I believe.)

    But, were I you, I would never have said this (in regards to E. Fuller Torrey):

    “Let’s take him for his word that these statements are true.”

    (Or, had I been your editor, I would have suggested leaving out that one sentence — and would have recommended that you provide links to any number of studies which indicate that “AOT” is not working as promised, by its promoters.)

    After all, Torrey (the world’s foremost individual promoter of “AOT”) is a notorious teller of untruths and half-truths.

    So…

    About the very questionable ‘effectiveness’ of “AOT,” I suggest checking out the following link, to an MIA comment (posted in June of last year) by Dr. Toby Watson…

    https://www.madinamerica.com/2012/06/tuesday-dinner-with-the-nami-mommies/#comment-12172

    Also, I most highly suggest you check out this following link, to an MIA post, titled “Community Treatment Orders Don’t Work”

    https://www.madinamerica.com/2013/04/community-treatment-orders-forced-treatment-dont-work/

    (Note: ‘Community Treatment Orders’ are, of course, the U.K.’s equivalent of “AOT”.)

    The conversation on that page refers to a Lancet article, which explains that, “the psychiatrist who championed [CTO’s] is calling for their immediate suspension.”

    Finally, I can’t help but point out, that I remain troubled by this fact, that you would force drugs on some people.

    (That you’ve done so would be forgivable, I feel… but, only once you’ve clearly renounced the practice, consigning it to past ignorance.)

    Because you show know sign of renouncing that practice, I can’t help but wonder, as you speak of the ‘homeless’:

    What do you really mean, as you conclude, “Instead of offering drugs to these folks, let’s offer what they really want, and need…”

    Upon reading that, I think, ‘OK, fine and good…’; however, then I’m suddenly reminded of your position on forced drugging; and, so, I wonder: Once you’ve given them a place to live, what then?

    E.g., what if some formerly ‘homeless’ resident comes to seem violent (or, perhaps, even seems to threaten what you might call “severe violence”)?

    You have said that you believe, ideally, “hospitals” should forcibly drug people who exhibit what you call “severe violence,” instead of calling the police.

    (As you know, I cannot agree with such policy, at all.)

    In fact, you indicate that such “patients” may have come from the jails.

    Therefore, from reading you, I gather, that: Despite your criticisms of long-term psychiatric drugging (criticisms which I know are sincere), you do think that the police should be used to bring supposedly “ill” people to psychiatric “hospitals” to be “treated” with drugs — if those supposedly “ill” (ostensibly, ‘psychotic’) “patients” are threatening “severe violence”.

    In deed, you seem to say that the police should never be allowed to take “ill” people to jail.

    (I believe that’s what you’re saying, after all, in your preceding blog post and accompanying comments, but I’m not sure, and you did cut the dialogue short there, so…)

    So, here I can’t help but wonder…

    Should your plan for the ‘homeless’ be trusted to offer just what is needed and wanted by such individuals, really?

    I mean…

    Would you or would you not recommend that housing administrators, who take in ‘homeless’ people, should call for any seemingly “violent” residents, to be sent to “hospitals,” instead of being formally arrested and charged with a crime???

    Hopefully, you do not read my comment here (nor my questions) as being overly-personal.

    Please, take all the time you need, considering a response…

    Respectfully,

    Jonah

  2. This is not really a comment, but a question. You said somewhere in this article that 7.6 million people experience psychiatric hospitalization every year. My understanding is that it is more like 2 million. Could you tell us your source for this? I actually think if your number is correct, in the long run it could be a good thing, because the more people who experience this, the larger the proportion of the population it is, the more likely the public in general will pay attention to these issues.

  3. The Medscape article was not available to non-subscribers. The other one displayed, but I think the larger figure referred to “secondary diagnoses,” meaning I suppose that admittees were given a psychiatric diagnosis but it wasn’t the reason for the admission. This is very interesting in itself, though, since it showed how willing even “regular” doctors are now to pin a psychiatric label on people.

    If you or anyone else has any more info about this, I would very much appreciate hearing about it.

  4. DJ Jaffe lies. E. Fuller Torrey lies. They make up “facts” to suit their purpose. What they’re advocating for is foolish. They don’t want “treatment” for the “worst” as they define it. SAMHSA already funds and supports a wide range of activities including help for the “worst.” What they want is ALL of it and that’s where they are foolish. It is folly to create a system of triage that only serves the “worst.” Imagine a system that only does heart transplants but does nothing less including prevention. Soon everyone would either be in line for a heart transplant or dead. DJ and Fuller are stupid. In addition, Fuller is a ghoul. After decades of collecting brains, he has not gotten a single iota of useful data. I can only presume it’s just to fuel his “brain” fetish. He has also been discredited for his theory that schizophrenia is caused by cat pee. Perhaps we should lock away all the kitties instead of people.

  5. This articles sums up my daughter’s painful experience. Thank you for putting it in words.

    My daughter is under civil commitment in Oregon, forced to receive an injection called Invega monthly She is only 24 years old, a beautiful sweet spirit who has been held down by force, restrained, and basically raped in the name of ‘medicine’. She is not violent but she has been so traumatized by her ‘treatment’ I marvel at her courage and dignity. She makes her jailors look tiny in comparison.

    You can’t imagine my horror of hearing Dr. Torry’s name mentioned under any circumstances, knowing that he is, at this moment, exploiting the horrific crime at Sandy Hook to make it easier to take away my daughter’s constitutional rights.

    Dr. Torrey’s literature is available on the website of the hospital where my daughter currently is at; it is listed as a ‘resource’ for gullible parents who are starved for consolation regarding their children. It is scandalous that patients can access NAMI’s literature and books by Dr. Torrey at these institutions but they cannot access literature from MindFreedom.

    Since Dr. Torrey would like to make it easier to take away people’s rights, warehousing them in institutions, cooping them up with hundreds of other individuals suffering various degrees of mental and emotional trauma, forcibly medicating them with harmful medications, I no longer feel like a citizen in this country.

    The hospital is run like a giant prison. Everyone is being chemically restrained. It is like Dante’s hell. Is it any wonder that people would rather live on the streets?

