I am the officer that was stabbed in the back of the head. This inmate was a menace and would use his mental diagnosis to manipulate the system. The officers that have been hurt by this man should be interviewed and so you can know the real con man Megginson is.
6
Having family members who have wrestled with mental illness and the criminal justice system along with those in various segments of law enforcement has informed my belief that too many inmates need to be in mental health treatment facilities. Rather than prison.
Coupled with those incarcerated for illegal drug use, possession and addiction and for abuse or misuse of legal drugs there is no criminal justice solution to what are primarily health and medical problems. Borne most heavily by the poor and the Black and the Brown.
Coupled with those incarcerated for illegal drug use, possession and addiction and for abuse or misuse of legal drugs there is no criminal justice solution to what are primarily health and medical problems. Borne most heavily by the poor and the Black and the Brown.
3
Such a tragedy. The systems have really let him down. And instead of giving him some slight relief with long-term, stable treatment he gets jail.
4
As an educator I have seen many a case like Mr. Megginson's over the last few years. When youth face a combination of poor family structure, mental illness and the loss of significant loved ones, there exists a recipe for disaster. In high schools these students typically face suspensions, repeated arrests and eventually they all wind up becoming dropouts. The best we can hope for is that the troubled youth meets up with the right mental health team at their high school. Intervention can take place in the form of in-house counseling programs coupled with extra support from outside agencies that monitor the student's mental health progress. The students who show the most success are those that have a support system at home. Those who lack family or parental influence rarely stand a chance of moving on with their life. I have witnessed many youth turn their lives around as a result of the concerted actions of a group of professional in the system. I recognize the case of Michael Megginson as one of those cases that unfortunately never seem to be resolved while the youth is still in his teens. I sincerely believe that this type of extreme case can be helped but schools cannot do it alone. There must be some sort of family or community intervention included.
8
How many people would be willing to sit in a room alone with Mr. Megginson after reading this story? Mr. Winerip and Mr.Schwirtz seek to expose and illustrate the all too real problems with our system of caring for the mentally ill with Mr. Meegerson as “exhibit A”.
The story reminds me of the cover story on Andrew Goldstein I read in the Sunday New York Times Magazine some years ago. The following week I was approached by a man in his 60s worried about the fate of his step son with whom he had lived in his apartment for years. Like Mr. Goldstein his step son had been in and out of hospitals for much of his life. Unlike Mr. Goldstein - but like most patients suffering from schizophrenia he had never hurt anyone. On the Tuesday following the Goldstein article his step father was approached by a member of the co-op board. She had read the article in the Times and was not at all sure that the patient should be allowed to continue living in the building. I have never forgotten that conversation: that his step son had lived in the building without incident for years didn’t matter. Fear has a way of obscuring facts. Telling Mr. Meegerson's story is important - the only problem is that readers might fear anyone with mental illness even more than they already do. And then what?
The story reminds me of the cover story on Andrew Goldstein I read in the Sunday New York Times Magazine some years ago. The following week I was approached by a man in his 60s worried about the fate of his step son with whom he had lived in his apartment for years. Like Mr. Goldstein his step son had been in and out of hospitals for much of his life. Unlike Mr. Goldstein - but like most patients suffering from schizophrenia he had never hurt anyone. On the Tuesday following the Goldstein article his step father was approached by a member of the co-op board. She had read the article in the Times and was not at all sure that the patient should be allowed to continue living in the building. I have never forgotten that conversation: that his step son had lived in the building without incident for years didn’t matter. Fear has a way of obscuring facts. Telling Mr. Meegerson's story is important - the only problem is that readers might fear anyone with mental illness even more than they already do. And then what?
8
I have a book of photographs taken in the abandoned "mental institutions" of the past, a collection that is eerie, haunting, sorrowful, and unbearably sad all at once. To see the remnants of largely forgotten people, and to imagine some of the horrible conditions in which they lived makes one all the more thankful that we supposedly live in a more enlightened time.
Until we read something like this, however, that shows how appearing to "solve" one problem, and to make whole previous injustices, can instead create a new set of equally intractable problems, and another cycle of misery.
The conditions of such hospitals were undeniably inhumane and sickening - not all of them, but enough that changes were certainly necessary. Yet the system that's taken its place is hardly ideal, or even satisfactory. What good is deinstitutionalization if comprehensive programs and infrastructure haven't been put in place? I would never wish the previous system to rise again, but I doubt anyone could look at our current state of affairs and call the reforms of the 1970s a success.
I do not know what the best solutions might be. I do know that it requires that tricky balance between civil rights for the ill and for the rest of society, as well as creativity and innovation. It seems plainly clear that what we have right now is, by and large, not working. We cannot continue to have prisons be the largest mental health providers in many urban areas , which is the current state of affairs.
Until we read something like this, however, that shows how appearing to "solve" one problem, and to make whole previous injustices, can instead create a new set of equally intractable problems, and another cycle of misery.
The conditions of such hospitals were undeniably inhumane and sickening - not all of them, but enough that changes were certainly necessary. Yet the system that's taken its place is hardly ideal, or even satisfactory. What good is deinstitutionalization if comprehensive programs and infrastructure haven't been put in place? I would never wish the previous system to rise again, but I doubt anyone could look at our current state of affairs and call the reforms of the 1970s a success.
I do not know what the best solutions might be. I do know that it requires that tricky balance between civil rights for the ill and for the rest of society, as well as creativity and innovation. It seems plainly clear that what we have right now is, by and large, not working. We cannot continue to have prisons be the largest mental health providers in many urban areas , which is the current state of affairs.
5
I am a psychiatric registered nurse with more than 20 years of experience. Many
dangerous psychiatric patients are unwilling or unable to manage their illness
by taking their medication or attending therapy or abstaining from mind altering
street drugs. Their failure to comply with prescribed treatment puts the general
public at risk. Should people who are a potential danger to others be allowed
loose on the street? We do not allow dangerous criminal to roam the street.
So why shouldn't we as a society find a way to protect ourselves? Certainly
we have a right to be protected from an individual who is dangerous. Does
it matter whether the danger is because of mental illness or criminal intent?
dangerous psychiatric patients are unwilling or unable to manage their illness
by taking their medication or attending therapy or abstaining from mind altering
street drugs. Their failure to comply with prescribed treatment puts the general
public at risk. Should people who are a potential danger to others be allowed
loose on the street? We do not allow dangerous criminal to roam the street.
So why shouldn't we as a society find a way to protect ourselves? Certainly
we have a right to be protected from an individual who is dangerous. Does
it matter whether the danger is because of mental illness or criminal intent?
6
Dangerous criminals are incarcerated in jail for life. Yet we allow violent psychiatric patients who have committed criminal offences freedom.
Where is the justice?
Where is the justice?
2
"Though there may be a consensus that Michael Megginson does not belong in jail, there is no agreement about where else he could go. "
This is the liberal dilemma--when all choices are bad, they become paralyzed to DO anything--except lament the injustices of life--and blame conservatives for something--anything.
This is the liberal dilemma--when all choices are bad, they become paralyzed to DO anything--except lament the injustices of life--and blame conservatives for something--anything.
2
Okay, then what do you propose? It is not just liberals who are responsible for these decisions. This is not a partisan issue.
4
Mental Health may be the result of nature, nurture, stimulus and response. With 40% of the prisoner population exhibiting “symptomatic behavior,” would it be too simple to reclassify the housing arrangements so similar personalities, behaviors threat levels were housed in closer proximity? It was about 25 years ago many state mental institutions were closed in favor of community scattered site housing and treatment models. We see a new population who may have fared better in mental health than criminal accommodations, and who may have benefited from systemic interventions. As long society devalues mental illness (by lack of funding and lack of insurance reimbursement) affected persons will navigate a treacherous path, often bring innocents into the mix before law enforcement intervenes and removes them from functioning society.
4
David Berkowitz, the Son of Sam who killed 7 people in NYC in the 70s, is no longer crazy or dangerous. He got saved & has been a Christian over 20 years. Jesus IS the answer to mental illness & crime. He transforms people. Every prisoner in ANY jail has a RIGHT to a bible so they can prepare for ministry - they can use their past to warn others what NOT to do. Every experience has value from that perspective. Mistakes are part of life. Nobody should need to spend more than 1-2 years for ANY crime - God DOES change people. And there should be no records which are what ruins people's lives. Prison should be an undefined time, like the mental hospitals, which do NOT help anyone since the drugs make people WORSE not better. THey are torture and deadly. I spent over 7 years in psych wards & 8 months in solitary in prison, without a bible. THAT was why it was torture.
see
Eric Garner GOT justice - we need the RIkers School of Ministry Forgiveness, not justice
http://www.1prophetspeaks7.blogspot.com/2015/01/eric-garner-got-justice....
free books, articles, music 1prophetspeaks.com
see
Eric Garner GOT justice - we need the RIkers School of Ministry Forgiveness, not justice
http://www.1prophetspeaks7.blogspot.com/2015/01/eric-garner-got-justice....
free books, articles, music 1prophetspeaks.com
1
Unfortunately, mental illness is something most institutions and families are not able to handle. Most medical plans pay for limited therapy sessions, and will simple release subjects from employment on disability. DSM-IV represents much of what we know about the "disease" of mental illness. Many families are both stressed and stretched to deal with mental illness. I have mental illness in the family, and unlike many afflictions, it doesn't go away and get better. The best you can do is maintain. These people do not belong in regular lockup. Its like throwing a match in a keg of kerosene. Its not going to end well.
5
A lot of afflictions never go away: diabetes, hypertension, many forms of cancer, back pain,AIDS, etc. The best we can do is manage them, not cure them. And, in fact, the treatments for many mental illnesses are more efficacious than treatments for these. It's a sad myth that mental illness is the only disease state that can't be cured.
5
The civil rights activists who fought for closing the mental hospitals seem to have gone AWOL when it comes to the patients who were in those hospitals ending up in prison.
And it's interesting that Andrew Goldstein, the man whose crime is responsible for Kendra's law and whom the article describes as having schizophrenia, isn't in a hospital for treatment of his mental disorder but in a prison.
And it's interesting that Andrew Goldstein, the man whose crime is responsible for Kendra's law and whom the article describes as having schizophrenia, isn't in a hospital for treatment of his mental disorder but in a prison.
1
And your alternate suggestion of where he should be kept is...?
1
Dealing with the mentally ill is a serious problem that needs the might of a Congress that doesn't shove it under the bed of smaller government. The mistaken idea that 330 million people and all their problems, can be run on a state level is simply stupid. We are watching this being proved too frequently.
Granter our government has problems but we need our whole population to receive proper treatment, aid, help, the list is long, More money breaks to the wealthy along with lower taxes is destroying democracy. There is a huge lesson there and we need to address it.
Granter our government has problems but we need our whole population to receive proper treatment, aid, help, the list is long, More money breaks to the wealthy along with lower taxes is destroying democracy. There is a huge lesson there and we need to address it.
Michael needs to stay in jail, but a jail that combines incarceration & rehabilitation. Society does not recognize personality disorder as the fundamental basis of much of psychopathology with very frightening and dramatic variations at its extremes. An individual who has limited and ineffective strategies for coping with stress will often turn to drugs, but also will experience more anxiety and stress. If vulnerable, this can lead to episodes of affective and psychotic breakdowns. Many afflicted individuals at their best may still be prone to behaviors which are not socially acceptable and for which society requires protection. Their normal brain are temporarily slowed by medication, but they will not learn to cope better with life's stress.
Society has not found the right combination of restricted freedom & support. Such individuals must be motivated to choose to change. Incarceration is often an extension of the neglect they experienced most of their development. They need both mental health services & career training with the gradual expectation of assuming greater personal responsibility! Confinement should not be for some arbitrary period of time, but based on a capacity to act appropriately and assume responsibility. Confinement should be graded: different levels of freedom & access to provide incentives for appropriate behavior. A fair assessment of consistent hard integration in therapy & career skills acquisition should be the basis for discharge.
Society has not found the right combination of restricted freedom & support. Such individuals must be motivated to choose to change. Incarceration is often an extension of the neglect they experienced most of their development. They need both mental health services & career training with the gradual expectation of assuming greater personal responsibility! Confinement should not be for some arbitrary period of time, but based on a capacity to act appropriately and assume responsibility. Confinement should be graded: different levels of freedom & access to provide incentives for appropriate behavior. A fair assessment of consistent hard integration in therapy & career skills acquisition should be the basis for discharge.
1
I wonder if allowing him to complete what he wanted to do, commit suicide, would have been the best thing considering how much pain and suffering he is going through and causing others.
