Hiding the Evidence of Society’s Side Effects

Margaret Altman, MSW
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Hiding and covering up evidence is a crime.
However, the dangerous side effects of psychiatric drugs have been hidden, denied and minimized by the psychiatric profession, by drug companies and by research groups and the FDA for decades. These terrible side effects that cause developmental damage to teens, sexual problems, disabling movements and tremors, traumatic mood shifts and suicidality are evidence of massive failures on the part of research teams, prescribing physicians and drug companies. They are glaring evidence that reliable, long term  research on the drugs has been faulty, long term effects have not been taken seriously, and that people who take the drugs are not considered to be vital and important members of society. In order to mask these criminal acts and valuations the evidence, the side-effects and lack of effectiveness of these drugs has been hidden.

Dr. David Healy speaks to this:

“Your voice is increasingly being silenced. You and your doctor may have been told there is no evidence linking the treatment you are on to the problems you are experiencing. This is because most data on prescription drugs is owned by the multinational pharmaceutical companies who run almost all clinical drug trials (60% of which are never reported). They simply are not sharing data that may affect their bottom lines. There is a gap in the data that only patients, doctors, and pharmacists can fill. If you think there is a problem, you’re probably right”    

In much the same way, society has hidden the individuals who are clear and disturbing evidence that the social systems of care for our most vulnerable citizens are failing. The systems of mental health care, the psychiatric system, the regulatory bodies that should be monitoring prescribing practices to youngsters, the complex, un-integrated, outpatient systems, shelters, and housing programs have all taken their massive funding, proclaimed their missions and are failing to provide even the basic necessities for life. Although new and effective alternative approaches have been found (respite and peer treatment) the momentum has stagnated. The individuals who urgently need these resources cannot usually campaign and take political action because they have been hidden away.  
Society, whether intentionally or not, has found a way to hide the most distressed individuals from view. These people are the evidence of social/political failures that would be glaring, weeping wounds on the social skin of this country and, like side-effects, they had to be stowed away in a manner that would leave little or no opportunity for escape. 
What better way to keep them quiet and invisible than to do it “legally” and “medically”?   There is no better place to hide these people who, when visible, are proof of social and psychiatric failure than in locked institutions.
The jail, and locked in-patient psychiatric units are full of these individuals. There is a waitlist to get in and no ticket out. They are there “legally” and “medically” and due to lack of public defenders, thousands of court cases, unavailability of residential programs and the system’s delaying tactics, people languish in jail and are put on 180-day holds in psychiatric units more often than not. 
People on the fringes of society who have been dehumanized due to repeated traumatic experiences, and marginalized and stigmatized due their emotional distress, have been warehoused — and often medicated and abused — and confined in miserable conditions. Can we see them there?  Can we hear their voices?  Can they leave when they wish to?
What better way to keep them quiet and invisible than to do it legally and medically?  Is there no better place to hide people who, when visible, are proof of social and psychiatric failure than in locked institutions?
The jail and locked in-patient psychiatric units are full of these individuals. There is a wait list to get in and no ticket out. Due to a lack of public defenders, thousands of court cases, unavailability of residential programs, and the system’s delaying tactics people languish in jail and are put, without recourse, on 180-day holds in psychiatric units.
I have worked with many such individuals in the LA County Jail, and the locked inpatient wards, and in each case the institution’s process — although in compliance with legal and medical protocols — seemed to conspire to keep the individual powerless, medicated, isolated and confused.
A case in point; Carol is a 19-year-old in the women’s jail in Los Angeles (Tower 2). She has a rap sheet with more than a dozen incarcerations for prostitution, petty theft, trespassing and attempted assault on an officer. She is a product of the foster care system and had been on psychiatric medications for ADHD and anxiety most of her life. She had been hospitalized just prior to being incarcerated (she tried to break into a residential program where a friend was staying). She has been chronically homeless, and has no family. In jail, she was started on antidepressants because she attempted to cut her wrists, and was called to my attention because a compassionate nurse found that she was losing weight and had been hiding under her bunk in the crowded cell.
In my contacts with her public defender (her court date was months away) and the psychiatrist (she saw him once), I found a complete lack of empathy and a great deal of stigmatization. She was perceived as “manipulative,” and thought to be faking her symptoms for attention. Her homelessness and prostitution were perceived as her own failure to cope with the life stresses that everyone has. Her being in-and-out of jail and hospitals was considered to be what she deserved due to her behaviors and her attitude.  The underlying sentiment was that she needed to be kept away from society. She was deemed infectious. She was a side-effect of failed systems.
I found her to be the product of repeated abuse and trauma and stripped to the bone of any feelings of worth and hope.
I worked with many inmates who deteriorated during their incarceration, and the re-traumatization was impossible to ignore. With increased symptoms of panic; flash-backs, hallucinations, and fears, came more medication, time spent in isolation, and dehumanizing statements from many of the staff who believed that they were “manipulating” the system. 
Is it spurious to think that the stigmatization and marginalization coincide with endless institutionalization?  It is my opinion, based on my work in the system, that continued institutionalization of individuals who are rendered increasingly distressed and powerless “works” for the social order.  Under the guise of caring about the most vulnerable of people lurks a great deal of self (and systemic) preservation, fear, and the belief that the distressed should be hidden from public view, and rendered impotent and silent. In this way they are not a threat, and the system can stay its course unimpeded.
Is it completely an “out of sight, out of mind” sort of affair?  That is not quite the case. Thanks to sites such as MIA, Impact Justiceand the Open Society Foundation voices are being raised in pursuit of uncovering the injustices, the abuse and the negligence. There are also vocal activists within the criminal justice system itself; people such as Joanne Belknap (a criminal attorney), who states:
“Something is terribly wrong in the United States when we incarcerate at a higher rate than anywhere in the world, but we are grossly inadequate in providing equal access to social and legal justice. At the same time that our government fosters and funds mass incarceration and allows private prisons (money-makers for the private sector), we find advocates for social and legal justice struggling to fund, open, and maintain schools, health-care programs, jail and prison reentry programs, abused women’s shelters, homeless shelters, child sexual abuse organizations, rape crisis centers, and so on.” (Belknap 2015)
Notable ex-convict criminologists who are published authors and activists as well, such as Dr. Angela Davis, Dr. Douglas Thompkins, Dr. Kathy Boudin, and Dr. Stephen Richards also are noted in the article above. 
The case of the hidden side-effects (be they human-caused, or drug-related) is not closed. The evidence may be hidden, but our job — our mission — is to find it and put the information into the public’s hands, hearts and minds.