    Our whole family has been traumatized by my daughter’s experience. To hear people like Dr. Torrey spout their ignorant hateful and condescending views of what my daughter is going through and what she needs is like vinegar in the wound. Are they unaware of how much pain the current policies are causing, yet they want to expand this suffering to others?

  6. Whenever I hear the privileged talk about this stuff, they always do it with a tone and language that feels eerily similar to other historic bigotry. They talk about persons experiencing economic distress and persons experiencing emotional distress about like people used to talk about “the coloreds.”

    It’s “those people” this and “those people” that. It’s talking ABOUT others from a position of privilege rather than listening to and talking WITH other human beings about what their needs are and how to be compassionate human partners that is at the root of the problem.

    As long as Dr. Torrey and those like him continue to justify their own bigotry, and as long as the public continues to allow and accept it, very little good can happen. The attitude that persons in the working class are stupid while persons in the privilege class are wise and learned is as much a root cause of the these ills as anything else.

    We rightfully talk about all of the injusticies of psychiatry and the mental health system towards persons labeled “mentally ill.” But we don’t talk enough (in my opinion) about the fact that it is really poor people labeled “mentally ill” who experience the bulk of the coercive treatment and abuse. If you are rich, you are far more likely to only ever be known as “eccentric” rather than “sick.” And even if you are ever labeled with a “mental illness,” if you are rich then you get to CHOOSE your “treatment.” Don’t like what a psychiatrist is telling you? You fire that psychiatrist and go pay to see someone who will give you the designer “therapy” you want. Rich people don’t end up civilly committed, generally speaking. It’s not rich people who are filling state hospitals or locked down in secure treatment centers. During the year I spent working in an involuntary psychiatric center (before I quit in protest) – there was only ONE person in the entire time who came there who did not receive public economic assistance and have income below the poverty line. That one person was only there because he had committed a felony and was mandated by the criminal justice system. Short of committing a crime, the wealthy just aren’t subject to this system.

    So when we talking about abuses in psychiatry and mental health that’s important, and we should all keep doing that. But there is another issue that is even more foundational – class. Not all persons experiencing emotional distress have the same horror stories in mental health, and the difference between horror stories and healing stories can usually be determined by no other factor than how much money you have. Sad, but true.

    On the other hand, if you are poor your experiences with “mental health” are overwhelmingly bad. Our society is completely comfortable with the most paternalistic and bigoted attitudes imaginable when it comes to the poorest members of our society. So it should be a shock to no one that homelessness is used as an excuse to justify paternalistic, coercive treatment because the problem as seen by the privileged is a disgusting, ignorant, less-than-human underclass that inconveniences or threatens the day to day of privileged people – that is the problem that people like Torrey try to “solve” from their privileged vantage point.

    • I’ve recently been talking about how the mad are like canaries in mines. Look at who is going mad and you see who is most oppressed in a society. It’s the poor, ethnic minorities, LGBT people and people who have faced immense trauma usually caused by abuse of power.

      I went to a workshop on privilege recently and I raised this.

      The other thing about homeless people is that my impression is that they are much more likely than most to have suffered early trauma such as child sexual assault and family violence. That makes dealing with the everyday difficulties we all face much more difficult and so homelessness becomes a bigger risk. I do not know if this is true but I’d love to read some research on it. So maybe the same problems that increase peoples risk of madness also increase their risk of homelessness.

  7. Homelessness requires the same qualities that would get someone hired or promoted in another context. Does anyone exhibit a stronger will to survive, or grapple with more existential and practical dilemmas, than a person who must craft or pursue a “home” (and, in most cases, who remembers having one), on a daily basis, with no real means of doing so–all the while regarded with as much fear and hostility by those in better circumstances?

    Obviously, survival of the homeless isn’t the goal of forced drugging proponents like Dr Torrey, CBS, pharmaceutical companies, or our government with its arrogant funding of “brain” research and self-serving censorship. We have met the enemy, and they is us. Whose brains exactly should be examined first?

    Perhaps Torrey should spend more time–a long duration, in fact– “visiting” those dank places where the homeless schizophrenics are hiding out, with no access to a support system–perhaps while heavily medicated (it wouldn’t matter if he “needs” to be, after all, since merely being homeless would qualify him, not to mention that the system he shills for has rendered diagnoses essentially meaningless except as a way to separate Them from Us). Perhaps he would learn some things about people other than himself, other than that he would rather be him than them.

  8. I’ve said it before: It’s an injustice that professionals take massive amounts of tax dollar money in total to supposedly “help” societies most disadvantaged people, but in doing so they just wind up putting that money in their pockets and throwing the “mentally ill” people back on the streets.

    We’ve had homeless people in this country, for generations, who could honestly say “I may be homeless, but society has spent MILLIONS of dollars over the years supposedly trying to help me.”

    Even when the person has housing, it’s still obscene when you consider how far apart the patients and professionals are economically. Being a poor person living in poverty and being forced to have to comply with “treatment” services that you know costs many thousands of dollars… produces just horrible feelings. As if to say, “Society wont pay next to nothing to actually help me, but they’ll pay these guys 6 figures a year to just shut me down, and then have the nerve to call it help…”

    • “Society wont pay next to nothing to actually help me, but they’ll pay these guys 6 figures a year to just shut me down, and then have the nerve to call it help…”

      How truthful this is. The State here recently shut down a way-ward girls home whose method of treatment was solitary confinement. I estimated they spent $90,000 per girl to house and drug them.

      They city meets to cry about the jobs lost. Who crys for the girls?

    • I don’t doubt that many people are making a living as middlemen in this process. But the real money that drives the current process is Big Pharma, I suspect. They have the most ot gain from this model, obviously. On the other hand, if Big Pharma disappeared tomorrow, a legion of Nurse Ratchetts would step in and find some other way to keep the system going.

  9. Hi Jonathan,

    I think you make some very interesting points here, not just for homeless people but anyone on AOTs (or CTOs here in the UK).

    In particular, the ethical issues e.g. why do we treat mental health service users worse than violent criminals, who do not have to be forcibly given a chemical lobotomy when out of prison!