This issue goes to the heart of how we define mental illness. The majority of individuals who are in Rikers and also in our hospitals have normal brains. Their IQ's are average plus/minus 10. They are capable of learning and capable of appreciating the difference between right and wrong. However, due to a lack of healthy role models, along with the often concomitant neglect/abuse they often have personality disorders. They have not been shaped to moderate their emotions. They have not been schooled in the advantages in delaying gratification to achieve important goals. They have learned that they often cannot count on others, so their is little to loose and much to gain by taking what they want through the use of intimidation or other forms of manipulation. Sometimes they will use feigning illness to manipulate others or the system to obtain their goals. Even individuals whose IQ's are estimable below average, though not mentally retarded, can demonstrate such skills. Further complicating assessment is the concomitant influence of drugs on their behavior; as many of these individuals self-medicate as an effective means of moderating stress. Much fewer have profoundly compromised brains.
Mental illness is a spectrum. Society must reform both systems of confinement (psychiatric or forensic) to treat all individuals as human beings. Provide all with behavioral modification and psychotherapy services to restore or develop individual adaptive capacity and dignity.
Mental illness is a spectrum. Society must reform both systems of confinement (psychiatric or forensic) to treat all individuals as human beings. Provide all with behavioral modification and psychotherapy services to restore or develop individual adaptive capacity and dignity.
1
You're wrong about them having "normal brains." Studies have found that a large number of prisoners have partial complex seizures which causes difficulty controlling temper and often violence. As many of these prisoners have had head trauma, it's not surprising many suffer from this. Sadly, although it can be treated, it usually goes undiagnosed.
Sorry Steve. There is no reputable scientific medical journal from which you have referenced. I happen to be a psychiatrist with a substantial neuroscience background having boarded in psychiatry and internal medicine. I'm surprised this was posted as it is so incorrect. Name your sources.
Some of these comments blame the lack of family support and I can see how from this one story that could be a reaction. But, that is NOT the problem. I would love to see the Times do a similar story on a mentally ill person not in jail. One with a loving, supportive family willing to go to any length to find help. The problem is there is no help. Even the very best (and absurdly expensive treatments) don't work for many. As a society we offer no place for people to turn. There are no long term options that can keep someone safe. Families are left to impoverish themselves seeking options that don't exist. Humane, long term care is not option. It is a necessity.
4
Of course there's help. Cancer treatments are usually even more "absurdly expensive" and don't work for many. Should we throw in the towel on those, too?
Our prison populations are dominated by sociopaths, substance addicts, and the mentally ill, primarily with schizophrenia and bipolar, and a few of low intelligence. Keep the sociopaths in prison as long as possible, execute the serial rapists and killers, detox the addicts and put them to work to pay the costs of their violations and incarceration, put those of low IQ into supervised living, and the mentally ill into mental health facilities.
4
I am sorry to say it but some of the mentally ill need to be housed in humane residential treatment centers, where their medications are professionally administered and audited, insuring that they keep being taken as prescribed. Such treatment centers come with 24/7/365 access to medical care and have Security Officers specifically trained and equipped to handle the patients without killing or causing serious bodily injury. For others having their medications administered out patient (where they physically go to a site and the meds are professionally administered and audited) can be an option.
What is a great way to make the mentally ill more violent and less manageable? Deny them their meds, which seems to happen a lot in jails and prisons.
What is a great way to make the mentally ill more violent and less manageable? Deny them their meds, which seems to happen a lot in jails and prisons.
4
I was working in NYC in the 1970s when 40,000 of these people were freed by the US Supreme Court based on a suit filed by the ACLU. The lightly ill cannot be institutionalized involuntarily. Setting up housing for them didn't work because they resisted being structured. Almost all got disability checks and were supposed to stay at this housing where they could get some spending money and keep up with their medications. Instead they wandered the streets of Manhattan carrying their trash bags full of belongings or pushed shopping carts. Many have violent outbursts and are picked up and taken to Rikers. I always knew where the familiar ones had been because after their absence they showed up clean, with a haircut and a new blanket. Mnay need to be institutionalized but all the old hospitals were torn down because they'd been empty so long and were so structurally obsolete and costly to maintain. Where is the money to build new ones? Rikers is not a mental asylum.
To NYHugenot:
When the state hospitals were closed, the money that was saved from this including the sell of valuable real estate was supposed toward funding community mental health centers. This never happened. One of the people to blame was that paragon of liberalism Mario Cuomo, who as governor took the money and put it into the general state funds. And one of the first acts of Andrew Cuomo as governor was to cut funding for mental health services.
When the state hospitals were closed, the money that was saved from this including the sell of valuable real estate was supposed toward funding community mental health centers. This never happened. One of the people to blame was that paragon of liberalism Mario Cuomo, who as governor took the money and put it into the general state funds. And one of the first acts of Andrew Cuomo as governor was to cut funding for mental health services.
2
Agreed. I have a teen who has bipolar disorder along with diabetes. We have seen how bad his bipolar can be when he is untreated, and we know that out of control diabetes makes it worse. We know that his problems with impulse control are related to bipolar, and we know that that lack of control results in impulsive snacking or forgetting to take insulin, and that out of control blood sugar makes the mental symptoms worse.
It's a vicious circle and I'm just grateful that he is willing (right now) to let others manage his meds and meals for him. That willingness decreases as he gets older, though. He might even be willing to let professionals do that for him once he is an adult... But if he doesn't, or if there are no services available to do that for him, I don't foresee a long or happy life.
I am concerned that the system will fail to see him as a whole person, with each issue compounding the others there are currently few options and a system that doesn't recognize that fact. Additionally, someone with mental illness doesn't always function consistently, so legal evaluators may see someone who is fine today, and won't take family input as to how the loved one is REALLY doing.
It's a vicious circle and I'm just grateful that he is willing (right now) to let others manage his meds and meals for him. That willingness decreases as he gets older, though. He might even be willing to let professionals do that for him once he is an adult... But if he doesn't, or if there are no services available to do that for him, I don't foresee a long or happy life.
I am concerned that the system will fail to see him as a whole person, with each issue compounding the others there are currently few options and a system that doesn't recognize that fact. Additionally, someone with mental illness doesn't always function consistently, so legal evaluators may see someone who is fine today, and won't take family input as to how the loved one is REALLY doing.
1
My family has a history of mental illness severe enough to have warranted a psychiast, meds and the occasional in-patient stay starting in grade school -- for my baby sister far more often than for me.
Both of us were "lucky" enough to be diagnosed early and treated at an amazing pediatric teaching hospital -- by many of the same doctors that treated our mom as a girl. My sister was often a danger to herslf and others, because she was SICK (not bad!), spent a lot of time in-patient (the psych unit was her home away from home for most of high school) and getting her stable took nearly a decade (which is about average for the severe, early-onset kids who were he floormates). Both of us take medication daily and will need to do so for the rest of our lives.
As a direct result of timely, appropriate mental health care both of us are college-educated, happily married and gainfully employed. I haven't been hospitalized since college (I'm nearly 40) and my sis hadn't been in going on five years (she's nearly 31).
My parents are upper middle class and white -- part (okay, a lot) of why the care sis and I got is a million times better than what Mr Megginson.
Both of us were "lucky" enough to be diagnosed early and treated at an amazing pediatric teaching hospital -- by many of the same doctors that treated our mom as a girl. My sister was often a danger to herslf and others, because she was SICK (not bad!), spent a lot of time in-patient (the psych unit was her home away from home for most of high school) and getting her stable took nearly a decade (which is about average for the severe, early-onset kids who were he floormates). Both of us take medication daily and will need to do so for the rest of our lives.
As a direct result of timely, appropriate mental health care both of us are college-educated, happily married and gainfully employed. I haven't been hospitalized since college (I'm nearly 40) and my sis hadn't been in going on five years (she's nearly 31).
My parents are upper middle class and white -- part (okay, a lot) of why the care sis and I got is a million times better than what Mr Megginson.
6
I wonder how many readers have read Madness and Civilization by Foucault since reading this article?
Sometimes when a sixteen-year-old has a baby society, ends up paying millions of dollars on account of her "mistake." Sometimes we don't. Sometimes we're lucky. Bringing a baby into the world before one is ready to care for it is an act of child abuse. For the rest of us we're just out money; Mr. Megginson is paying for the mistake with his life. His parents owe us.
5
Lynne, callingl it "her" mistake is incorrect. It is their mistake: the father of the child, the birthmother, the grandmother, the grandfather, the whole social network, which includes you and me. Pointing your finger at the young woman who brought the baby into the world and calling her a child abuser is a projection of guilt onto the young woman who had no clue what she was getting herself into. She made a mistake, the same mistake all of us make, which is looking for the love in all the wrong places.
5
No. An act of child abuse would be if she kept custody of him despite her lack of preparedness and proceeded to neglect and injure him, and deprive him of shelter, nourishment, and love. Instead, in what seems more like an act of mercy for them both, she left him securely with a grandparent - and reunited with him when she was still awfully young (22?) and raised him in a household with her husband and two other children while working hard and continuing her education. Isn't that what most of us would want from, and hope for, teenaged parents?
Given how early his mental illness presented, and the severity of it, it seems quite likely that he would've struggled mightily whether raised in squalor and neglect, or raised in privilege and comfort. The difference might be in degrees of severity, of course, but he does not strike me as someone for whom an older, married, financially secure set of parents would have enable him to avoid the scourge of his illness. Sometimes it's not only, or primarily, about the environment in which, and people to whom, we are born. Sometimes it is just - fate, ill luck, God's plan, whichever you prefer.
Given how early his mental illness presented, and the severity of it, it seems quite likely that he would've struggled mightily whether raised in squalor and neglect, or raised in privilege and comfort. The difference might be in degrees of severity, of course, but he does not strike me as someone for whom an older, married, financially secure set of parents would have enable him to avoid the scourge of his illness. Sometimes it's not only, or primarily, about the environment in which, and people to whom, we are born. Sometimes it is just - fate, ill luck, God's plan, whichever you prefer.
3
I've worked in mental health for more than a decade. I have seen a lot. I trained in Social Work at the Master's level. I have also worked on acute units inside psychiatric hospitals.
I have seen too many patients and staff in mental hospitals injured and sometimes disabled for life by habitually violent patients. Hospitals staff are trained and bound by law to treat people with the most humane reactions. They cannot intervene physically with a violent patient until after the fact...after they have attacked another patient or staff... and then they can only used approved physical management techniques. This is all fair and just for the most part. These techniques though are often ineffective against a large adult or even a large adolescent. Not when someone has you by the hair of the head and your head is being slammed against the floor. Step outside protocol; staff will lose their job and risk criminal charges. Todays hospitals face thin staffing do to thin budgets. Related to how much reimbursement private and public insurance pays.
When people advocate that habitually violent people be placed in hospitals I cringe.
There are no Evidenced Based Practices for "curing" these people. Often their is only medication and sedation. What's needed is a hybrid model between corrections and psychiatry where people are trained in mental health and are staffed and trained in managing habitually violent people. If we are to keep patients and staff safe in our hospitals.
I have seen too many patients and staff in mental hospitals injured and sometimes disabled for life by habitually violent patients. Hospitals staff are trained and bound by law to treat people with the most humane reactions. They cannot intervene physically with a violent patient until after the fact...after they have attacked another patient or staff... and then they can only used approved physical management techniques. This is all fair and just for the most part. These techniques though are often ineffective against a large adult or even a large adolescent. Not when someone has you by the hair of the head and your head is being slammed against the floor. Step outside protocol; staff will lose their job and risk criminal charges. Todays hospitals face thin staffing do to thin budgets. Related to how much reimbursement private and public insurance pays.
When people advocate that habitually violent people be placed in hospitals I cringe.
There are no Evidenced Based Practices for "curing" these people. Often their is only medication and sedation. What's needed is a hybrid model between corrections and psychiatry where people are trained in mental health and are staffed and trained in managing habitually violent people. If we are to keep patients and staff safe in our hospitals.
10
There were news-stories about the horrors of life inside mental institutions; TV reports showing the filthy, the underfunded, the poorly staffed state institutions. There were new drugs that magically transformed the treatment of mental patients. There was a new philosophy of care; of de-instituionalizing the formerly hopeless inmates of the decaying institutions; of putting them in group homes on sunny streets and with their daily drugs, reintegrating these folks back into society. But it didn't work out that way.
Many of the crazies liked being crazy; the drugs, chemical straightjackets like Thorazine and Stelazine were effective in depressing the psychosis but patients could easily stop taking or manipulate the use of them. Along comes Haloperidol, the genius of this drug is, as awful, as crippling are its effects, as it begins to wear off, the tremors increase, the symptoms of withdrawal are overwhelming, so the patient stands in line, he can't wait to get to get his next dose. All these drugs work in institutions where the people are easily monitored and confined, they do not work for the hard-core crazy, outside, in half-way houses or other assisted housing modalities.
In the early '70s, I spent some time at Bellevue and in State mental hospitals, I took these drugs and felt their effects and glad that my insanity was produced by indiscriminate psychedelic drug use and not organic by processes. The psychiatric wards and hospitals of my experience were safe havens.
