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A Further Perspective

Unbenign Neglect

It gets nuts when the sane are crazy too.

“On any given day in the U.S., the number of people with severe mental illness in prisons is estimated to be three times higher than the number in hospitals, according to a new report from the Treatment Advocacy Center and the National Sheriffs’ Association,” reported Seena Fazel recently in the Wall Street Journal.

“Interestingly,” continued Fazel, “they found that Arizona and Nevada had the highest ratio of prisoners with mental illness, with 10 times more mentally ill people in jails and prisons than in hospitals.” 

Arizona has 5.9 psychiatric beds per 100,000 population, or one-tenth of the recommended level to meet public needs (only Nevada had a worse ratio), reports the Treatment Advocacy Center in Arlington, Virginia, a national organization seeking to eliminate barriers to the treatment of severe and persistent mental illnesses, such as schizophrenia and bipolar disorder.

An estimated 4.5 million people in the United States have those two illnesses, with reportedly 2.3 million and 2.2 million people, respectively, afflicted with bi-polar disorder and schizophrenia.

Some 40 percent of those people are going without treatment, i.e., 1.8 million, reports the National Advisory Mental Health Council.

In Arizona, there are more than 50,000 people with schizophrenia and a minimum of 25,000 are untreated, according to E. Fuller Torrey, M.D., a research psychiatrist specializing in schizophrenia and manic-depressive illnesses, the Executive Director of the Stanley Medical Research Institute, and the founder of the Treatment Advocacy Center.

This is where Jared Loughner comes in and his reported behavior over the past year or so. Schizophrenia is characterized by the following: a noticeable deterioration in the level of functioning in everyday life, a withdrawal from reality, illogical patterns of thinking, bizarre delusions, and social and/or occupational dysfunction.

What preceded the shooting in Tucson was a job that Loughner no longer held, a school that he no longer attended, a girlfriend who was no longer around, the shooter’s bizarre anger about the nation’s allegedly lousy skills in grammar, and the shooter’s reported fascination with the idea that Bush and Cheney planned the 9-11 attacks. Hollywood couldn’t have written a script more in harmony with the Dictionary of Symptoms.

“The proven link between untreated mental illness and violence is indisputable,” asserts a statement from the Treatment Advocacy Center. Pointing to the aforementioned numbers in Arizona regarding the number of people suffering from schizophrenia and the lack of psychiatric hospital beds, the Center warns that “untreated mental illness is a public safety issue of significance in the state.”

More broadly and explicitly, the Treatment Advocacy Center points to the consequences of non-treatment:

• People with untreated psychiatric illness comprise one-third of the nation’s 600,000 homeless population. “Eight percent used garbage cans as a primary food source,” while “28 percent of homeless people with previous psychiatric hospitalizations obtained some food from garbage cans.” 

• Approximately 1,000 homicides are committed each year by people with untreated schizophrenia and manic-depressive illness.

• The suicide rate for schizophrenics is 10 to 13 times higher than in the general population.

“A 1998 MacArthur Foundation study found that people with serious brain disorders committed twice as many acts of violence immediately prior to their hospitalization, when they were not taking medication, compared with the post-hospitalization period when most of them were receiving assisted treatment,” reports the Treatment Advocacy Center. “Important to note, the study showed a 50 percent reduction in rate of violence among those treated for their illness.”

Bottom line, what’s crazy is how this society lets the mentally ill fall through the cracks.

About the Author

Ralph R. Reiland is the B. Kenneth Simon professor of free enterprise and an associate professor of economics at Robert Morris University in Pittsburgh.

Letter to the Editor View all comments (28) |

Bill Hussein O'Stalin| 1.24.11 @ 6:13AM

From the article: "Schizophrenia is characterized by the following: a noticeable deterioration in the level of functioning in everyday life, a withdrawal from reality, illogical patterns of thinking, bizarre delusions, and social and/or occupational dysfunction."

Is it my imagination or does that describe the Democrats and the passage of Obamacare?

Silver| 1.24.11 @ 6:53AM

Are you fucking retarded, or are you just trolling?

AnotherLIB| 1.24.11 @ 7:23AM

silver... you are keenly perceptive, did you get that from Oberman?

David W| 1.24.11 @ 9:22AM

tsk tsk tsk - language please. If not careful your parents may kick you out of the basement.

Deborah D | 1.24.11 @ 8:21AM

Love it!

daddio| 1.24.11 @ 7:23AM

In years gone by-people with mental illness would be locked up in asylums. These places were often not very nice places to be, resembling prisons. In the 70's, these places were closed and the mental patients were turned loose on the streets to fend for themselves. All this did was replace cruelty with cruelty. They are still being abused and neglected.