    It’s not just anti-psychotics that can go on a CTO, but lithium and valproate too. For mania, Valproate is the same as placebo for long term prevention of mania:

    http://www.thementalelf.net/publication-types/systematic-review/cochrane-review-finds-limited-evidence-to-support-valproate-as-a-maintenance-treatment-for-bipolar-disorder

    There is a logical fallacy that Psychiatrists use despite no evidence of long term benefits (and evidence of harm) of such drugs:

    1) We have to do something;
    2) This (e.g. Valproate) is something;
    3) Therefore, we have to do this

    It’s a bit like the logical fallacy:

    1) All cats have four legs;
    2) My dog has four legs;
    3) Therefore, my dog is a cat

    Surely, if Psychiatry claims to be a legitimate medical profession it must be evidence based!

    There is no evidence of chemical imbalance theories, yet this does not stop them for prescribing harmful drugs in the long term. I’m not anti-drugs, as there is a place in the short term for them (particularly minor tranquilisers).

    Regards,

    Mike

  10. I thought I had posted this, but evidently it did not hit the board? Housing First sounds like an excellent and caring program, and one that actually addresses homelessness. I have friends who work in area shelters. The residents are required to meet specific and often extensive demands, such as performing chores and attending job training. If they are “mentally ill,” they are sometimes unable to meet these demands and can not stay at the shelter. They also can not stay if they are actively addicted to alcohol or street drugs. If we want people to be safe and to not be homeless, first we need to provide them with a safe place to live. If the alternative is an unsafe or abusive environment such as a locked institution, people will “choose” to live on the streets.

  11. Here’s a short exercise: how much funding does E Fuller Torrey get directly and indirectly from pharmaceutical companies with a vested interest in continuing and increasing Rxs of psych meds? And how much funding did R. Whitaker get from anti-psychopharm sources before and when he was researching and writing Anatomy of an Epidemic? Given that, whose motives are more credible?

    The Canadian programme is excellent – though interestingly no one has mentioned the Finnish program that merits a whole chapter in Anatomy of an Epidemic. They use short courses of low doses of psych meds, when needed, in addition to intensive support and psychotherapy with obligatory involvement of family.

    Of course, the Finnish don’t have rich-poor divide of U.S., and they believe in redistributive taxation in which everyone contributes financially to the common good of their fellow citizens.

    All in all, it is a sad state of affairs. Emphasis on sad, as in “heartbreaking.”

  12. Homelessness, I often ask why anyone should have this problem when I am walking in home depot or the sears tool section. Look at how much better the power tools have become, lightweight fast lithium batteries no more cords… 10 guys can build a rather nice house start to finnish in a week these days.

    I saw some show on Netflix where they had this grand idea to give out housing vouchers or some sort, what ever.

    I think the solution to the homeless problem is to build some damb housing !!! Not wasting the dollars on “services”.

    “Services” = paperwork or at least 90% paperwork.

    Last I checked you can’t live in bureaucratic paperwork, or eat bureaucratic paperwork or drive bureaucratic paperwork to the store to buy office supplies to make more bureaucratic paperwork.

    Everyone would be richer if there were more people building actual things and less people doing bureaucratic paperwork.

  13. When I attended a social services day treatment group therapy center in San Francisco for several months, I became friends with a lot of people who lived on the streets and got along in life as panhandlers. Their stories and reasons for being on the streets were varied, and their personalities were diverse.

    One thing that was clear: they were mentally gifted, some of the sharpest and most aware people I knew in the city, and extremely insightful. They were savvy, tough, and sensitive to the feelings of others. A few of them I knew spent a lot of their vast spare time in the library, reading the news and watching documentaries, since they could do this all for free. They attended groups and other services where they could, so they could enjoy some company and interesting, intelligent, and hardy conversation.

    So why were they on the streets? They hated society, couldn’t stand the bullshit–the duplicity, hypocrisies, the expectation to conform, the compromise to their spirit and heart, the judgments, and on and on. At least some were very clear about this. Life is a game, and they were playing it their way.

    Certainly, this is not the case for all people on the streets. Many fall into this lifestyle because their basic soul needs have been neglected for too long, and they got emotionally violently knocked out of their connection to their natural intuition, which is what guides us through life.

    I once spoke at a city supervisor meeting at city hall against involuntary commitment and forced medication, and a social worker asked me, “What about the guy eating out of a trash can and covered with sores and feces? He wouldn’t be in that condition if he would have just taken his meds. Shouldn’t he be required to take them?”

    I answered that question bluntly, that she is way off in her cause and effect analysis, and not at all taking responsibility for what we, as a society, have created collectively. I pointed out to her that she is putting all the social ills on the homeless, when, in reality, it is her attitude that is the social ill, and is in large part responsible for what she is looking at, when she sees people digging through trash cans. She got mad and abandoned the conversation. I can understand that, but still, I felt she needed to sit with that for a while, and let it sink in.

    • Alex,

      Excellent and important comment. Thank you for sharing it. Your experiences and observations, in regards to that segment of the ‘homeless’ population, which you have known, are enlightening. They correspond well to what I have observed…

      (Hence, note: I say ‘homeless’ — because many people who are without personal physical shelter, do nonetheless have a home, a sort of meta-physical dwelling, in their hearts and minds, that they carry with them, wherever they go. Though, of course, it’s also true what you say, many “have been neglected for too long, and they got emotionally violently knocked out of their connection to their natural intuition, which is what guides us through life.”)

      I encourage MIA readers to thoughtfully consider all that you’re saying here, in this comment, of yours — especially at the end, where you relay the attitude of the “social worker” at the city supervisor meeting — because, from all that Jonathan Keyes (our blogger) is saying, by this point (in this blog post and his previous blog post), it seems to me that, despite his staunch opposition to long-term psychiatric drugging, as it’s promoted through “AOT” laws, he is still a strong advocate of short-term forced IM drugging of “patients” who are seemingly threatening violence.

      Hence, the services he recommends for ‘homeless’ people who’ve been labeled “mentally ill” might not appeal to many would be candidates for such services.

      (One comes to this conclusion, naturally, when one is considering the really extraordinarily high intelligence of much the ‘homeless’ population — i.e., really that segment of the houseless/apartmentless population which rightly shuns psychiatry and all its connected forms of paternal control.)