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Recommended Reading:

Belknap, Joanne, Kristi Holsinger, and Jani Little. 2012. Sexual minority status, abuse, and self-harming behaviors among incarcerated girls. Journal of Child and Adolescent Trauma 5:173–85.

Chang, Tracy F. H., and Douglas E. Thompkins. 2002. Corporations go to prison: The expansion of corporate power in the correctional industry. Labor Studies Journal 27:45–66.

Chu, Ann T., Anne P. DePrince, and Iris B. Mauss. 2014. Exploring revictimization risk in a community sample of sexual assault survivors. Journal of Trauma & Dissociation 15:319–31.

DeHart, Dana, Shannon Lynch, Joanne Belknap, Priscilla Dass-Brailsford, and Bonnie Green. 2014. Life history models of female offending: The roles of serious mental illness and trauma in women’s pathways to jail. Psychology of Women Quarterly 38:138–51.

Lutze, Faith E., Rosky, Jeffrey W., and Hamilton, Zachary K. (2014) Homelessness and reentry: A multisite outcome evaluation of Washington State’s reentry housing program for high risk offenders. Criminal Justice and Behavior 41:471–91.

Lynch, Shannon M., Dana D. DeHart, Joanne E. Belknap, Bonnie L. Green, Priscilla Dass-Brailsford, Kristine A. Johnson, and Elizabeth Whalley. 2014. A multisite study of the prevalence of serious mental illness, PTSD, and substance use disorders of women in jail. Psychiatric Services 65:670–4.

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Margaret Altman, MSW
Voiceless in America: Margaret Altman is a crisis intervention specialist and has intervened in many explosive situations within jails, emergency rooms, suicide prevention centers and psychiatric units. She enjoys writing and researching on a wide range of topics, primarily in realms lacking a sufficient knowledge base such as explosive behavior syndromes.

8 COMMENTS

  1. Another part of this problem that is seldom mentioned is the deferment of social responsibility. At no point in the cycle of this dysfunctional system does anyone take responsibility to be sure that people are cared for. Human lives are “hot potatoes” and people keep being recycled through the system again and again because the system can’t be objective and say “this isn’t working”. The amount that the government (both local state and federal) waste on ineffective programs could cure about every social ill we have. Housing programs in and of themselves receive trillions of dollars and very little of that money trickles down to become shelter for the homeless (combine the money spent between the USDA and HUD for such projects alone). Social services programs serve mostly those employed by them and the mental health complex fails to reduce the overall number of those suffering in the least.
    They seem to miss this single fact; You can’t fix a problem that you deny the existence of.

