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The costly criminalisation of the mentally ill

economist.com

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Re: The costly criminalisation of the mentally ill

#51

Post by Decade »

droithomme wrote: post #20

The article uses a woman as an example and gives her crimes as: "trespassing, prostitution, drugs, disorderly conduct, petty theft, drinking in public". The petty theft is later discussed as theft from a supermarket, probably of some small food item. As to the others, why should any of them be imprisonable offenses? Drinking in public? Drugs? Prostitution? Trespassing is not breaking and entering, which is reasonable…

Regarding the food item from Whole Foods, I doubt that she needed to shoplift in order to eat. Even if she did, there are certainly cheaper and more accessible places to shoplift than Whole Foods. This is not Bourbon Restoration France.

In my experience, when a crazy person gets the urge to take someone else's thing, then that person is not thinking, "Oh, it's theirs, hands off." The crazy person is just acting out the urges, and the lady was genuinely surprised that the police officers would have a problem with what she was doing.

I don't think the article was proposing ankle bracelets for everyone. That was just one solution that worked for some of Mr. Dart's patients. Incidentally, how messed up is it, that the sheriff is in charge of creating a decent home for the mentally ill in his district.

Those of us who deal with the marginally criminally insane, know that the system is just not set up to handle them. These people need adult supervision, and the social service just throws them into the street, to be arrested and put in jail every time.

Re: The costly criminalisation of the mentally ill

#52

Post by specialist »

phren0logy wrote: post #36
gcb0 wrote: post #32

Earlier quoted context omitted.

And those are not even the biggest group. Most of them will never see someone in your position and just wander the streets spend one night or another in jail, but mostly on the street. There are several documentaries about that. It's worse in the US because of the left over from the eugenics movement, when sanatoriums were deemed unnecessary. i'm trying to remember names but i can only recall one: skid row. When watc…

We see those guys all the time. I'm not sure how accurate those documentaries are; the mass closing of psychiatric hospitals was primarily a product of the Community Mental Health Act of 1963 (as mentioned in the article). The intent was good (get people out of poorly run institutions), but had some serious unintended consequences. Although some people could be managed in the community, most communities have not fund…

Given that the USA system is expensive, immoral, and counterproductive, is there a system or model or whatever we should work towards.

Having done some activism, I've learned it's an easier sell what you're for vs what you're against. I'm totally onboard with improving the care of mentally ill people.

But I don't know what to ask for. If someone pointed out a bandwagon, I'd totally hop on.

Re: The costly criminalisation of the mentally ill

#54

Post by calibraxis »

specialist wrote: post #52
phren0logy wrote: post #36

Earlier quoted context omitted.

We see those guys all the time. I'm not sure how accurate those documentaries are; the mass closing of psychiatric hospitals was primarily a product of the Community Mental Health Act of 1963 (as mentioned in the article). The intent was good (get people out of poorly run institutions), but had some serious unintended consequences. Although some people could be managed in the community, most communities have not fund…

Given that the USA system is expensive, immoral, and counterproductive, is there a system or model or whatever we should work towards. Having done some activism, I've learned it's an easier sell what you're for vs what you're against. I'm totally onboard with improving the care of mentally ill people. But I don't know what to ask for. If someone pointed out a bandwagon, I'd totally hop on.

Well, there's ideas like Participatory Society, but people criticize it for being too far in the "blueprint" spectrum. (http://www.zcommunications.org/topics/parecon)

Can't please everyone. :)

If that's a bit too fundamental, then consider Terry Kupers' argument in favor for rehabilitation. This situation is quite simple: instead of solving the problem through humane institutions (like childcare assistance, lifelong education, fiscal policy to reduce unemployment, drug rehab), we use the prison system. Which is not only expensive and violent, but it clearly makes the problem worse. (http://www.leftbusinessobserver.com/Radio.html#S130328)

Re: The costly criminalisation of the mentally ill

#55

Post by DanBC »

gruseom wrote: post #46
phren0logy wrote: post #37

Earlier quoted context omitted.

I'd be happy to say more, but probably the most important thing people can do is read the article. Lack of adequate services for the mentally ill is a huge issue. In the absence of services, they often end up behaving oddly enough for someone to call the police, leading to arrest. More and more often we see families who are relieved that their loved ones are arrested just to get access to treatment . That seems like…

The article implies that it's more than 5x as expensive to house the mentally ill in jail than elsewhere. Such a huge difference suggests that providing them with housing and care would more than pay for itself, so cost ought not to be an issue. I realize that's oversimplifying--for one thing, total cost to society is not the same as costs (and income!) to different institutions--but do you think it's basically corre…

Look at the outrage caused to some people when we suggest that someone's life should be saved with free-at-the-point-of-delivery health care.

Now apply that to giving people adequate care in the community and see heads explode.

Re: The costly criminalisation of the mentally ill

#56

Post by noloqy »

droithomme wrote: post #20

The article uses a woman as an example and gives her crimes as: "trespassing, prostitution, drugs, disorderly conduct, petty theft, drinking in public". The petty theft is later discussed as theft from a supermarket, probably of some small food item. As to the others, why should any of them be imprisonable offenses? Drinking in public? Drugs? Prostitution? Trespassing is not breaking and entering, which is reasonable…

Interesting post.