      Though I could be misunderstanding Jonathan (and, I would be more than happy to have him correct me, if I am misunderstanding him), it seems to me, that his views of people tagged “mentally ill,” is that they are not deserving of protection against psychiatric medical-coercion, forced drugging (as is the rest of society).

      To Jonathan, violence can well be prevented with hypodermic needles.

      Hence, I believe his views are somewhat comparable to E. Fuller Torrey’s views.

      And, in my capacity as a vocational and avocational counselor, who has had the unfortunate experience of being forcibly drugged (long ago though it was), I, for one, would highly recommend avoiding such ‘services’ as Jonathan is promoting.

      I would recommend, to anyone who has even the least self-respect and desire for justice: Steer clear of medical-psychiatry and all the guises in which it appears… (including all falsely advertised ‘free’ housing, which supposedly comes with no strings attached).

      People deemed “mentally ill” wind up living on the streets, quite often, because they have been deemed ‘violent’ in “hospitals” — and, thus, were forcibly drugged… and, in the process, were utterly humiliated.

      Their friends and family thus come to know them as ‘needing’ psychiatric drugs.

      They reject such drugs and wind up tossed out, on their own…

      I would not recommend that accept the “mentally ill” identity, as a prerequisite for free housing. Much better to remain houseless/apartmentless — and carry ones home in ones own heart…

      The ever-creeping and expanding paternalism of medical-coercive psychiatry is more than evident, in all talk that supports forced IM drugging.

      That is just my humble opinion, as inspired by your very thoughtful/insightful comment.

      And, by the way, I should add, Alex: Your recent MIA comments are all catching my attention, as you clearly have much experienced wisdom to offer.

      Great to know you’ve been out there, speaking up and standing up for what you know to be true.

      Respectfully,

      Jonah

      • Thanks for this confirmation, Jonah. It’s gratifying to know that my posts have been speaking to you, it encourages me.

        I’m especially moved and in complete agreement with what you say, here:

        “…many people who are without personal physical shelter, do nonetheless have a home, a sort of meta-physical dwelling, in their hearts and minds, that they carry with them, wherever they go,”

        along with,

        “ I would not recommend to accept the “mentally ill” identity, as a prerequisite for free housing. Much better to remain houseless/apartmentless — and carry ones home in ones own heart…”

        It’s a relief to read this. That is a reality that some segments of our society cannot even fathom, it’s such an enlightened perspective of personal responsibility. Our hearts are powerful creators of our experienced reality. And yes, many people who have found themselves marginalized from dominant society do know this truth. Those who’ve had it relatively easy in a material sense (e.g., not ever homeless) cannot.

        While, of course, some choose the label to receive services and housing, and it’s understandable, I think, from fear. In so many cases, they do discover soon after the dehumanizing and socially (et al) tortuous pay off.

        I saw this repeatedly, even mention it as an example in my film (my ‘favorite’ quote from a social psychotherapist upon hearing one particular complaint from a guy having trouble in his housing–“take your meds and don’t make waves.” Were I to ever write a book about the plethora of social service ills which I encountered and witnessed as I went through the system and then again, in advocacy, this would be my title. Says it all).

        Overall, when you say we carry our homes in our heart, that’s what I would call a really high spiritual truth, and it defines our power to own our experience, no matter what. It’s how I crawled out of this mess, I had some really good teachers who taught just this, as the way we actually create our reality.

        As I attempted to heal while in the system and voc rehab, and move forward from disability, I would stand up and they’d knock me down, and I’d stand up, and they’d knock me down, and I’d stand up, etc…

        I knew enough to know what they were doing was wrong, illogical, and illegal (non-ADA compliant), but, of course, being branded ‘the client’ brings on powerful stigma, rather unbeatable, in a social and professional sense–not ‘respectable,’ so literally, no respect. My word meant spit (and ‘you’re being paranoid’), regardless of how incredibly obvious their prejudices were, and I had plenty of evidence of discrimination, point blank. It’s impossible to know the feeling of this, unless one has experienced this crazy-ass second class citizenship thing, first hand. It’s a feeling beyond description.

        My experience in the system, following graduate school and MFT training, was both eye-opening and soul-feeding. As far as learning humanity at the core, it’s heart and soul, this education far exceeded any of what I learned in graduate school. To say that my formal education was all merely academic is an understatement. It’s hardly relevant to any of the reality on the streets, or about mental illness and disability, if at all! I’m willing to be proven wrong, but at this point, I feel I can say this with certainty. It could practically be an experiential research paper, the way I lived it.

        What I infer from your words is that the answer is always in the truth of our hearts, that is our most powerful reality and creator. Once we know how to hear and trust that, we don’t need anyone recommending anything to us. We know ourselves what it is we want, and we’ll know how to get it, once we trust our hearts.

        That’s incredibly hard work, to make this heart connection with ourselves, when we’ve suffered in certain ways, especially due to chronic betrayal, misguidance, and really negatively mirroring, especially in subtle ways that make us walk away not quite sure what happened and why we feel anxious. Now I see, it was because I was feeling demeaned.

        Once I got out of this mess and complete separated from the ‘mental health’ world, I had to heal from chronic patronizing–like really seriously patronizing–voices in my head. It was insidious. I had to re-route a lot of neural pathways myself, in states of meditation, once I disengaged from this world. My self-perception was tremendously messed up. Better now, thank God. Those are hard voices to wake up with in the middle of the night. It healed, though, eventually. Personally, I believe everything can heal, even our lives. One of the pearl I picked up along with way, although I’m aware that this is something else that much of society cannot fathom, but why would I want to listen to that? Good to know where we have choices about things, like where we tune in for our guidance…

        • “Good to know where we have choices about things, like where we tune in for our guidance…”

          Alex,

          That’s a great last line, and thank you for the reply. I am encouraged by your determination to free yourself from the ‘mental health’ system.

          For me, it seems, there are always more layers of residual, habitual dissembling, which, I’m noticing, it left in my life.

          My life ‘contracted’ as a result of the ‘treatment’ that was forced upon me…

          I mean, though I was only involved with psychiatry for three and a half years, it left a massive impression — such that, I am still recovering from psychiatry.

          I.e., really, I’m not at all fully healed from the havoc it wrought, in my life.