Many of the crazies liked being crazy; the drugs, chemical straightjackets like Thorazine and Stelazine were effective in depressing the psychosis but patients could easily stop taking or manipulate the use of them. Along comes Haloperidol, the genius of this drug is, as awful, as crippling are its effects, as it begins to wear off, the tremors increase, the symptoms of withdrawal are overwhelming, so the patient stands in line, he can't wait to get to get his next dose. All these drugs work in institutions where the people are easily monitored and confined, they do not work for the hard-core crazy, outside, in half-way houses or other assisted housing modalities.
In the early '70s, I spent some time at Bellevue and in State mental hospitals, I took these drugs and felt their effects and glad that my insanity was produced by indiscriminate psychedelic drug use and not organic by processes. The psychiatric wards and hospitals of my experience were safe havens.
4
Your knowledge of pharmacotherapy is incorrect. If you stop haldol there isn't any withdrawal. What happens is that the psychotic symptoms that the drug treated return. And I doubt many patients with any mental illness enjoy having it. To say they enjoy it is like saying something enjoys having cancer.
2
Haldol is a D2 blocker which acts very strongly on a class of Dopamine receptors. Any drug given in some dosage over a period of time will result in the system attempting to compensate for the effects of that drug over time. In this case, receptors will be upregulated (more will be made and placed within the synapses) and more dopamine will be released. Abrupt discontinuation of such drugs, just like the abrupt discontinuation of alcohol for a chronic alcoholic, will lead to a withdrawal phase! This is science fact found in any major pharmacologic reference.
For those who believe this is a problem that has to do with the 1970's deinstitutionalization movement, you are partly correct. Those laws do need to be revisited.
But you need to remember why the institutions were closed in the first place: Massive and major violations of human rights. People lived powerlessly in sub-human conditions. It became far, far too easy to justify locking away anyone with mental health conditions, not just those who have major issues. And, there was almost no effort to help these people get back into society. They were kept like lab rats to be studied by psychology students who thought the brain was "just so interesting."
If you think the American brand of institutionalization is a good thing, look at our nursing homes. In a society where we are supposed to respect our elderly, we still put them in institutions that would rather keep them drugged than deal with their issues.
If we are going to go back to institutionalization, we need to do a heck of a lot better than we have before. Many people do not believe we can do better. Inconsistent and in-personal bureaucratic institutions do not lend themselves to good recovery, especially in such a non-reflexive and prejudicial culture. The people with the power almost always eventually abuse that power, and it tends to get worse as time goes on.
But you need to remember why the institutions were closed in the first place: Massive and major violations of human rights. People lived powerlessly in sub-human conditions. It became far, far too easy to justify locking away anyone with mental health conditions, not just those who have major issues. And, there was almost no effort to help these people get back into society. They were kept like lab rats to be studied by psychology students who thought the brain was "just so interesting."
If you think the American brand of institutionalization is a good thing, look at our nursing homes. In a society where we are supposed to respect our elderly, we still put them in institutions that would rather keep them drugged than deal with their issues.
If we are going to go back to institutionalization, we need to do a heck of a lot better than we have before. Many people do not believe we can do better. Inconsistent and in-personal bureaucratic institutions do not lend themselves to good recovery, especially in such a non-reflexive and prejudicial culture. The people with the power almost always eventually abuse that power, and it tends to get worse as time goes on.
3
More than that, psychological treatment in the 70s was based primarily on the belief that mental illnesses were not medical diseases. So treatments were not effective, and there was very little science used in determining how to treat.
Mental institutions were basically prisons.
Improved treatment is the answer. Unfortunately since mental disorders are diseases of the body (not failures of the spirit) they require medical treatment. Medical treatment is not free.
Mental institutions were basically prisons.
Improved treatment is the answer. Unfortunately since mental disorders are diseases of the body (not failures of the spirit) they require medical treatment. Medical treatment is not free.
3
I agree. We as a society must put resources into treatment and maintenance of violent mentally ill patients. They do not belong in prison.
2
And if you believe that there is in the near future going to be funding available for the proper treatment of the mentally ill, I've got a great deal on a bridge to Brooklyn for you.
After the Newtown shooting, all the pro-gun politicians said it was due to mental illness and not guns and said we need to do better treating it. They then proceeded to do nothing to see that this was done and it is unlikely they ever will. The one thing that Democrats and Republicans agree on is that the mentally ill don't deserve decent treatment.
After the Newtown shooting, all the pro-gun politicians said it was due to mental illness and not guns and said we need to do better treating it. They then proceeded to do nothing to see that this was done and it is unlikely they ever will. The one thing that Democrats and Republicans agree on is that the mentally ill don't deserve decent treatment.
1
It is a Har thing. American culture is especially judgmental when it comes to mental illness. Religious beliefs clash with science, and no matter how much we learn people still believe that if patients tried hard enough, they could fix it
The brain is organ like any other. If it is not functioning properly, the patient can't fix it with pure stubborn will. Punishing mentally ill patients has no positive impact.
This man sounds like he has developmental disabilities on top of mental illness. Imagine if we treated the combative dementia patient this way! Yet since he is young POC, our first instinct is to send him to prison.
..
The brain is organ like any other. If it is not functioning properly, the patient can't fix it with pure stubborn will. Punishing mentally ill patients has no positive impact.
This man sounds like he has developmental disabilities on top of mental illness. Imagine if we treated the combative dementia patient this way! Yet since he is young POC, our first instinct is to send him to prison.
..
4
Mr. Megginson has had many different diagnoses and exhibits extreme loss of impulse control.
These are consistent with Traumatic Brain Injury. Usually psychiatric symptoms of TBA can be controlled with medication.
For all psychiatric patients with chaotic lives, losing medication, having it stolen, forgetting to take it, are common.
There is a medication delivery system that is very hard to lose, be stolen, or forget. It is subcutaneous tubes inserted inside one arm. It is used for delivering birth control hormone, i.e., Norplant. The meds usually last about 3 years. Inserted in 15 minutes with one tiny incision, under local anesthetic, with one stitch, it can be removed in 15 minutes as well. Learning the procedure is easy for a physician. The medication is delivered very consistently with no high or low levels.
This method of delivering meds could be adapted to psychiatric medication and would prevent the problem of uneven medication use.
Hopefully, someone, somewhere, will see this post and has the clout and energy to promote subcutaneous long term delivery of psychiatric meds.
It could make a huge difference for patients like Mr. Megginson.
These are consistent with Traumatic Brain Injury. Usually psychiatric symptoms of TBA can be controlled with medication.
For all psychiatric patients with chaotic lives, losing medication, having it stolen, forgetting to take it, are common.
There is a medication delivery system that is very hard to lose, be stolen, or forget. It is subcutaneous tubes inserted inside one arm. It is used for delivering birth control hormone, i.e., Norplant. The meds usually last about 3 years. Inserted in 15 minutes with one tiny incision, under local anesthetic, with one stitch, it can be removed in 15 minutes as well. Learning the procedure is easy for a physician. The medication is delivered very consistently with no high or low levels.
This method of delivering meds could be adapted to psychiatric medication and would prevent the problem of uneven medication use.
Hopefully, someone, somewhere, will see this post and has the clout and energy to promote subcutaneous long term delivery of psychiatric meds.
It could make a huge difference for patients like Mr. Megginson.
3
As a physician I agree with the diagnosis issue. If he didn't have traumatic brain injury that can cause partial complex seizures, one of the major symptoms of which is poor impulse control, when he first began he no doubt has it now. The fact that it isn't even included in the list of diagnoses in the article demonstrates how infrequently it is diagnosed even in patient in whom it should be at the top of the list.
And there are injectible forms of many psychiatric drugs that stay in the body for several weeks therefore eliminating the need for the patient to be compliant with taking the medications.
And there are injectible forms of many psychiatric drugs that stay in the body for several weeks therefore eliminating the need for the patient to be compliant with taking the medications.
The plight of the mentally ill in New York is already ridden with inadequate housing, limited inpatient psychiatric stays ( driven by managed care under the guise of "medical necessity") and This is one of the most underserved and misunderstood populations, and it is typically comprised of an economic underclass ,scraping by on about 10k in annual SSI payments.Over the past five years, The ACT model of providing high quality psychiatric care in the community,has slowly morphed into a model that encourages "graduation" from ACT to a lesser level of care.The State's misguided application of AOT (Kendra's Law) has resulted in cases being mandated to ACT teams throughout the boroughs, now with a forensic component.There has been no retooling or retraining of clinicians on how address both psychiatric and criminal histories, in a safe fashion.I currently work with the most dedicated group of skilled clinicians, comprised of psychiatrists ,social workers , nurses and rehab counselors, working with the most difficult and disturbed psychiatric population.
The forced inclusion of a forensic component , to this already complex setting,is likely to put treatment of the mentally ill back into the dark ages, overshadowed by a population that deserves its own criminal justice system.
The forced inclusion of a forensic component , to this already complex setting,is likely to put treatment of the mentally ill back into the dark ages, overshadowed by a population that deserves its own criminal justice system.
4
Jail is the new psychiatric center. This story is just as common in Upstate NY as it is in NYC. Try to imagine what life would be like if someone like this is a member of your family or living in your apartment building and the authorities will repeatedly tell you that there is nothing they can do!
4
Call me crazy, but I could have sworn there were about 177 comments here earlier, and now there's three. I wonder if it's somehow linked to mental illness.
Anyway, it was all said before, but the unfortunate situation is that we just don't have a good solution for the extremely mentally ill. Psychiatry isn't at the level where it can cure such extremes, and it's likely that people as disturbed as Mr. Megginson will have to be kept at inpatient facilities for most or all of their lives. It's clear though that jails are the wrong place for them, they increase the negative aspects of all mental illnesses and have zero treatment in place. Probably what we need to do is bring back the mental institutions of the pre-Reagan days, and when people have been determined to be too violent to be released back into society, that must become their permanent residence.
It really is an unfortunate situation, and I think we should also do more to prevent the problem, as we can't yet cure it. This would require considerable treatment for all children showing signs of extreme mental illness, and often taking them away from their parents. It would be helped by sex education and counseling to prevent all teen pregnancy, and also by the taboo concept of sterilizing people convicted of heinous, violent crimes. I know it's taboo, but until we start restricting abusive peoples' reproductive rights, they will produce mentally ill and violent children.
Anyway, it was all said before, but the unfortunate situation is that we just don't have a good solution for the extremely mentally ill. Psychiatry isn't at the level where it can cure such extremes, and it's likely that people as disturbed as Mr. Megginson will have to be kept at inpatient facilities for most or all of their lives. It's clear though that jails are the wrong place for them, they increase the negative aspects of all mental illnesses and have zero treatment in place. Probably what we need to do is bring back the mental institutions of the pre-Reagan days, and when people have been determined to be too violent to be released back into society, that must become their permanent residence.
It really is an unfortunate situation, and I think we should also do more to prevent the problem, as we can't yet cure it. This would require considerable treatment for all children showing signs of extreme mental illness, and often taking them away from their parents. It would be helped by sex education and counseling to prevent all teen pregnancy, and also by the taboo concept of sterilizing people convicted of heinous, violent crimes. I know it's taboo, but until we start restricting abusive peoples' reproductive rights, they will produce mentally ill and violent children.
3
Truly, this did happen, comments first went to zero and then three new ones appeared. Then all the rest came back, so in fact I wasn't crazy, or no more crazy than usual.
Anyway thanks for posting this, I realize it's an unpopular view but I hope I made clear, it'd be a preventive measure, not based on race or religion or any such factors, and I think it's better than the situation we have at present.
Anyway thanks for posting this, I realize it's an unpopular view but I hope I made clear, it'd be a preventive measure, not based on race or religion or any such factors, and I think it's better than the situation we have at present.
We once had safe places to keep severely disturbed individuals like Mr. Megginson. The liberals closed them with deinstitutionalization, making jails the current mental hospitals, and creating much of the 'homeless' issue.
There are 1/10 the inpatient beds now as compared to 1960 before the liberals started their campaign.
As the article indicates, community outpatient and self-administered prescription drugs do not always work for some individuals.
Others fly their plane into a mountain.
There are 1/10 the inpatient beds now as compared to 1960 before the liberals started their campaign.
As the article indicates, community outpatient and self-administered prescription drugs do not always work for some individuals.
Others fly their plane into a mountain.
3
Thanks to the eugenics movement North Carolina is paying millions of dollars to people who were forcibly sterilized by Charles Kuralt's Father in the period from the 1940s to the 1960s. That will never happen again.
I have to wonder if the woman he stole the cellphone from considers it "not a particularly violent crime"?
There should be more psychiatric facilities within the prison system, I agree. However, anyone who cannot control his behavior to the degree of abiding by the law needs, for the safety of the community at large, to be confined against his will. Call the place of confinement a prison, a hospital, or a rest home; the individual needs to be there until he or she can be reasonably expected to live a law abiding life. A condition of parole should be the taking of one's medications, and demonstrated failure to do so should revoke the parole.
There should be more psychiatric facilities within the prison system, I agree. However, anyone who cannot control his behavior to the degree of abiding by the law needs, for the safety of the community at large, to be confined against his will. Call the place of confinement a prison, a hospital, or a rest home; the individual needs to be there until he or she can be reasonably expected to live a law abiding life. A condition of parole should be the taking of one's medications, and demonstrated failure to do so should revoke the parole.
