Bring back asylums - interesting perspectives
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OVERKILL
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OK, here's the thread (2nd link):
This chart has been making the rounds lately, and since I am an American and have both worked in a mental hospital and been a criminal defense lawyer, I have opinions. The idea that insane people belong in institutions came under 2-pronged attack in the 1950s and 1960s.
From the left, radical psychiatrists such as R.D. Laing argued that it was society that was truly crazy, and that psychosis was a symptom of that overall situation. Hippies even embraced psychosis as a form of spiritual insight. The sociologist Irving Goffman wrote the hugely influential book "Asylums", which portrayed mental asylums as inhumane "total institutions" which broke down the humanity of their occupants. There were, of course, genuine abuses in this time period which provided grist for the mill.
The other attack on mental health treatment came from the libertarian psychiatrist Thomas Szasz, who wrote a book called "The Myth of Mental Illness" arguing that mental illness was a made-up construct applied to people who simply violated social norms.
I should add that both of these views are objectively false and dangerous. Schizophrenia, the illness at issue here, is not shamanic insight or a personality quirk, as anyone who has known someone with the disorder well can tell you.
People suffering acute schizophrenia are unable to control their thought processes, unable to correctly interpret reality, often unable to perform basic hygiene, and are a danger to themselves (mainly) and to others. This is a terrible disability, not a choice or a gift.
But in the late 1960s, a view took hold that confining people against their will for this illness was inhumane and should only be used as a last resort. The Supreme Court of the United States ruled that insane people could only be confined against their will if they were an immediate danger to themselves or others (slight oversimplification). Further, they had to be let out of confinement as soon as they were no longer *a danger* to themselves or others. This set up the infamous "revolving door" https://supreme.justia.com/cases/federal/us/422/563/#:~:text=Primary Holding,against his or her will
Patient X is admitted while floridly psychotic, is stabilized on antipsychotic meds, *must* be released within 2 months, lives in the community for 4 months before going off their meds and breaking down again, and it's time for Round 2. Then round 3, 4 ad infinitum.
The idea behind de-institutionalization was that "care in the community" would take the place of "total institutions". Patients were entitled to the least restrictive form of treatment. They would be placed in halfway-houses and treated with drugs and therapy.
This was the idea behind Kennedy's Community Mental Health Act of 1963, part of his 'New Frontier' program. This law gave turbocharged deinstitutionalization by redirecting federal funds to community care and away from asylums. https://en.wikipedia.org/wiki/Community_Mental_Health_Act
Yet the programs were never fully-funded, and finding places in the outside world for people who were obviously mentally disturbed proved to be incredibly difficult. Who wants to live next to a half-way house full of heavily-drugged paranoid schizophrenics? So millions of people were kicked out of huge 'Kirkbride Plan' mental asylums, which were often put to other uses or just left to decay. They were placed in various group homes and half-way houses, but frequently just ran away from them to live on the street, often using drugs. Since they could not be forcibly returned to the community placement unless they were actually dangerous -- not just floridly psychotic -- they dropped out of the system except when they "decompensated" in public.
Why do they go to prison? A few reasons. First of all, it is almost impossible to win an insanity defense in the USA. It's only attempted in under 1% of cases, and is only recognized in a fraction of these. Further, people in the system come to understand that some dangerously psychotic people just need to be off the streets. Since long-term confinement in asylums is no longer an option, prison is the only choice -- at least they'll be cared for and receive some minimum level of bare-bones treatment (depending on the state).
In practice, 'treatment' often means they're pumped full of drugs. Of course, prison is a terrible environment for someone with schizophrenia, and it's also dangerous for sane prisoners, since people with schizophrenia are in fact more dangerous than sane people. So the situation in the US is a product of a perfect horseshoe-theory storm of well-meaning procedural liberalism and cost-cutting at the expense of a vulnerable population with no political power. It's a huge failure. In my view, the U.S. needs to rebuild asylums.
