When Asylums Are the Only Hammer, Everybody Looks Like a Nail

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“If you’ve only got a hammer, everything looks like a nail.”

The Dix Visionaries, a group of CEOs, land developers, and community leaders, are determined to turn Dorothea Dix State Hospital’s grounds into a destination Central Park for Raleigh, NC. The Park, one visionary was heard to say, might have something like the Georgia Aquarium, the largest in the world, to draw tourists, restaurants and more hotels to NC’s capitol city. The contract between the state and the city for $10.5 million for 306 acres is awaiting the final stamp of approval by the Governor’s Council of State.  For the past two months, Dix has not been on their agenda. There is a good reason for this stall.

In the last week of January 2015, Raleigh psychiatric hospitals, both public and private, found themselves full. Patients trying to come in their doors were “diverted,” told to go to the emergency room at WakeMed. There the Emergency Department had 62 people waiting for a bed or other services. [Rose Hoban, “Wake Mental Health Patients Face Long Emergency Department Stays,” NC Health News, 2-11-2015]. Care coordinators from the Managed Care Organization didn’t arrive until Monday when WakeMed was also trying to “divert” patients — some back home where their crisis may have been triggered.  Many wandered back out onto the streets. Dave Richard, Assistant Secretary for the Department of Health and Human Services, found that most of the people weren’t brought in by law enforcement, but came voluntarily, (a fact that refutes E. Fuller Torrey’s claim that mental patients lack insight into their condition). North Carolina dropped from 1,461 public psychiatric beds in 2005 to 761 beds in 2010; that put North Carolina 44th in the nation in beds per capita. It is estimated that more than 1,600 individuals in NC are housed in jail or prison where there may or may not be a mental health clinic.

Emergency Rooms have become the triaged door to mental health care. Even without so many walk-ins, doctors and health care workers agree that the ER may be good for heart attacks and gun shot wounds, but not for delusions, extreme agitation or despair. If anything the average 75-hour wait for an already distressed person, strapped to a gurney or a chair awaiting a bed, while being guarded by someone from the sheriff’s office, is inhumane. No other diagnosis has ever been treated so callously, not even tuberculosis or AIDS. The bed a hospital worker may find may be hours across the state or on a ward where the acuity is already too high. The patient who was suicidal is only likely to feel worse, to have “deteriorated.”

Those who come voluntarily, when a bed is found, are put on involuntary status. That means they can’t just walk out, or refuse the heavy medication forced on them that might not have been needed if other services had been available sooner. This also means they have to answer YES to the question on official paperwork about have you ever been committed against your will. Currently in many counties, especially rural counties, with shortages of personnel, the only way to get a return phone call or an appointment in shorter than 3 months away or attention in a hospital setting is to be in major crisis. Crisis becomes a learned behavior and mind set.

Wake Med shouldn’t have been caught by surprise by the number of patients appearing in late January-February. It is February when people’s experiences of family Christmas get-togethers — to which they weren’t invited, the presents and Christmas cards they couldn’t afford, the presence of alcohol at holiday parties, the Goodwill jacket and wallet lost on the train, or the anniversary of their grandmother’s death — all disturb the mind after the fact because they have had no one to listen. Service providers only want to know: “Are you taking your pills? Are you sleeping? Are you suicidal? On a scale of 1 to 5, how happy are you overall with your treatment?”

When the news of overcrowding at WakeMed hit the Raleigh News & Observer, the cry from the public was to re-open the old Dix Hospital. One letter suggested that at least six to eight acres on the Dix property could be a new hospital, which would clearly be a blight on Raleigh’s Central Park environment due to public perception of those “dangerous people.”

There are many alternatives to crisis and hospitalization that consumer activists know about from attending conferences and networking with mental wellness advocates across the country. Unfortunately, all the presentations by current and former recipients of mental health services about alternatives to hospitalization have been made to employees of the Department of Health and Human Services, or at recovery conferences, to other recipients of services. But, the decisions are made by tax payers and legislators. Citizens and politicians are only familiar with treatments at the turn of the century.