8
Incarcerating individuals with mental illness who have repeatedly offended is much more expensive and yields lesser outcomes than does providing community integrated permanent supportive housing, supported employment and other education and vocational services and access to mental health services focused on choice. Mandating treatment is rarely effective or accepted while assertive engagement strategies that focus on the relationship, choice and motivational techniques have shown significantly more success in repeated studies. The likelihood of success increases when such evidenced based practices programs are implemented as designed. While it may feel more statisfying and "just" the standards that you suggest have been tried and still inexistence in some jurisdictions but do not show especially impressive outcomes.
1
As much as I don't like the idea of taking someone's freedom, I think you are correct. Sometimes it is a moral obligation to take your medication.
That said, there are people with mental health conditions who are not violent, do not infringe on other people's basic liberties, but who are also still forced to take medication. That's not right. We have a tendency to overgeneralize people like Mr. Megginson to everyone with a mental health condition. That needs to stop.
That said, there are people with mental health conditions who are not violent, do not infringe on other people's basic liberties, but who are also still forced to take medication. That's not right. We have a tendency to overgeneralize people like Mr. Megginson to everyone with a mental health condition. That needs to stop.
1
Karen,
Did you read the article? Community health and voluntary treatment has not helped Mr. Megginson.
Did you read the article? Community health and voluntary treatment has not helped Mr. Megginson.
1
Regardless of its intent the policy of closing hospitals and institutions for the severe and chronic mentally ill has not worked and with the experience we have now needs to be rethought. How do democratic societies with values comparable to ours deal with this issue?
5
Better availability of outpatient treatment programs and supports. The US has very little support for the mentally ill, either inpatient or outpatient.
You have raised a good question. The hard part may be finding democratic societies whose values actually do resemble ours. Private prisons are money makers and vested interests have actively encouraged criminal justice policies that are tough on crime and weak on rehabilitation, such as those in existance in Western European democracies. While I empathize for the desire to revenge and punishment (truly, as one of my siblings was a victim of a violent crime), catering to punitive responses to crime by locking people up and throwing away the key is extremely expensive. Arizona finds more and more money for private prisons and less and less for public education at every level. My state is by no means alone. Other western democracies have far fewer percentage of their population incarcerated than we do. We can't keep people in prision forever, and when individuals are released, even for nonviolent offenses, felony convictions (sometimes even a record of arrest) can become a barrier to finding housing and employment needed to establish a stable and crime-free life.
1
The hospitals also didn't work, that's why they were closed. There were far too many violations of human rights.
Take a look at Norway's prison system. I think they have something worth reflecting on.
Take a look at Norway's prison system. I think they have something worth reflecting on.
1
I would like to complement the reporters & editors who produced this article. It's thorough, fact-filled and balanced and provides a very thoughtful view of a difficult subject. There aren't easy answers to the problems of the seriously mentally-ill and presenting an honest & comprehensive analysis of Mr. Megginson's troubled iife is, in my opinion, a very positive step towards addressing these issues.
One small addition to the history of treatment efforts: It wasn't just simply the lack of funding for community-based living programs that prevented their creation several decades ago, it was that no neighborhood wanted one in their midst. Any legislator who supported the creation of several hundred of them throughout NYS would have been voted out of office. It was hard enough sticking drug clinics & homeless shelters in neighborhoods, the prospect of 6-10 mentally disturbed people living down the block from you was too scary. Of course, the result was that they ended up on street, the shelters, the subways, or the jails. Sad, but true.
One small addition to the history of treatment efforts: It wasn't just simply the lack of funding for community-based living programs that prevented their creation several decades ago, it was that no neighborhood wanted one in their midst. Any legislator who supported the creation of several hundred of them throughout NYS would have been voted out of office. It was hard enough sticking drug clinics & homeless shelters in neighborhoods, the prospect of 6-10 mentally disturbed people living down the block from you was too scary. Of course, the result was that they ended up on street, the shelters, the subways, or the jails. Sad, but true.
7
"An ounce of prevention is worth a pound of cure." David Lykken's 1988 classic, "The Case for Parental Licensure" is germane (Google it). One needs a certification to cut hair and do nails. But anyone can have children. The powers that be are concerned only with raising children who are productive, consuming and patriotic enough to defend their profits from the first two. 2/3rds of that population will become parents with no more instruction in child-rearing that what they got from their own parents. Child-rearing technology is, however, well understood: Listen, empathize, clarify, summarize, reframe, normalize, equalize, self-disclose and respect is one schematic. Observe to notice to recognize to acknowledge to accept to own to appreciate to understand to act appropriately is another. We are the blind raising the blind. We must learn to see.
"An ounce of prevention is worth a pound of cure." David Lykken's 1988 classic, "The Case for Parental Licensure" is germane (Google it). One needs a certification to cut hair and do nails. But anyone can have children. The powers that be are concerned only with raising children who are productive, consuming and patriotic enough to defend their profits from the first two. 2/3rds of that population will become parents with no more instruction in child-rearing that what they got from their own parents. Child-rearing technology is, however, well understood: Listen, empathize, clarify, summarize, reframe, normalize, equalize, self-disclose and respect is one schematic. Observe to notice to recognize to acknowledge to accept to own to appreciate to understand to act appropriately is another. We are the blind raising the blind. We must learn to see.
6
It's easy to blame the mentally ill and gloss over the reality that there is a wholesale and systemic abuse of anyone unfortunate enough to be caught up in the mental health system. By nature, there is even less accountability in mental health than in criminal justice. Sure there is paperwork and diagnoses, but there are simply no effective rules or laws which measure the degree and penalty of the accused. Instead, there are only those guilty of falling under the umbrella of 'offenders;' no forensic analyses, no un-biased peer-review. If any meaningful reform is going to come, it's going to come first by treating the accused as not guilty first! Rather than driving 6 year olds insane with treatments designed for prisoners of war and housing them in the same state institutions as any "undesirable": from minorities to homosexuals, to the learning impaired.
It's easy to blame the mentally ill and gloss over the reality that there is a wholesale and systemic abuse of anyone unfortunate enough to be caught up in the mental health system. By nature, there is even less accountability in mental health than in criminal justice. Sure there is paperwork and diagnoses, but there are simply no effective rules or laws which measure the degree and penalty of the accused. Instead, there are only those guilty of falling under the umbrella of 'offenders;' no forensic analyses, no un-biased peer-review. If any meaningful reform is going to come, it's going to come first by treating the accused as not guilty first! Rather than driving 6 year olds insane with treatments designed for prisoners of war and housing them in the same state institutions as any "undesirable": from minorities to homosexuals, to the learning impaired.
3
Initially, the mental hospitals were forced to let people out citing civil liberties. But in reality, the conservatives were rubbing their hands with glee because they knew they'd be saving money by booting vulnerable people out on the street. Most of the mentally ill are harmless and wind up living under bridges or sleeping on relatives' sofas. The rest of them who are violent wind up in jail. Jail costs money, but given the percentages, overall dumping the mentally ill has been a real money saver for the heartless politicos and administrators who think that medical care is a privilege and not a basic human right.
Initially, the mental hospitals were forced to let people out citing civil liberties. But in reality, the conservatives were rubbing their hands with glee because they knew they'd be saving money by booting vulnerable people out on the street. Most of the mentally ill are harmless and wind up living under bridges or sleeping on relatives' sofas. The rest of them who are violent wind up in jail. Jail costs money, but given the percentages, overall dumping the mentally ill has been a real money saver for the heartless politicos and administrators who think that medical care is a privilege and not a basic human right.
4
You people will find anything to blame conservatives for. It was not a conservative movement to de-institutionalize the mentally ill. It was all liberal. Trying to change the past to make it fit your own biases is not going to work, but I'm sure you'll keep trying.
It's one of the few things liberals and conservatives agree on: they're never going to fund the proper care of the mentally ill.
“Under state law, patients cannot be held against their will unless they are an immediate danger to themselves or others.”
“Immediate”.
This is the problem with the vast majority of lawmakers (and society) - they do not understand two crucial points:
1) the complexity and magnitude of CHRONIC, severe mental illness and
2) were it not for untreated mental illnesses, there would be little to no crimes among such individuals.
They treat it like any other “social ill” or “offense” - they criminalize it, toss the offender in prison and think the direly sick person will somehow magically morph into a normal, productive citizen after release (talk about insane logic!).
Some mental illnesses cannot be cured. Ever. The “immediate danger” standard does NOT apply when it comes to severe mental illness. It is not a one-off event; such latent, unpredictable danger is lifelong.
Instead of criminalizing and punishing mental illness, we need to establish TWO very different systems: a humane, rehabilitative prison system for “normal” criminals and a humane institutional system for safely housing and treating those severely mentally ill persons who can never be cured or released.
“Immediate”.
This is the problem with the vast majority of lawmakers (and society) - they do not understand two crucial points:
1) the complexity and magnitude of CHRONIC, severe mental illness and
2) were it not for untreated mental illnesses, there would be little to no crimes among such individuals.
They treat it like any other “social ill” or “offense” - they criminalize it, toss the offender in prison and think the direly sick person will somehow magically morph into a normal, productive citizen after release (talk about insane logic!).
Some mental illnesses cannot be cured. Ever. The “immediate danger” standard does NOT apply when it comes to severe mental illness. It is not a one-off event; such latent, unpredictable danger is lifelong.
Instead of criminalizing and punishing mental illness, we need to establish TWO very different systems: a humane, rehabilitative prison system for “normal” criminals and a humane institutional system for safely housing and treating those severely mentally ill persons who can never be cured or released.
1
“Under state law, patients cannot be held against their will unless they are an immediate danger to themselves or others.”
“Immediate”.
This is the problem with the vast majority of lawmakers (and society) - they do not understand two crucial points:
1) the complexity and magnitude of CHRONIC, severe mental illness and
2) were it not for untreated mental illnesses, there would be little to no crimes among such individuals.
They treat it like any other “social ill” or “offense” - they criminalize it, toss the offender in prison and think the direly sick person will somehow magically morph into a normal, productive citizen after release (talk about insane logic!).
Some mental illnesses cannot be cured. Ever. The “immediate danger” standard does NOT apply when it comes to severe mental illness. It is not a one-off event; such latent, unpredictable danger is lifelong.
Instead of criminalizing and punishing mental illness, we need to establish TWO very different systems: a humane, rehabilitative prison system for “normal” criminals and a humane institutional system for safely housing and treating those severely mentally ill persons who can never be cured or released.
“Immediate”.
This is the problem with the vast majority of lawmakers (and society) - they do not understand two crucial points:
1) the complexity and magnitude of CHRONIC, severe mental illness and
2) were it not for untreated mental illnesses, there would be little to no crimes among such individuals.
They treat it like any other “social ill” or “offense” - they criminalize it, toss the offender in prison and think the direly sick person will somehow magically morph into a normal, productive citizen after release (talk about insane logic!).
Some mental illnesses cannot be cured. Ever. The “immediate danger” standard does NOT apply when it comes to severe mental illness. It is not a one-off event; such latent, unpredictable danger is lifelong.
Instead of criminalizing and punishing mental illness, we need to establish TWO very different systems: a humane, rehabilitative prison system for “normal” criminals and a humane institutional system for safely housing and treating those severely mentally ill persons who can never be cured or released.
10
This is yet another example of how we as a culture need to focus on a more holistic view of mental health -- beginning with how we as a society contribute to the problem. Like many others who have found themselves incarcerated, Mr. Megginson's problems are deep-seeded. Clearly we can't rely on a system where people have to take drugs to remain in control. To reduce violence and bad behavior in the future, we need to start with the way we treat each other in the present. If everyone has an interest in reducing violence and bad behavior, this is everyone's responsibility. We can't just focus on the wrong that is done to the victim, when it is often the perpetrator who has been suffering his or her entire life. This begins in childhood. Instead of asking why a child is acting out or what is bothering him or her, we berate them, expel them from school, or implement other forms of rejection -- leaving them to emotionally fend for themselves -- causing them to resent authority and increase the likelihood of acting out in the future. What if instead of focusing on punishment, we focused on love and compassion -- helped them to understand the ways their behaviors affect others, teach them meditation and anger management skills when they are young, which, as referenced in this article, "resulted in a significant drop in the number of use-of-force cases." What if we could shift our focus and break the cycle?
This is yet another example of how we as a culture need to focus on a more holistic view of mental health -- beginning with how we as a society contribute to the problem. Like many others who have found themselves incarcerated, Mr. Megginson's problems are deep-seeded. Clearly we can't rely on a system where people have to take drugs to remain in control. To reduce violence and bad behavior in the future, we need to start with the way we treat each other in the present. If everyone has an interest in reducing violence and bad behavior, this is everyone's responsibility. We can't just focus on the wrong that is done to the victim, when it is often the perpetrator who has been suffering his or her entire life. This begins in childhood. Instead of asking why a child is acting out or what is bothering him or her, we berate them, expel them from school, or implement other forms of rejection -- leaving them to emotionally fend for themselves -- causing them to resent authority and increase the likelihood of acting out in the future. What if instead of focusing on punishment, we focused on love and compassion -- helped them to understand the ways their behaviors affect others, teach them meditation and anger management skills when they are young, which, as referenced in this article, "resulted in a significant drop in the number of use-of-force cases." What if we could shift our focus and break the cycle?