Lobotomies and involuntary electroshock are things of the past, and modern psychiatric drugs are much less debilitating. Asylums can be run humanely and transparently. But as long as the Supreme Court interprets the constitution in such a way as to make long-term confinement impossible, the problem is very hard to solve. I think the modern Court should revisit its decisions from the 1970s. Given its present ideological orientation, it just might do that. My fingers are crossed.
Comments get into references to "One Flew over the Cuckoo's Nest" and other films that portrayed life in institutions and worked to galvanize support for the dismantling.
Hollywood romanticization of abnormal being "normal" and the evils of institutionalization didn't help.
A 1990 book is also mentioned in the comments:
And in the thread about this book, this is singled out:
And a few more pages:
There's plenty more, sounds like this book might be worth picking up actually.
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Owen Lucas
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Of course not, my ancestors suffered under such programs. Buuuuuut. If you cannot be rehabilitated or don't want to be, and continue to be a threat to society, what do you do? Punish society further? Let the wackos get life after they kill someone?
Remember the guy who slashed the neck of that poor Ukrainian woman on that train? That's what happenes when you don't manage criminals correctly. He was let out of jail how many times again?
Isn't the MAID program in Canada basically euthanasia? It's a mercy killing for the public good.
Canada and the US sure has provided refugee status to many who would un-life someone for for lesser crimes, i.e. stoning for adultery, killing gays, religious expression. Imagine if they became the dominant form of gov't and rewrote the Charter/Constitution. You'd have bigger issues to worry about than dealing with druggies or the insane. Those would have been eliminated a looong time ago.
Suicidal empathy is a spectrum, and it starts at home.
Extreme, I know. But it sure would clean up San Francisco / Skid Row.
How's the current solution working out? Only keeps getting worse, right? I guess you're fine with it?
I'm starting to think that's all by design.
Dealing with the mentally ill is by far the worst part of my job.
I'm a Deputy Sheriff that works in a county jail here in GA and am in charge of supervising one of our 4 shifts.
Jails are not properly equipped to deal with the seriously ill. Yes, they sometimes commit crimes and should be here, but there are other issues that land them here.
The most infuriating is.
Most of these people draw a monthly disability check and live with family or friends....who spend that check for them. Occasionally the family will decide that they need a break and have the person arrested. It is far easier than you think. Most of these people are so unstable that you can get them worked up into a state of rage very quickly, when they do that, you call the deputies in, tell them you're in fear, and the mental person goes to jail. You get to keep the check.
Happens several times a year around here and it absolutely makes my blood boil. Most of the time these people have no idea what's happening to them, don't understand why they're here, and we don't have the tools to deal with them. I'm not involved with it on a shift level, but I have heard that when this happens we do try and get the benefits stopped, but I don't think that is particularly easy.
The system is also horrendously slow to deal with them and they can sit here for years while they get kicked around from here to the state run hospital and back.
Maddening, and it really takes a toll on the mental health of me and my officers.
I'm a Deputy Sheriff that works in a county jail here in GA and am in charge of supervising one of our 4 shifts.
Jails are not properly equipped to deal with the seriously ill. Yes, they sometimes commit crimes and should be here, but there are other issues that land them here.
The most infuriating is.
Most of these people draw a monthly disability check and live with family or friends....who spend that check for them. Occasionally the family will decide that they need a break and have the person arrested. It is far easier than you think. Most of these people are so unstable that you can get them worked up into a state of rage very quickly, when they do that, you call the deputies in, tell them you're in fear, and the mental person goes to jail. You get to keep the check.
Happens several times a year around here and it absolutely makes my blood boil. Most of the time these people have no idea what's happening to them, don't understand why they're here, and we don't have the tools to deal with them. I'm not involved with it on a shift level, but I have heard that when this happens we do try and get the benefits stopped, but I don't think that is particularly easy.
The system is also horrendously slow to deal with them and they can sit here for years while they get kicked around from here to the state run hospital and back.
Maddening, and it really takes a toll on the mental health of me and my officers.