If all you have is an Asylum Fix, then every worried or grieving or traumatized or elated individual looks like he or she needs long-term care.  It would make sense try something different—some tools that promise to promote wellness and recovery. North Carolina used to have many exemplary club houses, but for financial reasons, and job shortages for ex-patients only a few are left. The state is 15 years behind the rest of the country in developing drop-in centers and recovery and wellness educational program; the existing ones struggle for ongoing funding.

Here are 10 alternatives to crisis and misery:

  1. Respite Houses. Second Story in CA is for people before they are in crisis to take responsibility to prevent spiraling out of control. Staying up to 14 days in a house mostly staffed by peers, the guests are surprised to find that staff doesn’t want to “fix” them but to “be with them” This respite houses follows the philosophy of Intentional Peer Support developed by Shery Mead and recognized as a “promising evidence based practice.”
    [www.madinamerica/author/yjacobs/]
  2. Daily peer support by those who have “been there” with services up to two years, not for four weeks with a “fading plan” as Utilization Management of a Managed Care Organization often approves. Certified peer supporters above all listen and may also mentor, tutor, enable their assigned peer to keep schedules, get along with landlords, set goals, and be assertive with their physician and family about their needs and what is working and what is not helpful.
  3. Emotional CPR where a layperson, not necessarily a clinician, listens to what’s happening as opposed to observing symptoms and making a diagnosis. It is an education program that teaches Connecting, emPowering, and Re-vitalizing. [[email protected]]
  4. Mobile Crisis Teams staffed with peer support, a nurse, and a clinician. This service is especially suited to urban, but not rural, areas. Mobile Crisis goes to the client or a neutral place for an evaluation and seeks to stabilize the individual and make future appointments and sometimes even arrange transportation.
  5. Walk-In 24 hour crisis centers which may include a doctor and medication check, a nurse, peer support, de-tox time, with safe rest in a big lounge chair for three to 14 days for up to 16 people. Estimated annual cost is $900,000 to operate this residential program.
  6. A WRAP crisis plan with designated roles for chosen family members, friends, clergy, and occasionally a therapist and plans for rest, food, writing, favorite music, walking, sun light– whatever the person has found from experience to be restorative.  Best of all the Wellness Recovery Action Plan, designed by Mary Ellen Copeland, contains a list of signs that things aren’t going well and actions to take before a crisis. WRAP is a best practice and internationally used.
  7. Alternative Modalities such as meditation, deep breathing, acupuncture guided imagery, dance, art, music, journaling, and life coaching have been mentioned in personal stories as being “life savers.”  What is tragic is that all these supports recommended in Oprah and other self-help magazine are largely unavailable to the poor due to lack of training or access.
  8. Spiritual counseling, because for many individuals questions about sin, forgiveness, mercy, unanswered prayer, the existence of evil in the world, and transcendence occupy their minds. If conducted in a non-judgmental way, this counseling uses spiritual resources and personal faith to address the loss of hope.
  9. UNC’s Outreach and Support Intervention Services (OASIS) is for young adults experiencing the onset of psychoses [ Taylor Sisk, A Person-Centered Approach to Recovery,” The Carrboro Citizen and North Carolina Health News, 1/16/2013]. This daily, then weekly, support and education program has from 100-130 clients. About a quarter of clients are uninsured and Medicaid covers only certain services like medication management. 60-65% of participants return to school or work. OASIS addresses the fear that one is “losing his mind” and hopeless, only exacerbated by a trip to an Emergency Room.
  10. Healing Communities such as CooperRiis farm in Mill Spring, NC. 110 residents work with 150 staff on nutrition, exercise, work, modern psychiatry, psychology, substance abuse counseling, complementary modalities and a work and service program. The typical stay is six to nine months for those diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, major depression or anxiety disorders, and borderline personality disorder. The fee is $15,500 per month with scholarships available after the second month. CooperRiis program “affirms strengths and rekindles possibility.” [[email protected]]

Deinstitutionalization was supposed to redirect money back into the community. That’s what activists said. But politicians wanted the land back and savings from operating expenses.  The mental health budget in NC is trimmed every year. The savings of closing down NC hospital beds (51 million) that were to go into the community were placed in a trust fund, only to be raided by former Gov. Easley for the general fund. The 51 million was never replaced. Alternative recovery programs are either pilots or dependent on time-limited grants from endowments and foundations and block grants.