2
We may not need to expand hospitals if we expand Kendra's Law. As the article said, "After he assaulted his mother in 2009, he was mandated under Kendra’s Law to enroll with an ACT team as a condition of his probation. His mother said her son seemed happier in the program because he could live on his own." Kendra''s Law reduces hospitalization, homelessness, arrest, incarceration in the 70% range and cuts the cost of treatment in half. It just makes sense. Learn about it at http://kendras-law.org
DJ Jaffe
Exec. Dir.
Mental Illness Policy Org.
DJ Jaffe
Exec. Dir.
Mental Illness Policy Org.
We may not need to expand hospitals if we expand Kendra's Law. As the article said, "After he assaulted his mother in 2009, he was mandated under Kendra’s Law to enroll with an ACT team as a condition of his probation. His mother said her son seemed happier in the program because he could live on his own." Kendra''s Law reduces hospitalization, homelessness, arrest, incarceration in the 70% range and cuts the cost of treatment in half. It just makes sense. Learn about it at http://kendras-law.org
DJ Jaffe
Exec. Dir.
Mental Illness Policy Org.
DJ Jaffe
Exec. Dir.
Mental Illness Policy Org.
1
I think it is important to differentiate between mental illness and character disorder before referring an individual exhibiting violent or otherwise antisocial behavior to a treatment program (as opposed to incarceration). Antisocial personality disorder, for example, is not something that can be treated successfully with medication and outpatient therapy. Enrolling just one individual such as this in a community-based group treatment program is only inviting disaster. Although the true sociopath comprises only a relatively small part of the psychopathological spectrum, many who work in the criminal justice system tend to make this a blanket diagnosis of any and all who exhibit oppositional behavior inside the facility. Mr. Megginson strikes me as a particularly difficult long-term challenge because of this kind of mis-diagnosis and because of his life-long history of neglect and of being allowed to fall through the cracks.
I think it is important to differentiate between mental illness and character disorder before referring an individual exhibiting violent or otherwise antisocial behavior to a treatment program (as opposed to incarceration). Antisocial personality disorder, for example, is not something that can be treated successfully with medication and outpatient therapy. Enrolling just one individual such as this in a community-based group treatment program is only inviting disaster. Although the true sociopath comprises only a relatively small part of the psychopathological spectrum, many who work in the criminal justice system tend to make this a blanket diagnosis of any and all who exhibit oppositional behavior inside the facility. Mr. Megginson strikes me as a particularly difficult long-term challenge because of this kind of mis-diagnosis and because of his life-long history of neglect and of being allowed to fall through the cracks.
11
Distinguishing characterologic from more mentally compromising disorders is critical... yes! but this writer is not familiar with the full spectrum of antisocial personality disorder styles. Not all antisocial individuals are violent or even break the law. Higher functioning antisocial individuals may be executives of companies, while lower functioning individuals may not be so ambitious as to believe they can get away with lawlessness. Meanwhile, just because someone breaks the law is not the sole criteria for an antisocial personality even if violence was involved. The majority of individuals who act out towards others do so in a moment of heated passion and would not act violently if the circumstances had not provoked them. This does not excuse the behavior nor should it cause us to lower our guard nor require less responsibility of civil behavior from such individuals. An antisocial personality disorder is an individual acting exclusively in their own self-interests with little capacity for empathy for the cost to others. Antisocial individuals often pretend an entirely more benign agenda because they can read the expectations of others. fMRI of ASPDx shows a lack of medial PFC activity when asked moral dilemmas. Wars show a broad capability to dehumanize the other side during conflict, so there is a spectrum of behavioral predisposition. Since the Antisocial knows right from wrong, they can be taught the advantages of appropriate behavior.
No matter who you are, you have to feel for this guy. What has happened to him is absolutely horrible, and represents an absurd disconnect between our government and the real needs of citizens. Our mental health system is gravely lacking in what people actually need. I hope this story has helped to convince people that our country needs to take a step forward in helping those like Megginson.
1
No matter who you are, you have to feel for this guy. What has happened to him is absolutely horrible, and represents an absurd disconnect between our government and the real needs of citizens. Our mental health system is gravely lacking in what people actually need. I hope this story has helped to convince people that our country needs to take a step forward in helping those like Megginson.
3
It's not surprising that a high percentage of prisoners are mentally ill - no doubt it's always been this way, although closing the residential psychiatric hospitals likely increased that percentage. As someone else mentioned, the evolution of long acting injectable psychiatric medications (one month or longer!) may be able to make a difference, but giving them involuntarily will require a court order. Imagine the individual in the article moved next door to you - how comfortable would you feel if you knew his history of violence. If jail isn't the answer then we need to re-establish residential psychiatric facilities and broaden involuntary commitment.
1
It's not surprising that a high percentage of prisoners are mentally ill - no doubt it's always been this way, although closing the residential psychiatric hospitals likely increased that percentage. As someone else mentioned, the evolution of long acting injectable psychiatric medications (one month or longer!) may be able to make a difference, but giving them involuntarily will require a court order. Imagine the individual in the article moved next door to you - how comfortable would you feel if you knew his history of violence. If jail isn't the answer then we need to re-establish residential psychiatric facilities and broaden involuntary commitment.
5
One of my children was also wild, uncontrollable and violent from late toddlerhood. I read Ross Greene's 'The Explosive Child' and believed his thesis, that the reactions were developmental, and I have supported my son's growth, behaviour, and learning to that end. No meds ever. He's now nonviolent. it can be done but requires much time, love and support. There are no shortcuts here.
https://ourviolentchild.wordpress.com/
My heart breaks for this young man, Mr. Megginson. No offense to the family that loved and cared for him when young, but he didn't get the proper support at six that started him down the dead-end road he's on now. He's still young, and I hope with all my heart that he gets more of the help that works so that he can salvage a real life out of the pain and terror he has experienced.
https://ourviolentchild.wordpress.com/
My heart breaks for this young man, Mr. Megginson. No offense to the family that loved and cared for him when young, but he didn't get the proper support at six that started him down the dead-end road he's on now. He's still young, and I hope with all my heart that he gets more of the help that works so that he can salvage a real life out of the pain and terror he has experienced.
1
One of my children was also wild, uncontrollable and violent from late toddlerhood. I read Ross Greene's 'The Explosive Child' and believed his thesis, that the reactions were developmental, and I have supported my son's growth, behaviour, and learning to that end. No meds ever. He's now nonviolent. it can be done but requires much time, love and support. There are no shortcuts here.
https://ourviolentchild.wordpress.com/
My heart breaks for this young man, Mr. Megginson. No offense to the family that loved and cared for him when young, but he didn't get the proper support at six that started him down the dead-end road he's on now. He's still young, and I hope with all my heart that he gets more of the help that works so that he can salvage a real life out of the pain and terror he has experienced.
https://ourviolentchild.wordpress.com/
My heart breaks for this young man, Mr. Megginson. No offense to the family that loved and cared for him when young, but he didn't get the proper support at six that started him down the dead-end road he's on now. He's still young, and I hope with all my heart that he gets more of the help that works so that he can salvage a real life out of the pain and terror he has experienced.
3
This is a failure of policy. We spend too much on the things that don't offer our society enough return and not nearly enough on the things that would help improve the lives of people like this. Mentally ill individuals shouldn't have to be sentenced to incarceration and solitary confinement.
3
This is a failure of policy. We spend too much on the things that don't offer our society enough return and not nearly enough on the things that would help improve the lives of people like this. Mentally ill individuals shouldn't have to be sentenced to incarceration and solitary confinement.
5
Unfortunately until the laws are changed to permit involuntarily commitment of no brainer cases like Mr. Megginson, the only place for him is in jail or prison. He is the classic example of the mentally ill patient who receives treatment, gets well. He then feels better and stops taking his medication and returning to his original ill condition. While it sad to warehouse him like this, he will not give up his freedom voluntarily, so to protect society from him and the judges who release him from the hospital, he has to be jailed when he commits crimes.
Unfortunately until the laws are changed to permit involuntarily commitment of no brainer cases like Mr. Megginson, the only place for him is in jail or prison. He is the classic example of the mentally ill patient who receives treatment, gets well. He then feels better and stops taking his medication and returning to his original ill condition. While it sad to warehouse him like this, he will not give up his freedom voluntarily, so to protect society from him and the judges who release him from the hospital, he has to be jailed when he commits crimes.
6
Maybe if it were not such a shameful and painful thing to have to take medications, people would be more willing to do it.
Kevin, taking medication is generally not a shameful thing in this country; we have ads telling the public to ask their doc's for medications.
However there are other factors that go into the reluctance to take them:
Uncomfortable, even sometimes debilitating side effects that aren't always reversible by stopping the meds.
Expensive psych drugs that don't have a generic version are common, and taking combinations of multiple drugs is also common. This gets very expensive, especially if one can't work because they don't participate in consensus reality.
Patients often lack insight that they are ill. That is a common aspect of mental illness, and it is hard to get someone to take meds that make them slow and tremor, for a condition they don't believe they have.
Patients get 'better' on the drugs and believe that they are done needing the drugs, just as a patient who stops taking their antibiotics before completing the whole course of treatment.
People who have schizophrenia often have impaired cognitive function, even when not actively psychotic, and that can also be a barrier to consistent treatment as the patient gets confused about whether they did in fact take their meds that day or what its for.
However there are other factors that go into the reluctance to take them:
Uncomfortable, even sometimes debilitating side effects that aren't always reversible by stopping the meds.
Expensive psych drugs that don't have a generic version are common, and taking combinations of multiple drugs is also common. This gets very expensive, especially if one can't work because they don't participate in consensus reality.
Patients often lack insight that they are ill. That is a common aspect of mental illness, and it is hard to get someone to take meds that make them slow and tremor, for a condition they don't believe they have.
Patients get 'better' on the drugs and believe that they are done needing the drugs, just as a patient who stops taking their antibiotics before completing the whole course of treatment.
People who have schizophrenia often have impaired cognitive function, even when not actively psychotic, and that can also be a barrier to consistent treatment as the patient gets confused about whether they did in fact take their meds that day or what its for.
When I was in law school in 2007, I took a class on healthcare law. The one thing I remember from that class was my professor's comment about America's mental-health system: "Our mental-health system is the penitentiary system."
2
When I was in law school in 2007, I took a class on healthcare law. The one thing I remember from that class was my professor's comment about America's mental-health system: "Our mental-health system is the penitentiary system."
11
Speaking as someone who has lived with mental illness, this story comes as no surprise to me. I have had the luxury of good insurance and a caring family but I have seen the fate of those who don't have these advantages. The truth of the matter is that no one (outside of family) will ever care about this man or anyone else with a serious mental illness - I think at some level most patients are aware of this. Also, there is no cure or effective treatment for serious mental illness so the best alternative for these patients and public safety is permanent institutionalization. Ideally this should be provided in an appropriate setting, however since the funding is not available a jail must suffice for now. I believe strongly that public safety must always be the first consideration.
In the long term a cure is needed, however to prevent human suffering, both of the patient and their family, an investment in genetic testing is urgently needed so that a mother can be informed and have the option of abortion available to her.
In the long term a cure is needed, however to prevent human suffering, both of the patient and their family, an investment in genetic testing is urgently needed so that a mother can be informed and have the option of abortion available to her.
2
Speaking as someone who has lived with mental illness, this story comes as no surprise to me. I have had the luxury of good insurance and a caring family but I have seen the fate of those who don't have these advantages. The truth of the matter is that no one (outside of family) will ever care about this man or anyone else with a serious mental illness - I think at some level most patients are aware of this. Also, there is no cure or effective treatment for serious mental illness so the best alternative for these patients and public safety is permanent institutionalization. Ideally this should be provided in an appropriate setting, however since the funding is not available a jail must suffice for now. I believe strongly that public safety must always be the first consideration.
In the long term a cure is needed, however to prevent human suffering, both of the patient and their family, an investment in genetic testing is urgently needed so that a mother can be informed and have the option of abortion available to her.
In the long term a cure is needed, however to prevent human suffering, both of the patient and their family, an investment in genetic testing is urgently needed so that a mother can be informed and have the option of abortion available to her.
7
First of all, why is it that, we've become so pathetic in this country that we put the mentally ill in jail? This is beyond sick.
2
First of all, why is it that, we've become so pathetic in this country that we put the mentally ill in jail? This is beyond sick.
3
Because, for whatever the reasons, mentally Ill people commit crimes and society needs protection against those who cannot or will not obey its laws. Commit them to long term involuntary treatment or long term involuntary imprisonment, either protects the members of society who do obey.
