America: the insane way of dealing with "insanity"

[josephpalazzo]

Laura Mallia is no stranger to the way Florida handles the mentally ill.


Chronically homeless and struggling with a crack cocaine addiction, she has been arrested 65 times in and around downtown Sarasota and Palmetto.


She was banned from 7-Eleven for stealing coffee, from Starbucks for walking out with napkins and condiments, and from St. Martha Catholic Church for disrupting a Mass.


Her mother tried to help. But Mallia was left on her own when she developed Alzheimer’s disease and died in 2014.


“Laura has had mental problems since she was a young teenager,” Mallia’s sister, Catherine Orobello, wrote in a 2013 letter to the court. “She has been in and out of mental hospitals and has been diagnosed with paranoid schizophrenia and bipolar disorder. She is a menace to society and a danger to herself.”


Four times in the past decade, judges sent Mallia to one of Florida’s mental hospitals so that she could be made competent enough to face her charges. In 2005, she hit and spat at a jail guard. In 2009, she promised an undercover officer oral sex for $20. In 2011, she yelled at someone who refused to give her money at Publix and spat all over the inside of the responding officer’s squad car. In October 2014, she was caught with an $8 lump of crack cocaine.


For these four offenses, she spent a total of 15 months in Florida mental hospitals. It cost Florida taxpayers $143,000.


In each case, as soon as she could pass a competency examination, she pleaded no contest and was sentenced to time served, meaning she got no prison time for her crimes. Each time, she went back to life on the streets.


“You might as well take the money you spent on her, put it in a pile and burn it,”
said Larry Eger, Sarasota’s elected public defender.

There are cases like Mallia’s all over the state, costing Florida taxpayers millions of dollars each year.

Read more at: http://www.tampabay.com/projects/2015/investigations/florida-mental-health-hospitals/competency/

[stromboli]

And yet the obvious answer, treating mentally ill people as patients and not as criminals, apparently hasn't occurred to them. Portugal and I believe Uruguay got rid of criminal treatment of addicts and mentally ill and started treating it as a health issue, and made real progress. Other progressive countries using the same philosophy achieve similar results. A uniform policy and health care strategy would no doubt be considerably more successful and also save millions, but looking past the immediate solution for long term ones seems beyond the grasp of our lawmakers.

[gentle_dissident]

And yet the obvious answer, treating mentally ill people as patients and not as criminals, apparently hasn't occurred to them.

Self righteousness is a mental illness. The inmates are running the asylum.

[Baruch]

America today is like Bill Clinton ... reefer madness, without ever having inhaled.  MJ can cause derangement, even without second hand smoke.  One has to remember this ties into American racism ... the original push against drugs is because swave Black svengalis were using drugs to seduce White women.  Once the original meme gets going, and it becomes habitual, the behavior becomes unconscious, and it is no longer necessary to push the original motivation ... it becomes self justifying with new motivations ... like drug addiction is something that will weaken our resistance to the Communist Threat!

[TomFoolery]

America seems to have a love affair with the idea of using prisoners as a type of punishment. I think there's been an unwritten understanding that we need "undesirable people" in prisons as a crime deterrent. Don't commit crimes so you don't go to prison and end up spending all your time with those people, you know?

You hear it all the time... when a child molester or some other pervert goes to prison, many people relish at the idea that he'll get his comeuppance by being brutally raped by the other inmates. That means, if we don't stock our prisons with some aggressive men who use sex as a weapon of power, then who will make life hell for child abusers?

Sadly the mentally ill just fall into the same equation. It's not enough to just make you sit in prison and think about your crime: it's much better if you have a paranoid cellmate who imagines you're trying to kill him. It adds a nice element to it.

[Baruch]

Saw a sad program once, on the history of American incarceration.  Gave me a lot of sympathy for prisoners.

The French philosopher Lacan, addressed this ...
http://whatispsychoanalysis.ie/wp-content/uploads/2013/06/Issue-31-merged.pdf

[Johan]

I'm guessing there are countries that are able to do mental health care properly. Not sure what they are, but I'm guessing they exist. What I do know is that the US is not one of them. I believe that mental health care available to those without insurance is sub par at best in most cases.

Those with insurance do have to luxury of being able to find mental health care that is better than sub par. But even for them, the barriers to entry (other than money) for good quality care can be formidable. Which means that very often, those who most need care, and can afford it, still end up going without it.