People say we can’t have different programs because we can’t afford them. Can the state afford alternatives with better outcomes than the Asylum? Jail costs $95,000 a year and may not have a mental health clinic. State hospitals cost $1,667 per day and $1,440 in for profit hospitals. This works out to $608,455 a year. For this reason the state tries to keep the average stay at 3 days. Recidivism is high. Nonprofits point out that they could operate exemplary programs for a year on the savings from jail or emergency rooms but the pockets of money are in different budget categories that can’t be mixed. Patients have often laughed and proposed that they could stay in a five-star hotel with meals, privacy, TV, a visiting nurse, peer support and a chance to sleep in a safe uninterrupted environment.

The Raleigh asylum on a hill was lobbied for by Dorothea Dix just before the Civil War in reaction to patients being housed in jails and poor houses in squalid conditions. Patients at Dix Hospital lived in small enclaves on a farm where every person had a job vital to the community. Dorothea Dix believed that patients needed respect and compassion for what they had been through. She fully expected them to recover. When there is a shortage of psychiatric beds, let’s not call for the return of Asylums, but for programs in the community based on genuine caring and hope.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

32 COMMENTS

  1. If we’re talking alternatives to forced treatment, end mental health law, and you no longer will have the state sanctioned violence that you have today. People don’t get into the state hospital, as a rule, by their own request, no, they get there through a court hearing. There is nothing “voluntary” about the system, not even “voluntary” status, which is usually just a matter of plea bargaining. End forced psychiatric treatment, and then all psychiatric treatment becomes, by default as well as law, consensual.

    Dorothea Dix was a nineteenth century scoundrel, and naming a state park after her is the epitome of folly, if it isn’t the epitome of evil. The campaigning on behalf of asylum building that she had so much to do with also led to a great rise in the population of people labeled with “mental illness” or “lunatic”. In the twentieth century we have dealt with the results of Dorothea Dix campaigning, the burgeoning population of patients being warehoused in non-therapeutic, to say the least, institutions, by closing those institutions down–big improvement.

    Dorothea Dix may sound like the name of a fine old school in Raleigh, but such is far from the case. Honoring her with a park is an insult to all the people who were imprisoned, tortured, and perished in the institution that bore her name. As well as other institutions that she was instrumental in inspiring the construction of. We, as I indicated before, don’t need alternatives to forced psychiatry so much as we need an end to forced psychiatry, then all psychiatry becomes an “alternative” to force, and force itself becomes the crime it is when it is used against a non-mental patient or “mental health services consumer” victim.

    • Frank, you are of course right–if this one medical specialty weren’t forced on people, then people could choose the preferred treatment for their malady or no treatment at all.

      Just for information, those working to preserve a little part of the Dix property are only seeking preservation of the cemetery and the main bjuilding which is already designated an historic building.

      If you want to hang the massive, degrading, torturing, asylums, with back wards, around Dorothea Dix’s neck, then she would indeed be a scoundrel.

    • Frank you ignore the reality of Syphilis in the time period of Dorothea Dix. What do you do with a mad person? Someone you can not reason with?
      Yes I agree the mad should have be imprisoned at that time. Torture and death are secondary effects of the imprisonment.

      Psychiatry was trying to control people who will not or can not control themselves. Before the year 1943 there was no treatment for Syphilis there was no microbiology.

      Today we are left with a profession that presumed the cause of madness was a physical ailment/ physical defect. The Pharma Co. of today exploits the hope for a magic pill that will make people “good” instead of “bad”. They exploit hope for money and they get the money from Government.

      Todays PRE-crime use of psychiatry is of course wrong. A person should have to commit a crime before they are sent to a helpful prison.