Back in the early 1970s I was picked-up off the streets 5 times and taken to Bellevue, crazy with psychedelic drug-induced psychosis. They brought me down with the drugs used at that time and discharged me after a week or so. If I were acting out the same way today I have no doubt I'd be taken off to jail. For many individuals the out-patient models do not work. Some psychotics love their states of being and will not willingly take drugs to bring them down. It was a mistake, perhaps well-meaning, to close down the long-term care facilities.
8
Back in the early 1970s I was picked-up off the streets 5 times and taken to Bellevue, crazy with psychedelic drug-induced psychosis. They brought me down with the drugs used at that time and discharged me after a week or so. If I were acting out the same way today I have no doubt I'd be taken off to jail. For many individuals the out-patient models do not work. Some psychotics love their states of being and will not willingly take drugs to bring them down. It was a mistake, perhaps well-meaning, to close down the long-term care facilities.
17
To "richard",
I'm sure your right about "psychotics" who "love their states of being". Psychosis is the mind's way of defending a person from their aggressors. If this man wasn't enraged, hyper vigilant, and distraught over his family's wholesale destruction of his life and his community's collusion with this destruction, he'd probably be dead or catatonic by now.
I'm sure your right about "psychotics" who "love their states of being". Psychosis is the mind's way of defending a person from their aggressors. If this man wasn't enraged, hyper vigilant, and distraught over his family's wholesale destruction of his life and his community's collusion with this destruction, he'd probably be dead or catatonic by now.
I'm sure that J really loves his theory of the cause of psychosis, but no one yet truly knows.
And, regardless of cause, it doesn't change the fact that people with psychosis don't generally function well in society, and are hard to deal with no matter how much we love them. In my interactions with psychotic people, they can end up feeling victimized by very normal social interactions because of how their brains misinterpret the world. They can believe the most heinous, and false, things about what people did 'to them' and feel traumatized by it, regardless of whether what traumatized them was actually a delusion they created or true.
And, regardless of cause, it doesn't change the fact that people with psychosis don't generally function well in society, and are hard to deal with no matter how much we love them. In my interactions with psychotic people, they can end up feeling victimized by very normal social interactions because of how their brains misinterpret the world. They can believe the most heinous, and false, things about what people did 'to them' and feel traumatized by it, regardless of whether what traumatized them was actually a delusion they created or true.
Ella, people who live with mental illnesses aren't "misinterpreting" the abusiveness of being discarded, incarcerated, ignored, and blamed for their family member's inability to treat them with love and respect. Those behaviors actually are abusive.
Blaming people who live with mental illnesses for the stigma that other people inflict upon them is no less cruel or lacking in personal responsibility than any other form of victim blaming. If you wanted to, you could adjust to the feelings and behaviors of Mad people. Many people do, and we wouldn't be reading as many jailhouse horror stories of mentally ill inmates if more people did.
Blaming people who live with mental illnesses for the stigma that other people inflict upon them is no less cruel or lacking in personal responsibility than any other form of victim blaming. If you wanted to, you could adjust to the feelings and behaviors of Mad people. Many people do, and we wouldn't be reading as many jailhouse horror stories of mentally ill inmates if more people did.
You can thank President Reagan for this particular case and many others.
When he closed so many hospitals that treat mental and emotional ilnesses, he unleashed a nightmare all across the United States. Where did he think these people were going to live and who was to take care of them? The fact that this has continued to produce many other cases since then is living proof that these institutions must exist.
I had a friend whose Mother was in Saint Elizabeth's Hospital; she was released and the family suffered while trying to take care of her as it was impossible - unless they kept her drugged, which they did not do out of compassion. So while she suffered from hearing voices and acting on them, the family suffered from witnessing this.
It is unjust to keep anyone in prisons who are suffering from these
illnesses as there have never been changes in how inmates are
treated (violently) and there is nowhere to go except for families that are ill equipped to care for them. It is not just a failure because of a lack of family values - it is because a good family, with excellent values cannot always cope with the behavior of very ill family members. It is even a problem with institutions that house these individuals; low pay, poorly educated workers are not much better than the guards/doctors/ treatment than the prisons. This is a painful issue that must be
addressed.
When he closed so many hospitals that treat mental and emotional ilnesses, he unleashed a nightmare all across the United States. Where did he think these people were going to live and who was to take care of them? The fact that this has continued to produce many other cases since then is living proof that these institutions must exist.
I had a friend whose Mother was in Saint Elizabeth's Hospital; she was released and the family suffered while trying to take care of her as it was impossible - unless they kept her drugged, which they did not do out of compassion. So while she suffered from hearing voices and acting on them, the family suffered from witnessing this.
It is unjust to keep anyone in prisons who are suffering from these
illnesses as there have never been changes in how inmates are
treated (violently) and there is nowhere to go except for families that are ill equipped to care for them. It is not just a failure because of a lack of family values - it is because a good family, with excellent values cannot always cope with the behavior of very ill family members. It is even a problem with institutions that house these individuals; low pay, poorly educated workers are not much better than the guards/doctors/ treatment than the prisons. This is a painful issue that must be
addressed.
2
You can thank President Reagan for this particular case and many others.
When he closed so many hospitals that treat mental and emotional ilnesses, he unleashed a nightmare all across the United States. Where did he think these people were going to live and who was to take care of them? The fact that this has continued to produce many other cases since then is living proof that these institutions must exist.
I had a friend whose Mother was in Saint Elizabeth's Hospital; she was released and the family suffered while trying to take care of her as it was impossible - unless they kept her drugged, which they did not do out of compassion. So while she suffered from hearing voices and acting on them, the family suffered from witnessing this.
It is unjust to keep anyone in prisons who are suffering from these
illnesses as there have never been changes in how inmates are
treated (violently) and there is nowhere to go except for families that are ill equipped to care for them. It is not just a failure because of a lack of family values - it is because a good family, with excellent values cannot always cope with the behavior of very ill family members. It is even a problem with institutions that house these individuals; low pay, poorly educated workers are not much better than the guards/doctors/ treatment than the prisons. This is a painful issue that must be
addressed.
When he closed so many hospitals that treat mental and emotional ilnesses, he unleashed a nightmare all across the United States. Where did he think these people were going to live and who was to take care of them? The fact that this has continued to produce many other cases since then is living proof that these institutions must exist.
I had a friend whose Mother was in Saint Elizabeth's Hospital; she was released and the family suffered while trying to take care of her as it was impossible - unless they kept her drugged, which they did not do out of compassion. So while she suffered from hearing voices and acting on them, the family suffered from witnessing this.
It is unjust to keep anyone in prisons who are suffering from these
illnesses as there have never been changes in how inmates are
treated (violently) and there is nowhere to go except for families that are ill equipped to care for them. It is not just a failure because of a lack of family values - it is because a good family, with excellent values cannot always cope with the behavior of very ill family members. It is even a problem with institutions that house these individuals; low pay, poorly educated workers are not much better than the guards/doctors/ treatment than the prisons. This is a painful issue that must be
addressed.
5
Once again you misremember and make Reagan the bogeyman.
It wasn't the right wing that closed the hospitals - it was the left wing. The face of the group was Jack Nicholson in "One Flew Over the Cucoo's Nest", which portrayed the institutionalized severely mentally ill as just misunderstood people with an anti-authority complex.
The liberals made it impossible to keep the severely ill in hospital. Once the hospitals were empty, there was no need to maintain beds and staff in empty hospitals. And the people previously helped were, as you point out, sent home to their families or to live under bridges.
It wasn't the right wing that closed the hospitals - it was the left wing. The face of the group was Jack Nicholson in "One Flew Over the Cucoo's Nest", which portrayed the institutionalized severely mentally ill as just misunderstood people with an anti-authority complex.
The liberals made it impossible to keep the severely ill in hospital. Once the hospitals were empty, there was no need to maintain beds and staff in empty hospitals. And the people previously helped were, as you point out, sent home to their families or to live under bridges.
Sadly, some people are unable to live an independent life. They cannot be served by outpatient programs. In that 40% of prison populations are mentally ill, prisons have become our defacto asylums, and seem to do a poor job of treating those with mental illness. We need to reopen mental institutions and yes, confine people who have not been treated successfully elsewhere. They do not have to be cruel places. Maybe we can learn from our past mistakes on that. But we do the serious mentally ill great harm by sending them to prison. That clearly doesn't work.
1
Sadly, some people are unable to live an independent life. They cannot be served by outpatient programs. In that 40% of prison populations are mentally ill, prisons have become our defacto asylums, and seem to do a poor job of treating those with mental illness. We need to reopen mental institutions and yes, confine people who have not been treated successfully elsewhere. They do not have to be cruel places. Maybe we can learn from our past mistakes on that. But we do the serious mentally ill great harm by sending them to prison. That clearly doesn't work.
4
After many of the large state mental hospitals were closed, and the mentally ill were often set "free" on the streets with a bottle of pills, and a pat on the head, much of what remained, and remains today, coast to coast, pretty much amounts to one walked east, one walked west, one walked into the prisoner's nest. Like Mr. Megginson's, for example.
And please give blaming Reagan a rest, he had mostly democratic controlled Congresses to deal with, not to mention some of the large state hospitals were closed as recently as Bill Clinton's watch. Some smaller facilities opened in recent decades have even been downsized during the Obama Administration. There is plenty of blame to go around.
http://www.timesunion.com/local/article/Nine-state-psychiatric-centers-t...
And please give blaming Reagan a rest, he had mostly democratic controlled Congresses to deal with, not to mention some of the large state hospitals were closed as recently as Bill Clinton's watch. Some smaller facilities opened in recent decades have even been downsized during the Obama Administration. There is plenty of blame to go around.
http://www.timesunion.com/local/article/Nine-state-psychiatric-centers-t...
After many of the large state mental hospitals were closed, and the mentally ill were often set "free" on the streets with a bottle of pills, and a pat on the head, much of what remained, and remains today, coast to coast, pretty much amounts to one walked east, one walked west, one walked into the prisoner's nest. Like Mr. Megginson's, for example.
And please give blaming Reagan a rest, he had mostly democratic controlled Congresses to deal with, not to mention some of the large state hospitals were closed as recently as Bill Clinton's watch. Some smaller facilities opened in recent decades have even been downsized during the Obama Administration. There is plenty of blame to go around.
http://www.timesunion.com/local/article/Nine-state-psychiatric-centers-t...
And please give blaming Reagan a rest, he had mostly democratic controlled Congresses to deal with, not to mention some of the large state hospitals were closed as recently as Bill Clinton's watch. Some smaller facilities opened in recent decades have even been downsized during the Obama Administration. There is plenty of blame to go around.
http://www.timesunion.com/local/article/Nine-state-psychiatric-centers-t...
1
As someone who works in mental health I encourage readers to not consider this an either/or situation. The either/or approach makes us reactionary and not thoughtful about this societal issues connected to this case.
When victims act in ways that include victimizing others society often finds themselves facing this quandary - "How do we insure compassion and treat the victim, but also teach them that victimizing others is not okay?"
Often it becomes the case that, early on, violent behaviors are not addressed and are "excused" in an effort to protect the victim. The unintentional outcome of this pattern is that young children are not presented with the opportunity to learn alternatives to aggressive behavior when trying to express rage, hurt, sorrow, etc. It is only when they become physically big enough to do real damage to others that teams are forced to find ways to address the violent behaviors. At this point, we find ourselves as a society relying on institutions and the possibility of using a community setting begins to dwindle.
There are many cases that are not shared with the public where people are doing better, I have seen a few. typically these cases involve early interventions that support the victim through a compassionate set of supports that includes making a distinction between being a victim and victimizing others.
When victims act in ways that include victimizing others society often finds themselves facing this quandary - "How do we insure compassion and treat the victim, but also teach them that victimizing others is not okay?"
Often it becomes the case that, early on, violent behaviors are not addressed and are "excused" in an effort to protect the victim. The unintentional outcome of this pattern is that young children are not presented with the opportunity to learn alternatives to aggressive behavior when trying to express rage, hurt, sorrow, etc. It is only when they become physically big enough to do real damage to others that teams are forced to find ways to address the violent behaviors. At this point, we find ourselves as a society relying on institutions and the possibility of using a community setting begins to dwindle.
There are many cases that are not shared with the public where people are doing better, I have seen a few. typically these cases involve early interventions that support the victim through a compassionate set of supports that includes making a distinction between being a victim and victimizing others.
As someone who works in mental health I encourage readers to not consider this an either/or situation. The either/or approach makes us reactionary and not thoughtful about this societal issues connected to this case.
When victims act in ways that include victimizing others society often finds themselves facing this quandary - "How do we insure compassion and treat the victim, but also teach them that victimizing others is not okay?"
Often it becomes the case that, early on, violent behaviors are not addressed and are "excused" in an effort to protect the victim. The unintentional outcome of this pattern is that young children are not presented with the opportunity to learn alternatives to aggressive behavior when trying to express rage, hurt, sorrow, etc. It is only when they become physically big enough to do real damage to others that teams are forced to find ways to address the violent behaviors. At this point, we find ourselves as a society relying on institutions and the possibility of using a community setting begins to dwindle.