          So, like you, I continue to work on myself; one way I do that, is with music…

          Here is a song, on Youtube, which I like quite a lot…

          http://www.youtube.com/watch?v=qO2utn3lDag

          [Ben Harper – I Will Not Be Broken (Live on Letterman)]

          …Musical preferences are a matter of personal tastes, which are very individual’ so, of course, you can take it or leave it…

          Respectfully,

          Jonah

          • Jonah, thanks so much for the link. That’s very moving, and I hear you!

            I’ve heard many people say we’re all broken, one way or another. Personally, I think exactly the opposite, we are never ‘broken.’ We’re on a journey. Hokey and new agey as that may sound, I believe it hardily and heartily, and I live that way. Every day is a new day and every moment is a new moment. Anything can shift at any one moment. Our hearts can heal the moment we choose to let go of resentment, and then there’s a process to clear the mind from those negative impressions. Seems to me you are so on the right track!

            I feel good about where I am, too, moving forward, healing from negative introjections from that emotionally hostile environment. Indeed, it leaves an impression quickly.

            I’ve been working for the last 5 years years with students in a healing meditation class I created . I just finished with my group this morning. That was our theme today, healing negative voices and self-perception. Lots of layers to this, it affects us profoundly, in many kind of wicked ways. This is how I healed from the stigma issues. I feel very removed from the system now, MIA is the only place where I still participate in that world, and that’s because I feel these issues affect all of us on the planet, one way or another, no doubt in my mind about that.

            My film where 6 of us tell our stories of going through the system has been accepted to an online film festival called Spirit Enlightened, sponsored by a group called Culture Unplugged and just started playing, so it seems I’ve made my transition. I feel very attuned to the spiritual world now, rather than to the academic world.

            Challenges are what they are, and what we make of them. Social ills do, indeed, make life seem impossible, but that is what I yell most loudly about, when I choose to yell. These social ills we talk about here are what create the perception that something is wrong with us, or that we are broken. Certainly, they make people feel really badly about themselves, which makes for easy targets for abuse, oppression, and being controlled and manipulated.

            This is where standing in one’s own truth is not only powerful, it’s the most practical thing we can do. That way, we’re impervious to the negative projections of others, even from an entire society. It’s how a new society is being created, from these novel and refined truths that are being unearthed now, from those of us who have experienced social ills in the health care system. I can’t imagine anything more harmful than that. No way the world can stay the same at this point.

            Finally, back to music, when I was really down and out, my nerves frayed and my mind filled with crap and nothing but, as I detoxed from all those meds, about 10 years ago, music was also my salvation, so I really get you on this. I had a CD I listened to over and over and over, the only thing that could reach my heart at this time. This was on it. Singer is Linda Eder, Broadway and cabaret singer (I’m a theater guy). As you said to me, don’t know if it’s your taste, but this song in particular, was my voice:

            http://www.youtube.com/watch?v=pE0yiKoR0zk

  14. We’re real dangerous. Do you know how we fight? While in a state hospital one time, the staff were giving one of us a hard time. Another “patient” who was known as very self-injurious, snuck away and broke the teeth from a comb and using the sharp remains, ripped and ripped the flesh from her arms. Staff immediately saw the dripping blood and rushed to “care for” this young lady. After roughly washing and bandaging her arms, they strapped her to the chair that was secured to the pole in the middle of the day room (for humiliation). She looked over at the rest of us consoling the friend who was the original target of staff and she gave a sly wink. She had drawn staff’s attention to her in order to rescue her friend. You may not be able to relate to that level of “fighting” for a bit of power on a psych unit but those of us with lived experience can understand. Jonathan, why do you want so badly to justify your use of power, even if it’s only in rare situations? If you didn’t have a loaded syringe, what would you do? Can you even imagine another way to cope with the situation?

  15. Jonathan,

    You write (on December 20, 2013 at 10:04 pm),

    My philosophy is always preemptive. Violence doesn’t often come out of nowhere. Make contact. Listen. Try to respond to needs. Avoid titles and hierarchy. Be genuine. Offer a place to vent, to rage, that is safe. Offer food and drink if wanted. Give some if wanted.

    If all measures fail, and a person starts harming another person or staff, intervene with the least force necessary. Hold a person without harming the person. If possible move them to a safe place where they won’t harm others. The last, and hopefully very rare measure is to either restrain them or give a forced shot. It’s awful and absolutely a terrible thing to have to do. I don’t take it remotely lightly. But I also believe it is my duty to protect others from someone who is attacking others.

    That’s it. I really want to hear your thoughts. Please don’t ask me to give examples of emotional distress or violent behavior. I feel at this point that that is dodging. Really describe your philosophy so I can understand it.

    OK, here’s my response; your philosophy can’t work well, IMHO; after all, it begins with an expectation of violence.

    Whatever we begin by expecting, we wind up creating.

    So, your philosophy will create violence.

    And, this rule, “Avoid titles and hierarchy” …cannot be practiced in a psychiatric “hospital” — plain and simple.

    No way can it be practiced therein…

    Really, IMHO, you’re just fooling yourself, to think it can be practiced in any “hospitals” — and, especially, “hospitals” of the psychiatric kind.

    You yourself admit that those environments are structured hierarchically, they’re highly authoritarian environments.

    It’s simply ridiculous to think you (or anyone else) is going to significantly change that reality, sorry.

    (That is just the beginning of my response.)

    Next comes the description of my philosophy, which you’ve requested (no one has ever previously asked me for that, I have never before encapsulated it, in writing, and I find your request a positive challenge).

    My philosophy “Let’s live and let live, to the very best of our ability, with liberty and justice for all…”

    Wow. I guess you could call that a creed.

    (You are probably familiar with it; it’s derived of three clauses, two which are quite well known, the first being “live and let live,” the third being “with liberty and justice for all…” (That’s taken from the end of the ‘Pledge of Allegiance,’ which was recited, by myself and all my classmates, when I was in elementary school and junior high.)