      The pen is mightier than the sword. Some people are too stupid to understand this imaginary concept is real .
      The psychiatric action of threatening to take away a persons freedom (pen on paper) will likely make them angry, the anger at receiving “help” proves the person is “unwell” . This kind of psychiatry is a fraud. http://www.telegraph.co.uk/news/health/3311242/Trust-me-Im-a-junior-doctor-in-psychiatry-you-never-get-thanked.html

      • Huh? Syphilis was very much a 19th century disorder, and many people in the asylum were afflicted, and yet many with syphilis spent no time in the lunatic asylum, too. I figure it is still pretty irrelevant to my comment and our discussion. I certainly did not “ignore” syphilis. Today, we know, don’t we?

        Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum.

        http://en.wikipedia.org/wiki/Syphilis

        Syphilis is not psycho-somatic while much of what we call “mental illness” is psycho-somatic. Syphilis is a bacterial infection.

        Like I said, it’s basically irrelevant to the discussion at hand. They had syphilis back in Shakespeare’s day, too. What they didn’t have in Shakespeare’s day were big bustling lunatic asylums to confine syphilitics and others in. No, that comes later. Much later.

        In the 19th century there was an asylum building boom. These huge Thomas Kirkbride asylums were being built, and Dorothea Dix had much to do with inspiring the building of a number of them.

        By the end of the 19th century, national systems of regulated asylums for the mentally ill had been established in most industrialized countries. At the turn of the century, England and France combined had only a few hundred individuals in asylums, but by the end of the century this number had risen to the hundreds of thousands. The United States housed 150,000 patients in mental hospitals by 1904. Germany housed more than 400 public and private sector asylums. These asylums were critical to the evolution of psychiatry as they provided places of practice throughout the world.

        http://en.wikipedia.org/wiki/History_of_psychiatric_institutions

        From “a few hundred individuals”, you may note, to “hundreds of thousands” is a big leap.

        • Frank. I am saying back before microbiology, peoples behaviors likely were caused by physical disease. You turn it around and write many with mind altering diseases were free to roam about.

          If I had a real physical disease altering my mind I would want a cure, (forced treatment) wouldn’t you?
          Doctors/Dorothea Dix believed they were helping people in hospitals.

          In Shakespeare day https://en.wikipedia.org/wiki/William_Shakespeare there was no piped water supply, no sewage system, no firefighters, no public money for the ill.

          Free healthcare /Socialized medicine https://en.wikipedia.org/wiki/Socialized_medicine is a relatively new thing.

          • No. “A cure” and “forced treatment” are not synonymous, and I’m sure I would want no such thing if they were.

            Dorothea Dix was helping society imprison unwanted peoples in warehouses and prisons that back then claimed to be asylums, and today claim to be hospitals. Personally, I prefer life outside of prison.

            Yes, and in Shakespeare’s day they didn’t have so much industrial air pollution and auto emissions as they did horse shit. I imagine it was easier (healthier to boot) living with the horse shit.

            The thing is, back then, in Shakespeare’s day, they didn’t lock people up the way they do today, microbiology or no microbiology. I, for one, don’t have a problem with that.

          • RE: Locking people up (who are called mad) historically.

            Yes , In the year 1795 Pinel https://en.wikipedia.org/wiki/Philippe_Pinel wanted better treatment of the insane.

            If one person has money to spend to lock up another, they can spend the money.

            “The only difference between the sane and the insane is that the sane have the power to lock up the insane.” – Hunter S. Thompson

          • Regarding the “no thank you” article link.
            The question we should be asking is “Who is the insane person?”

            Max Pemberton ( the author) does not think he has a mental illness.
            I say he has the mental illness.
            1) The patient he claims to be his, is not his patient, as the person is unwilling.
            2) The chemicals he prescribes are not medicines, but drugs, for there is no physical illness in mental illness. The application of the chemical is not medicinal.
            3) To lose ones freedom, is not “in their best interests” as he claims.

            He is the insane one, imagining himself a Jesus-healer, with drugs he calls medicines. https://en.wikipedia.org/wiki/Miracles_of_Jesus

  2. Cannot all of these alternative to crisis and misery co-exist happily in a park like setting on 306 acres in downtown Raleigh? That way, the city gets its park, people get to use the park, it’s just that me of them may be “patients” and others members of the general public. Sounds too simple, I guess. It would sure put Raleigh on the progressive map, though.