Stammon| 1.24.11 @ 9:00AM

The myth of the evil mental institution colors the reality of mental illness today. I can only refer the reader to Madison State Hospital in Madison, Indiana. Fifty years ago this long term care institution for thousands and had it's own farms and industries to be self sustaining as possible. Today it is a shadow of it's former self, primarily being a juvenile and women's prison. No food or livestock is raised, no industry, just human storage.
We have a responsibility to look back at these older systems and ideas of long term care of the weak and ill and learn from them.

Appleby| 1.24.11 @ 7:30AM

I would say its time to bring back the long-term mental institution and send such people there. At least in a long-term facility they would get some treatment, and the rest of us would be safe from them. The current way of liberal refusal to deal with the problem is akin to PETA storming into zoos and letting the animals free.

P.S. It has been -30 here for three days in a row, at which temperature boiling water thrown into the air evaporates instantly. The socialists are handing out sleeping bags to those they still claim *choose* to sleep outdoors on the street, arguing that we had *no right* to force them indoors *against their will*.

Bob K.| 1.24.11 @ 12:56PM

It is an excellent and humane solution.

Now can you suggest any way it can be implemented without being sabotaged by the ACLU and the Judges?

martin j smith| 1.24.11 @ 8:26AM

It all depends on how you diagnose mental illness. By my reckoning as the MSM the difference between lies and truth will be blurred. We will be if not already in an Orwelian World. That means only the folks who can see the forest from the trees will be free of mental illness.
So keep your heads above water and watch for those who are slipping into lala even those who claim to be conservatives.

Tom| 1.24.11 @ 8:44AM

Those seeking refuge from the "mentally ill" by allowing MORE leeway to "psychiatrists" and "psychologists" do so at their own peril. There is a REASON psychiatry is labeled a "soft" or "in-exact" science. Virtually NOTHING "diagnosed" is PROVABLE. Psychiatry is a prime example of the "settled science" arguement put forth for "Global Warming". "Statistics" are nothing more than numbers--often chosen out of thin air--used to "prove" whatever one desires. "600,000 homeless", "eight pecent used garbage cans...". PROVE it. On any given day, we were told that "12 million, twenty-eight million, and forty million of "The Peoples" were without health insurance. Anyone with a "fertile mind" can "prove" anything "statistically". As to the "diagnoses":"What preceded the shooting in Tucson was a job that Loughner no longer held, a school that he no longer attended, a girlfriend who was no longer around, the shooter's bizarre anger about the nation's allegedly lousy skills in grammar...", try to imagine how MANY "otherwise" sane Americans would have fit these "parameters" at some point in time. Should THEY have been put at the mercy of psychiatrists? The "science" of psychiatry is populated almost entirely by leftists. Giving these people the power to indiscriminately "lock up" those they deem "unfit" would be quite a coup for the democrat party.

Robert Pinkerton| 1.24.11 @ 9:26AM

By way of supporting the above, I refer all to Soviet Psychoprisons, by Harvey Feierstein, Norton (I do not remember the publication date).

VBMax| 1.24.11 @ 1:47PM

Tom is exactly right.
Also from cchr.org (Citizens Comission on Human Rights)
"Psychiatric disorders are not medical diseases. There are no lab tests, brain scans, X-rays or chemical imbalance tests that can verify any mental disorder is a physical condition. This is not to say that people do not get depressed, or that people can’t experience emotional or mental duress, but psychiatry has repackaged these emotions and behaviors as “disease” in order to sell drugs. This is a brilliant marketing campaign, but it is not science. "

The Big E| 1.24.11 @ 2:33PM

I've worked as a criminal defense lawyer for 15 years, and in that capacity, I have represented literally hundreds of people who had been diagnosed with some severe mental disorder (not including addiction), most commonly bi-polar disorder. Some of those people present really sad cases, a lot of them have been greatly harmed by the incompetent mental health treatment they have received, and a few really should never have been at liberty in the first place.

I have also worked with and against scores of "mental health professionals." A few of those mental health professionals are true professionals, people who care first about their patients, and who exercise admirable professional judgment in treating their patients. Those men and women I have the utmost respect for. Unfortunately, I can count those true professionals on one hand, maybe two. The overwhelming majority of the mental health professionals I've encountered were quacks who did far more harm than good.

I often find myself thinking that we need to be able to do more to force the Jared Loughner's of the world to get the help they need, ever if it means locking them away to do it. But then I think about the people who would be tasked with providing that help, and that makes we wonder if its fair to be that cruel to people who are already suffering.

And let's never forget that a few years ago, a group of psychiatrists actually tried to get "conservatism" established as a mental illness. Google "conservatism as mental illness" and you'll what I mean.

This is just not as clear cut and issue as Jared Loughner makes it appear to be.

albert constantine, jr.| 1.24.11 @ 8:57AM

"Interestingly," continued Fazel, "they found that Arizona and Nevada had the highest ratio of prisoners with mental illness, with 10 times more mentally ill people in jails and prisons than in hospitals." 
What would be more interesting would be to determine how many of those diagnosed with mental illness are true schizophrenics, and how many are diagnosed with sociopathic, borderline or anti-social personalities. These folks are generally not well served by therapy (they may be worsened by it) and the most effective treatment for them after criminal act and due process is incapacitation (i.e. prison).