I'm not fond of declaring her mentally ill based on the offenses she has committed. Clearly, she isn't living an ordinary life, but plenty of ordinary people have used drugs, drank alcohol, trespassed and stole during the course of their lives. Prostitution might be a different case, but prostitution ultimately also is a choice. I can even imagine her shoplifting because she wasn't able to obtain the necessary money through different means: nobody would hire her, and whenever she prostitutes she gets arrested. Also, it appears that she doesn't rip out her veins when she isn't incarcerated - otherwise she would be dead by now. Furthermore it is not uncommon for "normal" people who get arrested to be put on suicide watch. The tendency for self affliction perhaps isn't so uncommon for the imprisoned.

I think that if the government would stop disturbing her in her daily life, a Pareto optimum would be reached. Naturally we have the moral obligation to kindly offer help with her problems - rehab, etc. - but shouldn't have the right to force her into anything as long as she isn't a menace to society.

What I'm trying to say is that the system now is turning her into a menace to society. Stop it!

Re: The costly criminalisation of the mentally ill

#57

Post by DanBC »

droithomme wrote: post #20

The article uses a woman as an example and gives her crimes as: "trespassing, prostitution, drugs, disorderly conduct, petty theft, drinking in public". The petty theft is later discussed as theft from a supermarket, probably of some small food item. As to the others, why should any of them be imprisonable offenses? Drinking in public? Drugs? Prostitution? Trespassing is not breaking and entering, which is reasonable…

Some people engage in self-destructive behaviour because their early life was destroyed by abuse. These behaviours can be things like taking drugs, risky sex, self-harm, and so on. Obviously not everyone doing these things has had awful experiences in early life.

For these people it's not acceptable to just let them get on with it. They're not happy, they're not fulfilling their potential, they are not well.

Re: The costly criminalisation of the mentally ill

#58

Post by Torkild »

DanBC wrote: post #57
droithomme wrote: post #20

The article uses a woman as an example and gives her crimes as: "trespassing, prostitution, drugs, disorderly conduct, petty theft, drinking in public". The petty theft is later discussed as theft from a supermarket, probably of some small food item. As to the others, why should any of them be imprisonable offenses? Drinking in public? Drugs? Prostitution? Trespassing is not breaking and entering, which is reasonable…

Some people engage in self-destructive behaviour because their early life was destroyed by abuse. These behaviours can be things like taking drugs, risky sex, self-harm, and so on. Obviously not everyone doing these things has had awful experiences in early life. For these people it's not acceptable to just let them get on with it. They're not happy, they're not fulfilling their potential, they are not well.

This is why I stopped voting for any politicians years ago. It's just enabling.

Re: The costly criminalisation of the mentally ill

#59

Post by gutnor »

sliverstorm wrote: post #50
rhizome wrote: post #42

Earlier quoted context omitted.

(e.g., sanitation) Really? Is there even a single documented case of a sanitation problem caused by mere nudity?

It would be hard to document such cases, when public nudity has been restricted for thousands of years. You should not have to stretch your imagination, however, to figure out all the possible transmission vectors.

Clean nudity is inferior to clean clothing, that's OK.

However, we allow fully clothed homeless that haven't bathed in months, or even anybody with poor personal hygiene. We allow dirty street, dirty buses and public transports, kids playing in sewers in bad area of town, hoarders and countless other documented hygiene threats.

So let's be intellectually honest and accept that nakedness is a morality issue first and foremost.

Re: The costly criminalisation of the mentally ill

#60

Post by DanBC »

The article doesn't mention the diagnosis of "Personality disorder". This is a difficult and controversial diagnosis, but it's important for this kind of article.

We'll hear about people who don't take their meds (this thread has such comments) but these people aren't the main problem. People with a probable diagnosis of PD are the problem.

Some numbers from the mostly rural UK county of Gloucestershire:

Population is roughly 800,000 people. There are about 4,500 people on the books of specialist MH services at any time. There are about 2,000 people with a probably psychotic illness. There are about 2,500 people with a probably mood disorder. There are between 20,000 and 30,000 people with a probable personality disorder.

Looking at the psychotic and mood disorders, and putting it very simply, you hospitalise for a short time while you stabilise the illness and sort out the meds. Then you release the patient back to the community with intense support from community workers (daily, weekly, monthly visits). You give an easy route back into services when these people need it. You also provide vocational support - help people back into work and to integrate back into society.

Now look at what happens to people with a personality disorder. There's no real treatment. This used to mean they were specifically excluded from treatment - turned away from specialist MH services. That doesn't happen anymore, but there's not much that can be done. And behaviours are often much closer to "bad" than "mad", and so criminal justice is involved a lot more than MH services.

Here's a harrowing Grauniad article (http://www.theguardian.com/society/2008/mar/30/prisonsandpro...) (contains description of self harm and suicidal behaviour)

> On the day Diane Kent set herself on fire in her cell at Low Newton prison, County Durham, two months ago, she had already tried to hang herself twice and asked a prison officer to take away her lighter because she was scared of harming herself. According to incomplete prison records, her request was refused.

This woman's burns were so severe she was kept in a medically induced coma for 5 weeks.

Women who attempt suicide by arson are sometimes put in prison (http://www.oxfordmail.co.uk/news/8389188.Woman_locked_up_for...) for endangering life.

Here's another example, again traumatic reading. (http://www.theguardian.com/society/2008/feb/03/prisonsandpro...)

And this is in the UK where we have much better services than the US. God only knows what it's like over there.

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