    • Rita, some consumers had suggested a treatment park of many choices–but then Raleigh couldn’t charge admission unless they went back to the old 18th century French practice of viewing the inpatients as entertainment. We also thought of using the large buildings as a training center and letting attendees stay in the little cottages and even old patient rooms–just as a reminder & to save money.

    • Well, you can’t let the crazies walk around with good citizens, they are all violent and dangerous, right? Same for poor folks and minorities etc. You have to keep the scum off the good neighbourhoods. That’s what is behind it.

  3. This is a great starting point to untangle the complex factors which sabotage patient outcomes , beginning with the initial ER visit, where so many of us have sought help only to discover that there is NO safe place to go for an intervention that addresses underlying causes of mental “disorientation” . I do not want to offend anyone by saying that the neglect of services in the community to reduce dependence on the hospitals is hurting those patients who do need medical investigation or carefully nuanced treatment response that in times past we came to expect from a hospital. I observed an ER which appeared overwhelmed and noted a number of cases which did not involve psychosis or mania which one would think could be addressed in community by respite or peer support etc. It appears that the over dependence on the ER , the gate keeper of the acute care ward, approaches a degree of chaos that contributes to the risk of neglect of patients who need staff to take more time to listen and get the facts straight before they are actually admitted and treatment begins. I could describe conversations with care seekers in the ER to support my point, including the patient who was using the psych ER to evade the possibility of domestic abuse or lesser civil charges; this seemed to confirm the professional opinion of a psychiatrist who told us that there are people “who know how to use the system.” I’m sure I’ve seen more examples of that.

    However, we have seen some of these questionable cases admitted to the acute care ward. They came and went and I wondered why they were there at all, while our own daughter’s care seemed botched and doctors seemed reluctant, unprepared and ill-supported to interpret her symptoms as paradoxical and iatrogenic rather than “treatment resistant”. I believe there are other patients like her who need more in-depth medical investigation to discover issues which may be demonstrated one day to be highly treatable with a holistic approach rather than with toxic drugs. I wonder whether the insurance and medicaid reimbursement plans provide revenue more readily for these cases which superficially appear to be more manageable,in terms of the interests of the health care system-not the patient necessarily, and does that contribute to a neglect of appropriation of resources to the more difficult and esoteric patient-case challenges. Is there a DEFAULT discarding of patients with the more mysterious challenges? Are true breakthroughs in psychiatric knowledge hindered by exploitative use of a discriminatory and neglectful triage system? Does this neglect trace back to eugenic reasoning?

    There is no shortage of kind-hearted souls working in acute care wards who don’t have the knowledge and experience or the support to coordinate a care plan that incorporates input from the different medical specialties to bring about stabilization of a patient. The current system, while hurting patients the most, also defrauds and degrades those professionals who truly want to help people. The system needs to be unburdened. The proposals for outpatient services will hopefully free up resources in the hospitals for those who need them the most. I’m hoping for an articulation of reform that will resonate with noble hearts and outrun the machinations of power seekers and guild interests. Thank you to everyone who has devoted themselves to this work long before I knew anything about it or could imagine we would need it.

    • I think you are right that the most difficult and mysterious cases go home, if there is one, while all sorts of “cherry picking” goes on to hospitalize the easy to treat-those who casually say I’m thinking of killing myself–in order to get a bed and roof and food and a rest. People do know how to use the system; yet the most needy do not.

      And, the system knows how to use people–for the easiest billing, to buffer themselves from radical complaining and from those with patient’s rights orientations.