Steve A| 1.24.11 @ 10:16AM

I'm not sure how, but this is somehow all Sara Palin's fault.

Richard Baker| 1.24.11 @ 10:22AM

Oh no, the lefties will say. Remember the "Snake Pit?" I love when I hear these folks on TV say that these people will be fine on the street as long as they take their medicine. Take their medicine? These poor unfortunates probably think the medicine is poison or something else and DON'T take their medicine on their own. All this because lefties want to feel good.

Jack London| 1.24.11 @ 10:45AM

This just in (OK, last week).

Mental Health America today urged the House of Representatives to reject a repeal of the health reform law, which it said takes ground-breaking steps to expand access to care and prevention of mental health and substance use conditions.

"The health care reform law marks a tremendous step forward in our efforts to improve access to care for individuals with mental health or substance use conditions and in our advocacy for prevention of these conditions," said David Shern, Ph.D., president and CEO of Mental Health America.

"Despite significant advances in our understanding of how to effectively treat behavioral health conditions, people with serious mental illnesses who are treated in our public systems die on average 25 years earlier than the general population due to inadequate care. Health plan barriers and inadequate coverage limit access to outpatient mental health services at twice the rate as for other services.

"Treatment for these conditions is recognized as critical to overall health and the law embraces that truth. By including mental health and substance use services as essential benefits that must be covered in new plans offered to the uninsured and through the expansion of Medicaid, it will improve care for conditions that are among the most chronic and disabling affecting the U.S. population."

Dr. Shern said the law removes barriers and improves access to care by prohibiting pre-existing exclusions and extending to new plans sold through the exchanges and the expansion of Medicaid the requirements of the Mental Health Parity and Addiction Treatment Act, which establishes that discriminatory limits on mental health and substance use conditions will no longer be permitted.

Mental health and addiction treatment have historically been subject to blatantly discriminatory limits on coverage through private insurance plans that block access to effective and critically needed therapies.

The health care reform law also establishes a new requirement that coverage for dependent children must be available up to age 26 and provides additional funding for school-based health clinics.

"These provisions are critical in light of the fact that half of all people with a mental health diagnosis first experience it by age 14, but will not receive treatment until many years later, if at all," Dr. Shern said. "It also places a high priority on prevention by covering preventive services and programs to support community-based prevention activities."

He noted that the health care law reduces the federal deficit by over $100 billion over the next 10 years and saves more money in the years beyond that time period.

"This law improves the quality of care while reducing cost. Repeal will only dig a bigger hole in the deficit and deny services and treatments that can help millions of Americans live full, productive lives," he said.

"We should allow the law to move forward and deliver on the progress it will achieve."

Mental Health America is the country's leading nonprofit dedicated to helping all people live mentally healthier lives. With our century of service to America and our more than 300 affiliates nationwide, we represent a national movement that promotes mental wellness for the health and well-being of the nation- everyday and in times of crisis.

Bill Hussein O'Stalin| 1.24.11 @ 11:18AM

Here's some real nutiness. You get elected President of the USA which means you have as one of your responsibilities security for the US and the free world. After 9/11 it is revealed that you couldn't be located for a few hours when authorization was need to strike at Osama Bin Laden well before 9/11. Then it's revealed you were having sex in the Oval Office with at least one interns Was that the afternoon? And he's still around with all his supporters in the press praising and adoring him. -1 (Olbermann)

moochelle soetoro| 1.24.11 @ 1:14PM

Yeah, sure, "mental illness is a public safety issue of significance in the states". Blah, blah blah. I say "Big a** deal!"

Everybody knows that childhood obesity is an epidemic and costly threat to our NATIONAL SECURITY!

So, Let's Move, with me, the Sasquatch!

Purple Lips| 1.24.11 @ 3:40PM

Most of the insane went to grad school, got tenure or went into public service. And insanity knows no political affliation; Senator Lugar has been playing a Conservative for 30 years. Reminds me of my Uncle Lou, who thought he was Napolean.

JimE| 1.24.11 @ 6:16PM

Obama's new Health czar Kermit Gosnell says that with stimulus money he will be able to open new camps and process up to ten thousand units a day.
"Think of Auschwitz but with tech and green infrstructure" , Gosnell was qouted as saying.

Steve in Pittsburgh| 1.24.11 @ 8:59PM

I'm schizophrenic...NO I'M NOT!

shipley130| 1.29.11 @ 3:41PM

Obama appoints the crazies to be Czars. Van Jones for instance thinks Bush was involved with 9/11 and he thinks it's time for the black man to take the whip. Sounds schizo to me.

Adidas | 8.11.11 @ 4:52AM

is good

العاب | 4.11.12 @ 3:46PM

thank you

is good

More Articles by Ralph R. Reiland

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