There are many cases that are not shared with the public where people are doing better, I have seen a few. typically these cases involve early interventions that support the victim through a compassionate set of supports that includes making a distinction between being a victim and victimizing others.
When victims act in ways that include victimizing others society often finds themselves facing this quandary - "How do we insure compassion and treat the victim, but also teach them that victimizing others is not okay?"
Often it becomes the case that, early on, violent behaviors are not addressed and are "excused" in an effort to protect the victim. The unintentional outcome of this pattern is that young children are not presented with the opportunity to learn alternatives to aggressive behavior when trying to express rage, hurt, sorrow, etc. It is only when they become physically big enough to do real damage to others that teams are forced to find ways to address the violent behaviors. At this point, we find ourselves as a society relying on institutions and the possibility of using a community setting begins to dwindle.
There are many cases that are not shared with the public where people are doing better, I have seen a few. typically these cases involve early interventions that support the victim through a compassionate set of supports that includes making a distinction between being a victim and victimizing others.
2
Is it just possible that not everyone is curable of whatever ills they may have? Everything has its price and the emptying of the country's mental institutions for a multitude of reasons is no different. Shall we go back to the Willowbrook days?
In an ideal world those who are the focus of this article would be compliant with counseling and medication, and would have a solid support system socially. Alas, we don't live in an ideal world which is startling news to many.
In an ideal world those who are the focus of this article would be compliant with counseling and medication, and would have a solid support system socially. Alas, we don't live in an ideal world which is startling news to many.
Is it just possible that not everyone is curable of whatever ills they may have? Everything has its price and the emptying of the country's mental institutions for a multitude of reasons is no different. Shall we go back to the Willowbrook days?
In an ideal world those who are the focus of this article would be compliant with counseling and medication, and would have a solid support system socially. Alas, we don't live in an ideal world which is startling news to many.
In an ideal world those who are the focus of this article would be compliant with counseling and medication, and would have a solid support system socially. Alas, we don't live in an ideal world which is startling news to many.
There are basically two groups of people; those who have the ability to moderate their behavior according to the rules of society (whether they do so or not) and those who do not have that ability. Violations from the norm from the first group is a simple matter, they broke the law of their own free will and do the time if they do the crime. Those who are permanently in the second group need full time supervision which would be more suitably provided in a medical setting than in a penal one.
The big problem is in those who are in the second group but could, if they see their counselors and take their meds, be in the first group. They can function in society if they do what they need to, but there needs to be some form of coercion in order to ensure this.
The big problem is in those who are in the second group but could, if they see their counselors and take their meds, be in the first group. They can function in society if they do what they need to, but there needs to be some form of coercion in order to ensure this.
Statistics, while being of questionable reliability and an over-simplification of the facts, imply that +60% of those incarcerated in this country have a clinical mental health diagnosis. Here in Portland, Ore., a city that prides itself as forward-thinking and socially conscious, two incredibly stupid things are being considered in the face of the mental health crisis.
The first is building a $200 million dollar courthouse, of which only about 40% will be used to adjudicate actual criminals(based on statistics). The second is a concerted effort to build a 150 bed short-term care mental health facility by a consortium of local health providers, in an attempt to detract attention for the nearly complete abandonment of evidence-based mental health care resources in the community.
All while Multnomah county sits on a 500+ bed facility that was built as a jail and never opened. There are no excuses. This is a simple case of who is being heard. Those mentally challenged patients, like Michael Megginson, will never be heard above the din of law and order, budget cuts to services helping disadvantaged or big pharma paving the way with more expensive, mind-numbing therapy. This society's lack of regard for addressing the mistakes of the past and charting a more humane course for the future basically relegates a segment of our population to a chaotic form of euthanasia.
The first is building a $200 million dollar courthouse, of which only about 40% will be used to adjudicate actual criminals(based on statistics). The second is a concerted effort to build a 150 bed short-term care mental health facility by a consortium of local health providers, in an attempt to detract attention for the nearly complete abandonment of evidence-based mental health care resources in the community.
All while Multnomah county sits on a 500+ bed facility that was built as a jail and never opened. There are no excuses. This is a simple case of who is being heard. Those mentally challenged patients, like Michael Megginson, will never be heard above the din of law and order, budget cuts to services helping disadvantaged or big pharma paving the way with more expensive, mind-numbing therapy. This society's lack of regard for addressing the mistakes of the past and charting a more humane course for the future basically relegates a segment of our population to a chaotic form of euthanasia.
Statistics, while being of questionable reliability and an over-simplification of the facts, imply that +60% of those incarcerated in this country have a clinical mental health diagnosis. Here in Portland, Ore., a city that prides itself as forward-thinking and socially conscious, two incredibly stupid things are being considered in the face of the mental health crisis.
The first is building a $200 million dollar courthouse, of which only about 40% will be used to adjudicate actual criminals(based on statistics). The second is a concerted effort to build a 150 bed short-term care mental health facility by a consortium of local health providers, in an attempt to detract attention for the nearly complete abandonment of evidence-based mental health care resources in the community.
All while Multnomah county sits on a 500+ bed facility that was built as a jail and never opened. There are no excuses. This is a simple case of who is being heard. Those mentally challenged patients, like Michael Megginson, will never be heard above the din of law and order, budget cuts to services helping disadvantaged or big pharma paving the way with more expensive, mind-numbing therapy. This society's lack of regard for addressing the mistakes of the past and charting a more humane course for the future basically relegates a segment of our population to a chaotic form of euthanasia.
The first is building a $200 million dollar courthouse, of which only about 40% will be used to adjudicate actual criminals(based on statistics). The second is a concerted effort to build a 150 bed short-term care mental health facility by a consortium of local health providers, in an attempt to detract attention for the nearly complete abandonment of evidence-based mental health care resources in the community.
All while Multnomah county sits on a 500+ bed facility that was built as a jail and never opened. There are no excuses. This is a simple case of who is being heard. Those mentally challenged patients, like Michael Megginson, will never be heard above the din of law and order, budget cuts to services helping disadvantaged or big pharma paving the way with more expensive, mind-numbing therapy. This society's lack of regard for addressing the mistakes of the past and charting a more humane course for the future basically relegates a segment of our population to a chaotic form of euthanasia.
1
How many of the mentally ill are given a full MEDICAL biochemical evaluation.
From the leading biochemical textbook , "The Metabolic and Molecular Bases of Inherited Disease" chap 66
"There is considerable evidence that many inherited metabolic disorders remain undiagnosed or misdiagnosed. There are a number of reasons the most important of which is the fact that many physicians are not aware of most of the highly specific symptoms or syndromes that are excellent keys to the diagnosis and consequently do not perform comprehensive examinations."
***********
My comments:
Tranquilizers or anti-depressants may control symptoms but they do not address the underlying biochemical lesion. But they are superficially cheaper than a full medical evaluation.
The tragedy is that many of these biochemical conditions can be treated IF they are identified thru a full medical evaluation.
One cause of schizophrenia [there are many causes] is methylenehydrofolate reductase deficiency. The use of betaine has been helpful in controlling symptoms.
President Obama wants to ban "conversion therapy" for homosexuals because it is ineffective and harmful. We should also undertake research to determine if certain forms of talk therapy [especially classical Freudian psychoanalysis] are effective against biochemical illnesses.
We should insist that before talk therapy is used the therapist require a full medical biochemical examination be done.
From the leading biochemical textbook , "The Metabolic and Molecular Bases of Inherited Disease" chap 66
"There is considerable evidence that many inherited metabolic disorders remain undiagnosed or misdiagnosed. There are a number of reasons the most important of which is the fact that many physicians are not aware of most of the highly specific symptoms or syndromes that are excellent keys to the diagnosis and consequently do not perform comprehensive examinations."
***********
My comments:
Tranquilizers or anti-depressants may control symptoms but they do not address the underlying biochemical lesion. But they are superficially cheaper than a full medical evaluation.
The tragedy is that many of these biochemical conditions can be treated IF they are identified thru a full medical evaluation.
One cause of schizophrenia [there are many causes] is methylenehydrofolate reductase deficiency. The use of betaine has been helpful in controlling symptoms.
President Obama wants to ban "conversion therapy" for homosexuals because it is ineffective and harmful. We should also undertake research to determine if certain forms of talk therapy [especially classical Freudian psychoanalysis] are effective against biochemical illnesses.
We should insist that before talk therapy is used the therapist require a full medical biochemical examination be done.
6
Excellent post.
There is an enormous amount of evidence in the neuroscience literature linking inflammation, oxidative stress and nitrosative stress (oxidative stress + reactive nitrogen species) and diminished levels of the body's principal antioxidant, glutathione, with a wide range of DSM disorders and impaired connectivity between brain regions.
Probably the worse in this regard: Schizophrenia and Autism.
Drugs are only band aids if they do not address the oxidative stress and inflammation.
N-acetylcyste is a well-studied supplement that increases levels of glutatione. (There are others, including alpha-lipoic acid.)
Two studies that suggest it may be a useful part of a non-drug intervention:
Neuropsychopharmacology. 2008 Aug;33(9):2187-99. .
Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients.
http://www.nature.com/npp/journal/v33/n9/pdf/1301624a.pdf
PLoS One. 2012;7(2):e29341.
Glutathione precursor N-acetyl-cysteine modulates EEG synchronization in schizophrenia patients: a A double-blind, randomized, placebo-controlled trial
http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/j...
There is an enormous amount of evidence in the neuroscience literature linking inflammation, oxidative stress and nitrosative stress (oxidative stress + reactive nitrogen species) and diminished levels of the body's principal antioxidant, glutathione, with a wide range of DSM disorders and impaired connectivity between brain regions.
Probably the worse in this regard: Schizophrenia and Autism.
Drugs are only band aids if they do not address the oxidative stress and inflammation.
N-acetylcyste is a well-studied supplement that increases levels of glutatione. (There are others, including alpha-lipoic acid.)
Two studies that suggest it may be a useful part of a non-drug intervention:
Neuropsychopharmacology. 2008 Aug;33(9):2187-99. .
Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients.
http://www.nature.com/npp/journal/v33/n9/pdf/1301624a.pdf
PLoS One. 2012;7(2):e29341.
Glutathione precursor N-acetyl-cysteine modulates EEG synchronization in schizophrenia patients: a A double-blind, randomized, placebo-controlled trial
http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/j...
How many of the mentally ill are given a full MEDICAL biochemical evaluation.
From the leading biochemical textbook , "The Metabolic and Molecular Bases of Inherited Disease" chap 66
"There is considerable evidence that many inherited metabolic disorders remain undiagnosed or misdiagnosed. There are a number of reasons the most important of which is the fact that many physicians are not aware of most of the highly specific symptoms or syndromes that are excellent keys to the diagnosis and consequently do not perform comprehensive examinations."
***********
My comments:
Tranquilizers or anti-depressants may control symptoms but they do not address the underlying biochemical lesion. But they are superficially cheaper than a full medical evaluation.
The tragedy is that many of these biochemical conditions can be treated IF they are identified thru a full medical evaluation.
One cause of schizophrenia [there are many causes] is methylenehydrofolate reductase deficiency. The use of betaine has been helpful in controlling symptoms.
President Obama wants to ban "conversion therapy" for homosexuals because it is ineffective and harmful. We should also undertake research to determine if certain forms of talk therapy [especially classical Freudian psychoanalysis] are effective against biochemical illnesses.
We should insist that before talk therapy is used the therapist require a full medical biochemical examination be done.
From the leading biochemical textbook , "The Metabolic and Molecular Bases of Inherited Disease" chap 66
"There is considerable evidence that many inherited metabolic disorders remain undiagnosed or misdiagnosed. There are a number of reasons the most important of which is the fact that many physicians are not aware of most of the highly specific symptoms or syndromes that are excellent keys to the diagnosis and consequently do not perform comprehensive examinations."
***********
My comments:
Tranquilizers or anti-depressants may control symptoms but they do not address the underlying biochemical lesion. But they are superficially cheaper than a full medical evaluation.
The tragedy is that many of these biochemical conditions can be treated IF they are identified thru a full medical evaluation.
One cause of schizophrenia [there are many causes] is methylenehydrofolate reductase deficiency. The use of betaine has been helpful in controlling symptoms.
President Obama wants to ban "conversion therapy" for homosexuals because it is ineffective and harmful. We should also undertake research to determine if certain forms of talk therapy [especially classical Freudian psychoanalysis] are effective against biochemical illnesses.
We should insist that before talk therapy is used the therapist require a full medical biochemical examination be done.
6
Excellent post.
There is an enormous amount of evidence in the neuroscience literature linking inflammation, oxidative stress and nitrosative stress (oxidative stress + reactive nitrogen species) and diminished levels of the body's principal antioxidant, glutathione, with a wide range of DSM disorders and impaired connectivity between brain regions.