  2. Thanks for this article, Margaret.
    The issue of society’s responsibility needs to be further addressed. To a significant degree, it is the problems within our societies that cause emotional distress to begin with. Society then blames the individuals and just wants them to disappear.
    For many years, I have taught a concept that I call the “ascending and descending ladder of emotional pain metabolism”. This basically states that in a well functioning society, people in positions of responsibility help hold and metabolize emotional pain for those more vulnerable or with less power. Thus, parents attend to their children’s emotional distress, extended families and friends help parents, local communities take responsibility for extended families, and ascending levels of government take care of communities. In many societies, we are seeing a descending, or inverse triangle of responsibility for emotional pain metabolism, with vulnerable individuals and children ending up feeling and being left alone with the emotional pain dumped down by society. Thus federal governments dump responsibility on State and Provincial governments, who dump on municipalities that dump on families. Vulnerable individuals end up showing symptoms of this emotional pain, and are then labelled as aberrant.
    Until societies take true responsibility for taking care of families and children, many will continue to suffer.

  3. Dr Hoffman
    Thank you for your eloquent comment; where may I find your writings? I read all of your posts and would like to have much more at hand and in mind. I use the word “digest” a great deal, I like “metabolize” as another gustatory and descriptive word.
    I await your reply
    Margaret

    • Hi Margaret,,

      Norman, please.

      I like the words digest and metabolize, because in psychotherapy, and relationships, these words describe what often is helpful. People feel overwhelmed with their emotions, and we, by sitting with them, hearing them, and being able to engage these emotions, do actually help in the metabolism of feelings. Children, and grown-ups too need to be able to feel that sense of another person being with them to break down overwhelming feelings into smaller bits and gradually be able to digest these feelings.
      some of my writings can be found at drnormanhoffman.com, and others at studentmentalhealth.ca.
      I look forward to further communications with you.

      Norm

  4. Good points. Personally, I’ve found that “mental health professionals” are often more concerned with keeping people “in line” than with helping them/us. That’s certainly true of many I’ve encountered at the clinic I go to. Actually, its true of both private practice and community mental health, now that I think about it. Its hard to be anything more than a “compliant patient” when dealing with “professionals” such as these. I’m blessed because I have upper-middle, maybe upper class people behind me, so I get more leeway (although I still get comments and sneers at the clinic).

    Anyway, society creates deviant individuals and then punishes us/them harshly, especially those who are low on the totem pole to start with. “Personal responsibility,” “accountability,” etc….all those buzzowords that seem so popular in American culture (and often in the mental health arena, too). In the US, social problems are apparently “personal” problems. You’re homeless because of “poor life choices.” Oh, wait…you’re schizophrenic. That’s it… You’re in jail because you deserve to be. You need to be punished. I don’t wanna hear your sob story. On and on it goes, as the mental health and justice systems get bigger and bigger and ever more vicious.

    Again, thanks for the article.

  5. Margaret,

    Great article. I recently read about the need for “the richest nation on earth” to take more responsibility for responding to the Syrian refugee crisis by welcoming more refugees into this country. While I wholeheartedly agree with that sentiment, I find it intolerable that so many who are already here are being exploited and/or ignored, like those you have described. A tragic aspect of this is that most who experience the dehumanizing effects of the sick systems in society feel all alone as if they’re the only one experiencing this. Such an isolating condition! Thank you for recognizing these societal side-effects for what they are and for reminding us of how they connect to the bigger picture.

  6. Thank you for your comment. Of course, isolation is one of the most effective strategies for social and psychological control and then abusing the vulnerable individual further reduces the ability to trust, to reach out for support etc. Many injustices are hidden in this society; I am researching the current practice of coercing mentally ill women to be sterilized in order to get reduced sentences in jail and in prison. This began in 1909 and is still going on. There is a case in Tennessee right now and other cases in Georgia. Can you imagine the terror, the anger, the guilt of having to make such a decision when you are in emotional pain and incarcerated? I have a great deal of info on this and if you are interested I can send you the article link.
    Again, thanks for your comment.