Here's another example of what the public doesn't get to see.
How do you deal with someone that is so unstable that they don't care what their living conditions are?
Meaning, old food, feces, urine, nothing bothers them, and if it happens to be painted on their bodies, they don't care and will actively do it.
My job, that person and living quarters has to be cleaned. You can't leave them in filth.
But you know that the moment you open the door, there's a well above average chance that the person is going to physically fight you and that you and your officers might be in real danger, and the inmate might get hurt in the process.
Even medicated, they're still a danger to you and themselves.
And if you go hands on, you are now in a use of force situation that has to be documented to the nth degree, which in and of itself isn't a problem, but it is super easy for the optics of that situation to be skewed to the negative towards you and your officers even though you're 100% in the right and did the right thing.
The public doesn't see that. They see cops beating mentally ill people.
Again, infuriating, sad, and mentally draining. I've been doing this for 12 years now, and if I had a magic escape button, I would push it and never look back.
How do you deal with someone that is so unstable that they don't care what their living conditions are?
Meaning, old food, feces, urine, nothing bothers them, and if it happens to be painted on their bodies, they don't care and will actively do it.
My job, that person and living quarters has to be cleaned. You can't leave them in filth.
But you know that the moment you open the door, there's a well above average chance that the person is going to physically fight you and that you and your officers might be in real danger, and the inmate might get hurt in the process.
Even medicated, they're still a danger to you and themselves.
And if you go hands on, you are now in a use of force situation that has to be documented to the nth degree, which in and of itself isn't a problem, but it is super easy for the optics of that situation to be skewed to the negative towards you and your officers even though you're 100% in the right and did the right thing.
The public doesn't see that. They see cops beating mentally ill people.
Again, infuriating, sad, and mentally draining. I've been doing this for 12 years now, and if I had a magic escape button, I would push it and never look back.
Not sure about prisons, but on the county jail level where all of these people enter 'the system' we as Deputies/Officers do not touch meds in any way. Only nurses/doctors administer those. As a medium sized county jail (~350 beds, ~300 inmates on a given week) we have 24 hr medical staff, mostly consisting of a single nurse overnight and a small team during the day.
Yes there are counties that probably do have officers administer meds, but they would still be packaged by medical professionals. Way too much liability for a Sheriff to be having officers dole them out.
OVERKILL
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You put them away for the rest of their life, or, you execute people who meet the threshold for execution (where applicable) but you said:
Owen Lucas said:
You didn't define "unredeemable", it could be somebody who the schizophrenia meds don't work on, so they'll need to stay in an institution for the rest of their life. It's a short walk from there to executing the mentally disabled with such an ambiguous statement.
That's why I asked.
Back in the asylum days, he may have still been in an asylum. I've read that he was schizophrenic? But with us using jails as impromptu ghetto mental health facilities, the "revolving door of justice" smacks you on the arse, it spins you through so quickly. How often do we complain about people using the wrong tool for the job on this forum? And yet society has totally embraced this idiocy of using prisons for mental health problems. It's the quintessential "everything looks like a nail when you only have a hammer".
That's a topic for another thread.
Let's just say that this has created a whole pile of controversy and unintended consequences, like offering MAID to vets experiencing PTSD and all manner of other inappropriate applications.
But the program wasn't conceived as serving the "public good", but rather the individual good. To allow people to die with dignity on their own terms, rather than some protracted battle with terminal cancer, gasping for weeks in palliative while your body stubbornly refuses to let go.
However, given the potentially broadening scope and present misuse, it seems bizarre the government's position on suicide by firearm, one of their planks of "firearm regulation", talking about how suicide is the #1 death by gun category in Canada and we need to work on this, while ignoring their own role here, as firearm suicide is massively eclipsed by "death by government" through MAID.