      • I apologize, Candace, for being unclear in my remark about the more mysterious cases. No, I don’t think mysterious cases go home. I suspect that mysterious cases are subjected to long hospital stays and subjected to medications which may make them worse, and as a last resort these mysterious cases may be coerced to have ECT, despite that ECT has caused mania in some patients. The more mysterious cases are possibly the more blatant proof that the psych “meds” are really not meds but poisons, anything other than chemical balancing agents. I’m advocating for greater understanding and respect of the physiology underlying mania and psychosis and for the use of natural and holistic means to improve the patient’s chances of stabilization. Medical literature states that among the possible causes for mania ( and some mania includes psychosis) is an infection or the antibiotics used to treat infections (both evidently have been implicated in the cortisol fluctuations known/thought to trigger mania). That possibility needs to be considered and discovered by the treatment team. I’ve been told that if a mania were caused by an infection , then the mania should subside with the resolution of the infection. How can we be sure that is really so in every case, since antibiotics themselves can cause mania? Perhaps some bodies don’t resolve mania as efficiently as others. I also want to ask someone about the possibility that the toxic meds themselves might cause fluctuations in cortisol levels and hence iatrogenic mania. This is one question that I would like included in open dialogue, but I doubt that psychiatrists want open dialogue because they really don’t have all the answers. Is it possible that what is labeled treatment resistant is really a very robust immune response against the toxic drugs? I’m not embarrassed to ask such questions at the risk of revealing ignorance. The doctors themselves should be asking more questions, and they are not. They have been too complacent. The failed system needs to go. Unfortunately , there are people who have been permanently maimed the drugs. At the very least they need support in weaning as much as possible. They are not to be thrown away.

  4. I never thought of it this way before but it’s true. I was held in a state hospital for two and a half months. My final bill was $62,400. With that kind of money I could have lived in the finest hotel in the city where the “hospital” is located, and I could have eaten gourmet meals three times a day! I could have afforded the services of a psychiatrist who actually knew how to do talk therapy (if I could have found one in the city, most of the ones who knew how to do real therapy, rather than poking pills down people, retired because they couldn’t put up with the attitude of the pill pushing psychiatrists who took over everything). I probably would have found healing and well being much faster than I did.

    What wrong with this picture?????

    • Stephen, nothing is wrong with this picture except a machine-practice-field out of control, Not only have “talking” psychiatrists left the field and retired, as you say, but new students aren’t entering the profession either. If your life goal is to help people, why would you want to be a modern day psychiatrist?

  5. Bonnie, I am so glad to see your writing on this very important topic. The ER is the main entry point for hospitalization in my state whether thru private insurance and or Medicaid and Medicare. I have been dragged by my former husband to the ER several times in the past always around holidays, always on the end of a weekend of extreme stress. Sometimes I was given a choice and stupidly agreed to get ” help”. Other times I was seen as a “problem”> My experiences were hellish. The worst time was a suppossed “voluntary ” admission again with my husband’s “kind” support. As a LISW I asked to have a floor admission. When we got to the hospital I had no choice to go to the ER and again was seen as a “problem” patient. I would never go or ask anyone to go to a inpatient psych unit for treatment. But that begs the question because when ERs are seen as the portal point that means there are no other good or peer related alternatives. NADA,. NADA, NADA for anyone rich or poor. It is an immense travesty and the conventional media in my state and city have no interest what so ever in true and ethical investigative journalism. My correspondence goes unanswered and NAMI who has the ears and the eyes of the powers that be continues to live with their heads under the sands.

  6. It’s a good thing to talk about all the possible helpful interventions that people could experience. Like all alternatives to the present system, though, they will have to be fought for. I think working for alternatives and fighting against the routine abuse offered by psychiatry now have to be done at the same time. The psychiatric/drug company system is not going to give up its power without a fight.

    • Regarding “The psychiatric/drug company system is not going to give up its power without a fight.”
      Who is paying the “psychiatric/drug company system” ?
      Who is paying the 18 billion dollar (a year) bill (U.S.) for antipsychotics?
      Medicare / Medicaid is paying. Are they getting the results they want?

    • “Helpful interventions” doesn’t sit well with me. I can do without anybodies paternalism, however subtle or blatant. The thing about meddlesome neighbors, and family members, not to mention states, that bothers me so much is precisely that meddling. We need alternatives to force because we’ve got force. Eliminate force, and we will have nothing but consensual treatments. Thing is, those consensual treatments will no longer be alternative.

      In my view you don’t survive psychiatry by getting a job in the mental health profession. Just saying.