    The middle clause (“to the very best of our ability”) is just straight up encouragement to do our best; I guess that’s inspired by The Four Agreements. (Maybe you are familiar with that book? If not, see: http://www.toltecspirit.com/ )

    Really am glad that you prompted me to come up, with that…

    (I’ve thought about it previously, many times; though, never before have I written it out…)

    OK, so…

    To expand on my philosophy…

    IMHO, here are five realities (A through E) that we absolutely must diligently strive to incorporate, into our current understandings, of what it is to be human…

    A) Everyone has an intrinsic enlightened nature. Everyone.

    B) Manifesting that enlightened nature, on a regular basis, requires the development of a strong belief in that enlightened nature itself.

    C) All of the most seemingly insoluble problems, which humanity faces, are effects of this one fact, that: By this point in time, far too many people are failing to manifest their enlightened nature, on a regular basis.

    D) Effective solutions to all our most seemingly insoluble problems do exist, and these solutions can be widely adopted, but their adoption is dependent upon many more people manifesting their enlightened nature, much more frequently, than is typically the case, currently.

    Obviously, then…

    E) It is imperative that, we, who care to be humanity’s most effective ‘problem solvers,’ must, first and foremost, find effective ways to encourage one another, to realize, that: We do all have an intrinsic enlightened nature, which shall be accessed, on a regular basis, the more we believe it exists…

    Now, what happens if millions of people adopt a philosophy which suggests that very large numbers of people, in every society, are ‘mentally ill’ — even permanently so…?

    (Note: everywhere that the ‘mentally ill’ concept exists, there is that ‘chronically mentally ill’ notion, in tow, likewise existing; truly, the latter is derived from the former, historically.)

    Of course, there have always been some few who’ve claimed that ‘recovery from mental illness’ is possible, yet the vast majority, of the countless millions of believers in that ‘mentally ill’ notion, will not buy in to notions of what might reasonably be called ‘full recovery’ (which could also be called ‘cure’) …Rather, most tend to believe that very many (perhaps, most) ostensibly ‘chronically mentally ill’ people shall surely always be ‘ill’; that widespread belief inevitably drive down the number of people who might, otherwise, believe in the intrinsic enlightened nature of such individuals.

    After all, most folk are naturally led to strongly believe, that, even if there is an intrinsic enlightened nature, in a supposedly ‘mentally ill’ person, it cannot be regularly manifested…

    And, note: You, Jonathan, yourself, admit, that psychiatric “hospitals” will not produce dramatic improvements, in people’s lives…

    Those places will just engender endless believe in ‘chronic mental illness.’

    Here, let me come back to your philosophy.

    I find it fascinating that you begin with this line, “My philosophy is always preemptive.”

    IMHO, that does strike me as being a ‘fear-based’ philosophy.

    Alex kindly took you to task, on that point. Now, I will go just a few steps further — e.g., by reminding you of the definition of “preemptive”.

    Google “define preemptive,” here’s what comes up, at the top of the screen…

    pre·emp·tive

    1. serving or intended to preempt or forestall something, esp. to prevent attack by disabling the enemy.

    Think about that definition, just a moment.

    From the time, that the George W Bush Administration decided to declare a ‘preemptive war’ against Iraq, I have viewed the so-called “War on Terror” as an operation that parallels, perfectly, the somewhat lesser known “War on Mental Illness.”

    Do you know that preemptive war?

    Check out the following link, when you have a moment…

    http://lmgtfy.com/?q=%22War+on+Mental+Illness%22

    As I’m growing sleeping, I think it’s time to sign off, for now… I’ve offered you enough for this evening.

    (Though, it seems to me, that there are some questions you’ve asked, which I’ve not yet answered, I must get some sleep.)

    In deed, I’m off to sleep.

    Respectfully,

    Jonah

    • “Whatever we begin by expecting, we wind up creating.”

      I believe this is universally true. The good news, is that we can change our expectations, that is our choice, we have free will here. Our minds are malleable, we can shift our focus any time we want, wherever we are in life at any given time. Therefore, in reality, we can create anything we want, because we can choose what to expect.

      So why all the insidious and toxic turmoil in the mental health world? (of all places–it’s just so hard to get past the tragic irony of it all). From what expectation did this madness become a reality?

  16. Respected people of MIA,

    I would like your opinions on what I’m about to write.

    1.)I once saw a woman on the street (in fact, I keep seeing her from time to time). She used to live in what was a small bus stop. She would not wear any clothes. She would sometimes be seen touching feces. She would shout at things which were not there, and her hair was very dirty and matted. I was so intrigued by her behaviour, that I approached her (but I kept my distance) and tried to ask her what her name was. Next thing I knew, she took a brick and was running behind me trying to throw it at me. All I did, was to try and ask her, her name. If a psychiatrist had seen her, she would have definitely been given the label of schizophrenia. The amazing thing was, I would also sometimes see her go to a nearby shop and buy little things to eat. She was fine with the shopkeeper.

    2.)I once met a guy with a diagnosis of bipolar disorder. His behaviour was very peculiar. A certain person went up to him and said, “Good morning”, and I don’t know what this person with the bipolar label perceived, but the next thing I saw, this guy with the bipolar label, held his collar and threatened to beat him up.
    ****

    The people I mentioned in point 1 and 2 were extreme cases. I have also met people with labels like schizophrenia and bipolar disorder who have masters degrees and doctorates in various fields ( science, engineering, law, literature etc.). Many of these people were quite intelligent, very articulate, and had full insight into their problems.

    When people in society see the kind of people I mentioned in points 1 and 2, it is sort of natural that they want these people locked up and “treated”, and if not “treated”, at least isolated from society. This fear obviously stems from people wanting to be physically safe.

    How can these people be isolated or “treated” without any force whatsoever, especially when they believe that they are completely okay?

    Also, I find that psychiatric labels are dangerous because they are very simplistic descriptions of complex behaviours that people exhibit. Once a person has a label, a person is often treated by many as though he has a hard disease and the causal factors that go into that person exhibiting those behaviors is often ignored. That is, most people might say, “This person has schizophrenia or bipolar disorder, and this is why he/she behaves this way.” Usually, only people who have experience with psychiatry would think, “This person behaves in a certain way or has exhibited certain behaviours in the past. We do not exactly understand why. We do not know the life experiences this person had. We do not understand his innate biology properly. We don’t know how his/her innate biology and life experiences together culminated in him/her exhibiting these behaviours. Some of these behaviours could have also been drug induced. It is because of this person’s behaviours or symptoms, that this person was given a label of schizophrenia or bipolar disorder.”