[Baruch]

I'm guessing there are countries that are able to do mental health care properly. Not sure what they are, but I'm guessing they exist. What I do know is that the US is not one of them. I believe that mental health care available to those without insurance is sub par at best in most cases.

Those with insurance do have to luxury of being able to find mental health care that is better than sub par. But even for them, the barriers to entry (other than money) for good quality care can be formidable. Which means that very often, those who most need care, and can afford it, still end up going without it.

Unfortunately in psychotherapy ... it is hard to tell what works and what is just placebo.  Even some of the recent psychoactive drugs have been accused of this.  Talk therapy costs $100 per hour ... nobody but Trump can afford that, and he is unwilling to get it ;-)  If there are any countries with good mental health care, we need to find them and eliminate them ... NWO has spoken.

[GSOgymrat]

I work in crisis counseling in emergency departments and community mental health centers, so I am very familiar with this topic. The situation varies from state to state and in North Carolina we are still dealing with a disastrous mental health reform. The whole situation is complicated but as far as the mentally ill and the legal system, the situation in my county is improving. We have a mental health court designed specifically for people with mental health and substance abuse problems so they can avoid incarceration. Local law enforcement goes through training to assist mentally ill people access treatment through a mental health center or emergency room rather than just put them through a judicial process. We have counselors and social workers who are stationed at homeless shelters to assist people with mental health or substance abuse problems access treatment. The goal is to treat people outside a hospital if possible, particularly because available psychiatric beds are difficult to find. The biggest problem is, like with everything else, funding. North Carolina's Republican government refused to expand Medicaid coverage and therefore did not get additional federal healthcare funds. There are effective ways to help people but the resources are not available.

[stromboli]

Good post, GS. A good summation of both the problem and the solution. The odd thing is that in other countries like Uruguay and Portugal, I believe that one reason the change was made from treating addiction or mental health as a health issue rather than a legal one was actually, long term, for the purpose of saving money. When you incarcerate someone you have to take care of them- bed them, feed them, see to their health needs and have people to watch them and build expensive facilities to house them.

You would obviously be the expert, but I think there is an argument for that.

[Baruch]

The purpose of the US system of lockup is to punish, not to rehabilitate.  But don't underestimate the cost of even out-of-clinic rehabilitation.  In America today, I don't think anyone is willing or able to pay for anything, either lockup or clinic ... we are bankrupt morally and financially.  Less than 100 people own more in the US than 1/2 the rest of the population combined.  We should have stuck with King George.

[josephpalazzo]

I work in crisis counseling in emergency departments and community mental health centers, so I am very familiar with this topic. The situation varies from state to state and in North Carolina we are still dealing with a disastrous mental health reform. The whole situation is complicated but as far as the mentally ill and the legal system, the situation in my county is improving. We have a mental health court designed specifically for people with mental health and substance abuse problems so they can avoid incarceration. Local law enforcement goes through training to assist mentally ill people access treatment through a mental health center or emergency room rather than just put them through a judicial process. We have counselors and social workers who are stationed at homeless shelters to assist people with mental health or substance abuse problems access treatment. The goal is to treat people outside a hospital if possible, particularly because available psychiatric beds are difficult to find. The biggest problem is, like with everything else, funding. North Carolina's Republican government refused to expand Medicaid coverage and therefore did not get additional federal healthcare funds. There are effective ways to help people but the resources are not available.

Under a single payer (or a universal) health care program, many treatments would be available to these people. But don't bring that up or else you will be branded a socialist or a communist, even though Medicare IS a socialist measure, and very popular among the 65+ folks. The partisanship has poisoned the well to the extent that no rational discussion is possible.

[GSOgymrat]

Under a single payer (or a universal) health care program, many treatments would be available to these people. But don't bring that up or else you will be branded a socialist or a communist, even though Medicare IS a socialist measure, and very popular among the 65+ folks. The partisanship has poisoned the well to the extent that no rational discussion is possible.

I've advocated for a single payer healthcare system, or at least a healthcare consortium controlled by the federal government, but most people oppose "big government" even when it is the most efficient means of managing resources. What we have in the US is an inefficient patchwork of different systems, which is one reason US healthcare costs are high and our outcomes don't match our financial investment.