      • To clarify, I’m not against so-called “alternatives” either. Of course, some “alternatives” are superior to others. I do worry about “alternatives” becoming a ruse by which the mental health system expands. There is an easier way to lower the chronic “mental illness” rate. You can find it elucidated in the pages of Mad In America and Anatomy of an Epidemic. That easy way is simply to stop using psychiatric drugs, exclusively, and to the extent that they are being used. Many of us have known this to be the case for some time. It’s just a matter of making it common knowledge. What we have is not so much a health/sickness problem as it is a prescription drug (abuse) problem. Of course, perhaps I am over simplifying, but you get the drift. The mental health system doesn’t have to be this sort of epidemic contagion and fashion that it has become. Furthermore, it is public safety that is being used as an excuse for this expansion, and this kind of fear mongering has to be exposed for exactly what it is.

    • Ted, you are right. Our exposure of the routine abuse of forced psychiatry is but background noise to the manufacturing plants of the latest pill for the latest descriptor of human behavior to be added to the DSM. It is time to expend at least half our energies on being FOR what we want.

      • Some of us neither want nor need alternatives, any more than we want nor need psychiatry. Some of us neither want nor need “mental health” care, treatment, intervention, interference, facilities, illusion-nesses, tortures, etc., etc., etc. I’m very much for leaving well enough alone, and this is a matter of opposing non-consensual psychiatry and “mental health treatment”/ intervention. When the system is adamant on convincing people that they are “sick”, regardless of whether they feel they are “sick” or not, I have to stand opposed to this sort of propaganda, and brain washing. Well enough is still, very much, well enough. Requiring well enough to admit to a “sickness” is still requiring well enough to, as Sir Walter Ralegh succinctly put it, a few centuries ago, “give them all the lie”.

        • “When the system is adamant on convincing people that they are “sick”, regardless of whether they feel they are “sick” or not, I have to stand opposed to this sort of propaganda, and brain washing.”

          I’m with you on that one. Psychiatry is first and foremost about blaming the victim and making you the problem. People go “crazy” for a reason and that usually means they are the most sane people in the room.

          “It is no measure of health to be well adjusted to a profoundly sick society.” – Jiddu Krishnamurti

  7. It was this reported 3 months of waiting for services that destroyed my family and left the disabled adult to be exploited and abused. Deputy Secretary Dave Richard knows her circumstances and the failings and illegal actions of the service array but does nothing. DHHS lacks leadership just as much as it lacks beds. The annual cost for prisoners was reported as 95k a year when it is actually 35K for close custody the most expensive class. The aforementioned disabled adult has been placed into treatment recently but no effort has been made by the state to contact her family or caretaker and the services she will receive is likely to be the same inadequate services she has received six times before. Psychiatrists erring on confidential status are ignoring Family’s importance despite federal law Title 42 Chapter 114 Section 10801 which outlines the core issues. This disabled adult is likely having the same revolving door medication for the wrong diagnosis. This is why recidivism is high for the mentally ill. Bottom line the leaders of the system don’t know the law, don’t follow what they do know, and lack leadership to make the needed accountability. We don’t need promises of a better system coming. How can we say our present set of law don’t work if we aren’t enforcing them? How can we expect new laws to work in a culture where law is ignored?

    • Regarding “This disabled adult” if you put someone on psychiatric drugs they can not take care of themselves due to the chemicals effects on the body and brain. What do you do then? You have to put someone in charge of the disabled adult. Does the disabled adult enjoy someone being in charge of them? Likely no, so more psychiatric drugs for any resistance to the “person-in-charge”/owners orders.

      Who profits from this? The Pharma Co. selling a cure/treatment for a fictional disease everyone believes in.

  8. In reply to markps2 citing the very good intentions of Pinel with which I agree.
    When Jesus encountered the Gerasene demoniac of whom the townspeople were afraid and had shackled the poor man in the grave yard because the “maniac” was violent and incoherent and big in body, Jesus quietly went to the grave yard and sat on a wall and talked to the man. Forget the sending the pigs off the mountain possessed by demons which was the contemporary explanation for why the man in the graveyard calmed down. Jesus talked to the man and sent the disciples to get clothes for him