"It's only OK to kill yourself when the government pulls the trigger."Suicidal empathy with respect to the strange bedfellows found with modern progressives, who want to destroy the West because it's a "genocidal colonial settler construct" that "needs to be dismantled" and a certain poli-religious movement that wants to do the same thing, but for very different reasons, and would also gladly toss these "allies of convenience" off a roof when they seize control, is a whole other conversation, and we should probably avoid discussing that further in this thread. I mention the above only to convey that I'm aware of what you are referencing, but that's divorced enough from this conversation, and given its inherent R&P associations, I think we should avoid mentioning it further.
Of course it is, I mentioned that earlier. The infiltration and indoctrination starts at the education system.
Owen Lucas
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I should have been clearer. Criminals that recommit....A LOT. The solution would indeed be life in jail or shipping them off somewhere else. Then we wouldn't have to worry about killing anyone. But the problem is, there is an undersupply of mental institutions and there is too much of a political / financial roadblock to bringing asylums back.
Look at countries that have mostly resolved this, I presume Singapore and the Arab countries. Very harsh punishments solve most of these issues.
There's no other tool though. As I said earlier and others have mentioned, asylums / mental health care is difficult to get started and manage. How can we accomplish this when we can barely fill potholes?
I'll take the easy way out and ship em out to some foreign land but this is all a pipe dream and will likely be the state of affairs until:
- The Constitution / laws are changed
- Some massive disruption forces change, i.e. war, natural disaster, real pandemic
- Completely new form of government.
All possibilities suck and we will have to fend for ourselves which means moving away to more hospitable places.
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I'd like to put something out there to people discussing in this thread. It is a bit pedantic, but it has real meaning when we're talking about this subject.
That is the difference between a prison and a jail.
A prison, is typically run by the state or the feds (Talking about the USA here) and only houses convicted felons. You're there because you took a plea deal or were found guilty by a jury. So, right or wrong, you are supposed to be there.
Jails, on the other hand, are usually owned/run by local governments (County/City) and contain a mixed population. The rules are different for those of us that work in jails because our population is made up of pre-trial (presumed innocent), convicted but serving out a term less than a year, and convicted felons(here for court, new charges, or whatever).
Prisons, at least here in Georgia, do have special facilities for handling medical/mental folks that have been convicted. It might not be the same as a full on mental hospital, but generally they probably receive better care there.
Jails, as I've mentioned in my other posts, we're really sort of caught in the middle of a world of crap. People that have been arrested and waiting for trial, you can't ship them to a mental hospital without a judges order, and usually that order is just short term to determine their competency. They still end up back at the county jail.
People that are convicted of Misdemeanor charges, those (usually) get to stay with us at the jail, and you can believe that we work as hard as possible to kick them out on the street as soon as we can. Again, we're not built to handle these people and the sooner we can get rid of them (legally) the better for our facility. Sounds harsh, but that is the way the system works.
That is the difference between a prison and a jail.
A prison, is typically run by the state or the feds (Talking about the USA here) and only houses convicted felons. You're there because you took a plea deal or were found guilty by a jury. So, right or wrong, you are supposed to be there.
Jails, on the other hand, are usually owned/run by local governments (County/City) and contain a mixed population. The rules are different for those of us that work in jails because our population is made up of pre-trial (presumed innocent), convicted but serving out a term less than a year, and convicted felons(here for court, new charges, or whatever).
Prisons, at least here in Georgia, do have special facilities for handling medical/mental folks that have been convicted. It might not be the same as a full on mental hospital, but generally they probably receive better care there.
Jails, as I've mentioned in my other posts, we're really sort of caught in the middle of a world of crap. People that have been arrested and waiting for trial, you can't ship them to a mental hospital without a judges order, and usually that order is just short term to determine their competency. They still end up back at the county jail.
People that are convicted of Misdemeanor charges, those (usually) get to stay with us at the jail, and you can believe that we work as hard as possible to kick them out on the street as soon as we can. Again, we're not built to handle these people and the sooner we can get rid of them (legally) the better for our facility. Sounds harsh, but that is the way the system works.