    There’s a huge amount of difference between people with the same labels. Some of them have barely any insight into their behaviour while others have full insight into it, with some others coming in between. Some people may lose insight but only during certain moments, i.e. it is episodic. But insight also comes with experience and insight is a powerful tool in preventing or even eliminating further “episodes”.

    Because of the fact that these labels are used on huge numbers of people with varied behaviours and levels of insight, the sort of “treatment” and consideration that society gives to extreme cases also trickles down to people who are insightful and reasonably intelligent. It is unfortunate and there must be something done to change this.
    ****

    Coming back to my main point, how do we make other people feel safe from the extreme cases, without any form of coercion at all? It’s a question that I find is very complex. Also, I find that this notion of being involuntarily treated because you’re a danger to yourself or to others is fraught with complications.

    A person should be allowed to be a danger to himself/herself, when this is done with full insight (again, insight has to be judged by another person which is again fraught with complications). Whatever the law ( a man made construct which keeps changing because men and their ideas change) says, if one wants to terminate his/her life because he/she deems that it is not a life worth living, it’s completely up to him/her. And if it’s not up to him/her legally, well….it should be.

    Now, when you’re a danger to others, it’s different. Steps must be taken to ensure the safety of other people but then it should also be properly assessed why this person has come to the stage that he/she has become a danger to others. That is, all causal factors should be probed.
    ****

    I was given labels too. OCD and Bipolar Disorder (Bipolar 2). When I first saw a psychiatrist, I had depression and obsessions (I was only given an OCD label first and also “adjustment problems” or something of the sort). I was given an SSRI which made be hypomanic and I subsequently got labeled bipolar. I don’t have any obsessions any more (read my comment here: https://www.madinamerica.com/2013/09/cognitive-behavioral-therapy-beats-antipsychotics-ocd/#comment-34781 ). The only reason I feel depressed is because I have psychiatric labels and a history as a psych. patient. I live in fear of what being labeled and having been a psychiatric patient might do to my life because enough people know about it. I wonder if they have a pill to make the labels go away. I don’t take SSRIs (or any medications any more). Since I don’t have any obsessions or compulsions, scratch the OCD label. Because I don’t take SSRIs, I don’t experience hypomania. So scratch the bipolar label. Now, I feel scared and depressed precisely because I got involved with psychiatry.

    I can’t blame psychiatry for everything though. A lot of it was chance I think. It’s just that I got involved in a field with so many grey areas, both in it and associated with it, that it’s scary. I like distancing myself from the “antipsychiatry” label though because of all the connotations associated with it (like not being scientific, believing in scientology etc.), nor will I say that psychiatry is totally useless for everyone. I just think that psychiatry is a field which helps some but hurts others because of all the grey areas in it and associated with it.

    That being said, this diagnosis of bipolar disorder based on hypomanic reactions to SSRIs is disgusting. Jeff Fisher has written about this and I’ve commented on it as well ( https://www.madinamerica.com/2013/02/bipolar-by-definition-2/ ). This is how you turn temporary problems into chronic ones.

    • “How can these people be isolated or “treated” without any force whatsoever, especially when they believe that they are completely okay?”

      Don’t you see the woman as already isolated? In fact, she’s some sort of caste.

      “Caste is a form of social stratification characterized by endogamy, hereditary transmission of a lifestyle which often includes an occupation, ritual status in a hierarchy and customary social interaction and exclusion based on cultural notions of purity and pollution.” ~ wiki

      In her instance, she is exclusion and pollution and you don’t know the rules and the ways of the street (technically, you were in the wrong for making unsolicited contact with her. I understand why she was going to defend and protect herself – by throwing a brick at you).

      Treated? To what end, transformation? There are at least two instances of “treating” somebody. The first is relational and behavioral, the second is “medical” and “therapeutic”. When we treat people like shit and garbage we can effectively turn them into shit and garbage. At that point, being nice or respectful or kind is cruel.

      “When you live in the shit you become the shit.”

      A woman like that belongs to the Earth, not to the world.

        • You were something of a threat because you entered her space, uninvited.

          Should she have treated you as if you were an Angel or savior?

          Should she have been accepting of you? What would that look like, lunch at the corner diner? I’m not being sarcastic.

          You were intrigued but she had no interest in “entertaining” you, and why would she? I’m curious, what did you think or expect would happen? What would it look like if things went your way, instead of hers?

          I suppose it is difficult to think of yourself as a threat when you weren’t there to stab her to death or throw a net over her and drag her away somewhere. And likely, she knew that.

          Did you intend to become a regular contact for her? If she would have engaged you, would you have established some sort of “help” relationship? And if so, to what end? To get her into “treatment”? Some housing, medicine and TV service? Some friends at the local mental health services community, people who can relate to and identify with touching feces and talk about it in group?

          Please understand, I’m not being rude and you’re not being charged or faulted but it was truly naive of you to have approached her. “schizophrenia” didn’t make her chase you with a brick. YOU are what made her chase you with a brick. If you understand.

          • Nice post mjk. I understand that it was my going up to her that provoked her to chase me with a brick.

            I did not want to save her, or get her “treated” or anything like that. I just found her intriguing and wanted to talk to her and find out what she thought. I wanted to delve in to the mind of such a person, wanted to know and understand her ideas and beliefs. It was my selfish curiosity that led me to approach her.

          • “I wanted to delve in to the mind of such a person, wanted to know and understand her ideas and beliefs.”

            She’s probably loaded with knowledge of Hell (terrors and horrors, and worse).

            Some things people do not know they do not want to know. I call it black knowledge.

            O No Now Know

            Once we know something we cannot unknow it.

            We can be “guilty” of knowledge and knowledge CAN harm a person.

            This is why people want to shield and protect kids (and sometimes, adults) from “truths” and “knowing”, at least until they’re mature enough to tolerate and handle certain truths and realities about life, people and the world (“the way it is”).

            Knowledge can wreck a mind. Doorways and windows, of the mind, accessing mental spaces, mental dimensions… Heaven and Hell are both internal AND external conditions.

            When that woman closes her eyes to sleep, she might go to Heaven (inside) and there’s no knowing what that Heaven is for her. She might go to Hell and there’s no knowing what that Hell is for her. No knowing, unless she tells. She quite likely isn’t ever going to take somebody inside and show them around. But who knows, maybe there are a LOT of people already inside of her. Maybe she does take people in. Do they ever get out, though.

            And what if she isn’t even a resident inside of her own self? What if she resides inside of somebody else? I wonder who knows how to call a soul back into its own body. Or evict souls and spirits where they trespass. Maybe she’s a haunted house. Predators, parasites and vampires.

            I’d wonder about the things that never cross her mind…

            But all in all, what’s her lot in life? And why’s it gotta be shit and bricks? Whose plans and purposes does she serve, if not her own? Could be the shopkeeper’s.

      • @mjk:

        “Don’t you see the woman as already isolated? In fact, she’s some sort of caste.”

        Sure she was isolated. Imagine if someone asked her to move out of the small public bus stop that she made her home, just for a while so they could clean it. If she responded to the cleaner by trying to throw a brick at him, she would obviously have to be forcibly restrained, if only for a while, so he could actually clean the place up.

        How can you completely avoid force in situations like that?

          • @mjk: “If anything, she’d probably just ramble and bitch and yell and complain.”

            Likely, but this might not always be the case.

            The guy with the bipolar label I talked about went after someone because that someone wished him a good morning.

          • “Likely, but this might not always be the case.”

            Correct.

            Life cannot be totally controlled. What will be will be. There is always risk and chance (danger) and no amount of security measures can ever make each one and all always so safe.

            This is one of my favorite examples of what *should* be a safe place (and a “safe” person) but in this instance is the most dangerous. What interests me so much about this video is how the woman recognizes the danger she’s in and she’s trying to escape.

            http://youtu.be/hxgNKNEtk18

            The bus stop woman might someday be bludgeoned to death or might maim someone’s face with a brick. Should there be a mission to get every such person off the street and locked away in their cage or box, so no crime or tragedy can ever occur?

            As I type this, police and ambulance pass by the house and their sirens always get my attention. We live in a sick and dangerous world (constant pursuit of Safety and Health). Coercion, force, violence, disease, disorder…

            It’s all an endless conversation.

    • I would approach a homeless person living under a bridge. I’d gently ask if I could get them anything; a sandwich, a blanket, a new box to live in, anything. He’d snarl at me to go away and I would. The next day I’d show up and ask the same thing. He’d snarl and I’d go away. Eventually, he’d get tired of me and he’d test by asking for a new box. I’d drive all over the city if necessary to find him a nice large refrigerator box and take it to him. He’d snarl a few more times and eventually, he’d let me give him a clean, warm blanket. With enough time and patience, he’s got a home a job, meaningful relationships and is living as a productive member of the community.

      The key was relationship. It had to take time to build and to develop the trust. If you get chased away once, don’t give up. Who knows what trauma they’ve experienced that made them chase you away? The shop person obviously had a “relationship” where the person knew they wouldn’t be hurt. On hospital units where they have done away with restraints and forced medication, they did so by learning how to build relationships and help people heal in safety. I wish others here could learn that.

  17. I do have one suggestion though. This is an idea I got and subsequently implemented. I asked the psychiatrist who was seeing me to show me my file. I was a little alarmed by some of the stuff written in there. Many of the assessments were quite subjective, and some details were even erroneous. So, I told him that I wanted to put my own notes into the file. My own version of my experiences, about my agreements and disagreements with the assertions about me in the said file, my problems with the notion of SSRI induced hypomania being used to make a bipolar diagnosis etc. I was allowed to do this.

    I think in addition to the notes of psychiatrists, patients should be able to put their own notes in their files. This makes the power equations between psychiatrists and their clients better. If a third person reads the file, it also makes for a more objective assessment.

  18. Anosognosia – a term used when a client/ patient fails to be properly subservient and the psychiatrist has such a grossly overblown ego that he/she is deeply hurt and offended. – We need respite centers where individuals can go when they feel like they may be going downhill. A place to stay for a while without being locked in, and being able to leave when they feel they are up to it. Someplace where they don’t loose their rights, where people won’t have to lie about being suicidal or have people exaggerate incidences so the person get into a facility. Places where everyone isn’t considered to be on the edge of committing violent acts. Places where people are treated with respect. (Another word for this is peer centers.) If facilities weren’t so demeaning there would be fewer people avoiding ‘the system’. “The mental health system simply offers you a few token favors if you keep your worker happy by always taking your drugs and doing what they say, and if you don’t, you get scolded. Keeping people on drugs seems to be the main focus, not helping people lead a happy and meaningful life. You need to act in your enlightened self-interest, and do the work needed to bring greater happiness to your life.” (a line from my new play -Sugar Daddies- which will open in Reno in December.)

  19. Florida lawyer and pro bono advocate of the rights of the psychiatrized, Wayne Ramsay, has compiled a series of essays that comprise a useful online book providing an excellent introduction to the critique of psychiatry: primarily an anthology of quotes with bibliography sprinkled with cogent insights of his own, often from a legal perspective.

    http://wayneramsay.com

    But in the second last essay ‘Why Psychiatry is Evil’ he mentions a conversation he had with Thomas Szasz about Torrey:

    “It is impossible for me to believe someone who so eloquently and convincingly debunked the concept of mental illness, including schizophrenia, as Dr. Torrey did in ‘The Death of Psychiatry,’ could be sincere now when he promotes these very ideas. In 1990 at the Thomas S. Szasz Tribute Dinner in New York City in a face-to-face conversation with Dr. Szasz, author of ‘The Myth of Mental Illness,’ I asked Dr. Szasz, ‘Whatever happened to Fuller Torrey?!’ Dr. Szasz answered with a single word, ‘Funding’, and suggested I ask another psychiatrist who was with us that night, Dr. Ron Leifer, who gave me the same answer. Dr. Szasz wrote an article about Dr. Torrey’s turnabout titled ‘Psychiatric Fraud and Force: A Critique of E. Fuller Torrey’ in the Journal of Humanistic Psychology (Vol. 44, No. 4, Fall 2004, p. 416).”