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After seeing my old friend arrested and on the evening news I wondered what will happen to her if she is convected when she goes to court and ends up doing time. I found this fantastic film explaining what happens when folks like my friend enter the system.
My take away is when folks like my old friend that have {schizophrenia ) do something stupid like my friend did to get into the system and when a person thinks the guards are actually out to get them those folks can't and won't follow the rules and keep getting more and more in trouble and get more and more time.
Prison is the NEW Asylum! Its a good watch...
Not a lawyer, don't know what state she's in, but I can tell you the basics of what would happen here in GA. I suspect a lot of states will be similar.
She's out on bond and not medicated, she'll probably do something again, even if it is minor and go back to jail.
If a company or person underwrote her bond, they'll probably come off of it (the bond) and she'll be stuck in the county jail until she can get someone else to sign her bond for both the new charge, and the older, more violent charge.
If she can't, she'll sit there getting minimal treatment. Also keep in mind, jailers and jail medical staff can't force medicate someone (generally). So if she chooses not to take her meds, she'll spiral downward. She might end up being force medicated, might not, hard to say. She'll probably get sent to a state institution while she waits for her court date while they try to determine if she's competent to stand trial, or they attempt to get her competent.
She sounds like she's not super deeply gone, so she'll probably end up competent and tried (or take a plea), probably convicted of a more minor offence. Something that only requires a year of time or so. Maybe, if the state has a mental health court, she'll get put in that program where they are usually required to do a little bit of time in a rehab facility and then continue on probation with daily/weekly check in's with the court with the intent being to make sure she's staying medicated and following the program.
This rarely works.
Or, they send her to prison for some time, and she ends up in a state-run hospital.
--edit--
As far as getting in more and more trouble.
Usually not if they're in jail. An inmate has to usually do something pretty assaultive for us to take a new charge on them. It does happen, but if we know they are a mental case, we will usually go out of our way to not make it worse on them unless we really can't avoid it.
If they're out on bond, that's when the real trouble can start, especially if they stay unmedicated.
One Flew Over The Cuckoo's Nest. how come nobody has mentioned this classic as a major reason for demise of Mental Hospitals in North America? The Canada & USA homeless situation is more about the BS of not institutionalizing those who NEED the structure and don't need a prison record.
Worked for the NH State Hospital for several months in the late 50`s as an attendant floating to units needing staff. In the early 70`s when the State started the catastrophic emptying of the facility it was so sad to see people I remembered wandering the streets in dire straights. The governor at the time was only too happy for the reduction in the state budget. Nothing has improved since despite some well meaning projects.
4wd
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And the cost of theft is passed on to all other citizens in more ways than one can always grasp …
Few years back my wife saw a woman begging outside a coffee shop. So she bought her a cup of coffee.
When she offered it to her, the woman slapped it out of her hand and responded “I don’t want f’ing coffee, I want money.”
There is a good sized homeless encampment in Boston near a Methadone clinic. The current mayor ran on a campaign promise to clean it up.
The result? They’ve moved the people off the main, more visible street to the side streets. They’re still there.
When she offered it to her, the woman slapped it out of her hand and responded “I don’t want f’ing coffee, I want money.”
There is a good sized homeless encampment in Boston near a Methadone clinic. The current mayor ran on a campaign promise to clean it up.
The result? They’ve moved the people off the main, more visible street to the side streets. They’re still there.
OVERKILL
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I did mention it in one of the long-winded posts, and it's mentioned in the linked twitter thread.
OVERKILL
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As I said, I expect things will need to get dramatically worse before the idea of bringing back asylums is actually considered again. Getting that setup would be a considerable undertaking and it's not going to be done unless the public effectively demands it, which they aren't currently doing, because they are still being gaslit by the special interest groups and SJW's.
Homelessness is too big of a cash cow right now, so stopping it is not really beneficial for the people involved.
California spent something like $24billion since 2019 to “do something” about homelessness, there is no slowing that thing down any time soon.
California spent something like $24billion since 2019 to “do something” about homelessness, there is no slowing that thing down any time soon.