Probably the worse in this regard: Schizophrenia and Autism.
Drugs are only band aids if they do not address the oxidative stress and inflammation.
N-acetylcyste is a well-studied supplement that increases levels of glutatione. (There are others, including alpha-lipoic acid.)
Two studies that suggest it may be a useful part of a non-drug intervention:
Neuropsychopharmacology. 2008 Aug;33(9):2187-99. .
Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients.
http://www.nature.com/npp/journal/v33/n9/pdf/1301624a.pdf
PLoS One. 2012;7(2):e29341.
Glutathione precursor N-acetyl-cysteine modulates EEG synchronization in schizophrenia patients: a A double-blind, randomized, placebo-controlled trial
http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/j...
There is an enormous amount of evidence in the neuroscience literature linking inflammation, oxidative stress and nitrosative stress (oxidative stress + reactive nitrogen species) and diminished levels of the body's principal antioxidant, glutathione, with a wide range of DSM disorders and impaired connectivity between brain regions.
Probably the worse in this regard: Schizophrenia and Autism.
Drugs are only band aids if they do not address the oxidative stress and inflammation.
N-acetylcyste is a well-studied supplement that increases levels of glutatione. (There are others, including alpha-lipoic acid.)
Two studies that suggest it may be a useful part of a non-drug intervention:
Neuropsychopharmacology. 2008 Aug;33(9):2187-99. .
Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients.
http://www.nature.com/npp/journal/v33/n9/pdf/1301624a.pdf
PLoS One. 2012;7(2):e29341.
Glutathione precursor N-acetyl-cysteine modulates EEG synchronization in schizophrenia patients: a A double-blind, randomized, placebo-controlled trial
http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/j...
Medicine is closer than ever to having the technology to finally actually know the physiology of the mind and with it, mental illness.
How far would an extra $100 billion per year, dedicated to brain research, go for solving this gap in knowledge? Too much, you say? But add to the direct cost of billions spent barely and ineffectively treating the mentally ill the billions lost by them not adding to the common economic good, and of those dedicated to treating them contributing in only a narrow way and that monumental sum becomes an investment in the future of mankind.
We spent a trillion dollars to try and prevent a 9/11 from happening again and yet for those with mental illness and those who love them the equivalent of a 9/11 happens every year but its diluted over the many months of the year instead of being compressed into one moment of time.
Will you support a trillion dollars in dedicated research to find the secrets of the brain and have the opportunity to end mental illness for all time?
How far would an extra $100 billion per year, dedicated to brain research, go for solving this gap in knowledge? Too much, you say? But add to the direct cost of billions spent barely and ineffectively treating the mentally ill the billions lost by them not adding to the common economic good, and of those dedicated to treating them contributing in only a narrow way and that monumental sum becomes an investment in the future of mankind.
We spent a trillion dollars to try and prevent a 9/11 from happening again and yet for those with mental illness and those who love them the equivalent of a 9/11 happens every year but its diluted over the many months of the year instead of being compressed into one moment of time.
Will you support a trillion dollars in dedicated research to find the secrets of the brain and have the opportunity to end mental illness for all time?
3
This mother is beyond the pale. I've had some of the same struggles as this man and neither of my parents have EVER told me that they wish they'd never had me, berated me, left me to rot in a jail cell, or conditioned a place for me in the family home on my "compliance" with "treatment".
Our family values, or lack thereof, are at the root of the behaviors being exhibited by this man and that, by decontextualizing them from their social origin, are getting ruthlessly and irresponsibly pathologized. No other group of workers in this country can grab so much power over a person's life without even an inkling of professional consensus on which problem or problems they purport to be solving with their knowledge and skills.
What do we know for sure? This guy is abused, abandoned, bereaved, and alienated. Why don't these "experts" begin addressing the KNOWN causes of the "dysfunctions" that are being trivialized as an "incurable brain disease".
Our family values, or lack thereof, are at the root of the behaviors being exhibited by this man and that, by decontextualizing them from their social origin, are getting ruthlessly and irresponsibly pathologized. No other group of workers in this country can grab so much power over a person's life without even an inkling of professional consensus on which problem or problems they purport to be solving with their knowledge and skills.
What do we know for sure? This guy is abused, abandoned, bereaved, and alienated. Why don't these "experts" begin addressing the KNOWN causes of the "dysfunctions" that are being trivialized as an "incurable brain disease".
3
You assume she actually said all that. My experience with the mentally ill is that their accounts are not necessarily reflective of reality. This is what makes it so hard to prosecute crimes against them - they're far more likely to be victims than perpetrators, though all the headlines go to the latter.
1
To ACW,
Misguided opinions like yours are what makes being labeled with a mental illness so dangerous. Once you've been branded as "crazy", no one will believe that you're a victim of abuse. As a result of this, the causes of your sadness, confusion, and anger will never be uncovered and remedied. Without the opportunity to heal from injustice, these labels become self-fulfilling prophecies.
Misguided opinions like yours are what makes being labeled with a mental illness so dangerous. Once you've been branded as "crazy", no one will believe that you're a victim of abuse. As a result of this, the causes of your sadness, confusion, and anger will never be uncovered and remedied. Without the opportunity to heal from injustice, these labels become self-fulfilling prophecies.
Its not like we live in the dark ages where there is no medication available. There is all kinds of treatment that is available. So why has this gone on for so long? Maybe he is just a really tough case. But for prisoners or people who have committed no crime, there can be a long road to find the right combination of therapy and drugs. It is not a cookie cutter answer. But this story seems extreme. But it seems to have a good ending so far. Mental illness is the most neglected illness but I think that is because you can't see it on an X-Ray. I wish you could. There would be a lot less suffering.
3
Medicine is closer than ever to having the technology to finally actually know the physiology of the mind and with it, mental illness.
How far would an extra $100 billion per year, dedicated to brain research, go for solving this gap in knowledge? Too much, you say? But add to the direct cost of billions spent barely and ineffectively treating the mentally ill the billions lost by them not adding to the common economic good, and of those dedicated to treating them contributing in only a narrow way and that monumental sum becomes an investment in the future of mankind.
We spent a trillion dollars to try and prevent a 9/11 from happening again and yet for those with mental illness and those who love them the equivalent of a 9/11 happens every year but its diluted over the many months of the year instead of being compressed into one moment of time.
Will you support a trillion dollars in dedicated research to find the secrets of the brain and have the opportunity to end mental illness for all time?
How far would an extra $100 billion per year, dedicated to brain research, go for solving this gap in knowledge? Too much, you say? But add to the direct cost of billions spent barely and ineffectively treating the mentally ill the billions lost by them not adding to the common economic good, and of those dedicated to treating them contributing in only a narrow way and that monumental sum becomes an investment in the future of mankind.
We spent a trillion dollars to try and prevent a 9/11 from happening again and yet for those with mental illness and those who love them the equivalent of a 9/11 happens every year but its diluted over the many months of the year instead of being compressed into one moment of time.
Will you support a trillion dollars in dedicated research to find the secrets of the brain and have the opportunity to end mental illness for all time?
3
This mother is beyond the pale. I've had some of the same struggles as this man and neither of my parents have EVER told me that they wish they'd never had me, berated me, left me to rot in a jail cell, or conditioned a place for me in the family home on my "compliance" with "treatment".
Our family values, or lack thereof, are at the root of the behaviors being exhibited by this man and that, by decontextualizing them from their social origin, are getting ruthlessly and irresponsibly pathologized. No other group of workers in this country can grab so much power over a person's life without even an inkling of professional consensus on which problem or problems they purport to be solving with their knowledge and skills.
What do we know for sure? This guy is abused, abandoned, bereaved, and alienated. Why don't these "experts" begin addressing the KNOWN causes of the "dysfunctions" that are being trivialized as an "incurable brain disease".
Our family values, or lack thereof, are at the root of the behaviors being exhibited by this man and that, by decontextualizing them from their social origin, are getting ruthlessly and irresponsibly pathologized. No other group of workers in this country can grab so much power over a person's life without even an inkling of professional consensus on which problem or problems they purport to be solving with their knowledge and skills.
What do we know for sure? This guy is abused, abandoned, bereaved, and alienated. Why don't these "experts" begin addressing the KNOWN causes of the "dysfunctions" that are being trivialized as an "incurable brain disease".
3
You assume she actually said all that. My experience with the mentally ill is that their accounts are not necessarily reflective of reality. This is what makes it so hard to prosecute crimes against them - they're far more likely to be victims than perpetrators, though all the headlines go to the latter.
3
To ACW,
Misguided opinions like yours are what makes being labeled with a mental illness so dangerous. Once you've been branded as "crazy", no one will believe that you're a victim of abuse. As a result of this, the causes of your sadness, confusion, and anger will never be uncovered and remedied. Without the opportunity to heal from injustice, these labels become self-fulfilling prophecies.
Misguided opinions like yours are what makes being labeled with a mental illness so dangerous. Once you've been branded as "crazy", no one will believe that you're a victim of abuse. As a result of this, the causes of your sadness, confusion, and anger will never be uncovered and remedied. Without the opportunity to heal from injustice, these labels become self-fulfilling prophecies.
J, you assume much about their family situation, and you appear to assume that this man is capable of the same things as you.
It is actually YOU and your ilk that stigmatize getting treatment that works, because you assume that everyone will accept treatment without coercion. Not everyone will, and it ought to be acceptable to mandate treatment in those who are dangerous without it.
Families must know that It's OK to have boundaries and ensure that your ill loved one doesn't harm you, even if that means they can't live with you. People who are ill still must face the consequences of their choices.
It is actually YOU and your ilk that stigmatize getting treatment that works, because you assume that everyone will accept treatment without coercion. Not everyone will, and it ought to be acceptable to mandate treatment in those who are dangerous without it.
Families must know that It's OK to have boundaries and ensure that your ill loved one doesn't harm you, even if that means they can't live with you. People who are ill still must face the consequences of their choices.
1
Its not like we live in the dark ages where there is no medication available. There is all kinds of treatment that is available. So why has this gone on for so long? Maybe he is just a really tough case. But for prisoners or people who have committed no crime, there can be a long road to find the right combination of therapy and drugs. It is not a cookie cutter answer. But this story seems extreme. But it seems to have a good ending so far. Mental illness is the most neglected illness but I think that is because you can't see it on an X-Ray. I wish you could. There would be a lot less suffering.
3
"Though there may be a consensus that Michael Megginson does not belong in jail ... At times, he was just as violent in hospitals. He once jumped over a nurses’ station at Kings County Hospital Center in Brooklyn, attacking clinicians"
While I feel sympathy for this man's situation, I can't help but feel relieved that he's not on the street doing things like "attacking" people. In view of his recurrent slips and refusals to take medication which might help him, he seems like a potential danger to society.
While I feel sympathy for this man's situation, I can't help but feel relieved that he's not on the street doing things like "attacking" people. In view of his recurrent slips and refusals to take medication which might help him, he seems like a potential danger to society.
4
People wonder why are prisons are full. Prisons are now combination jails and mental institutions. It's the only way someone with severe mental illness can be taken off the streets.
And this may also partially explain police officer involved killings. When a large proportion of the people you are dealing with are mentally ill and unpredictable, officers may be less hesitant to use deadly force. Here in Columbus we have already had at least two police shootings involving mentally ill individuals this year.
And this may also partially explain police officer involved killings. When a large proportion of the people you are dealing with are mentally ill and unpredictable, officers may be less hesitant to use deadly force. Here in Columbus we have already had at least two police shootings involving mentally ill individuals this year.
4
I have experienced first hand the frustrations that come with a loved one who has severe mental illness. Though we love them, the families are unequipped to handle these diseases at home. The hospitals and jails are also unequipped and are hampered by laws that give power to the mentally ill to decide for themselves at a time when they are not in a mental state to be making those sort of decisions. Society as whole is failing to provide care and compassion to these people that sorely need help and support. We need to keep examining these issues and thinking of different, creative solutions. Cases like these that are brought to light help people understand the complications that surround giving care to the mentally ill. We need to keep talking and forging forward with potential solutions. This is not the time to become discouraged.
7
"Though there may be a consensus that Michael Megginson does not belong in jail ... At times, he was just as violent in hospitals. He once jumped over a nurses’ station at Kings County Hospital Center in Brooklyn, attacking clinicians"
While I feel sympathy for this man's situation, I can't help but feel relieved that he's not on the street doing things like "attacking" people. In view of his recurrent slips and refusals to take medication which might help him, he seems like a potential danger to society.
While I feel sympathy for this man's situation, I can't help but feel relieved that he's not on the street doing things like "attacking" people. In view of his recurrent slips and refusals to take medication which might help him, he seems like a potential danger to society.
11
People wonder why are prisons are full. Prisons are now combination jails and mental institutions. It's the only way someone with severe mental illness can be taken off the streets.
And this may also partially explain police officer involved killings. When a large proportion of the people you are dealing with are mentally ill and unpredictable, officers may be less hesitant to use deadly force. Here in Columbus we have already had at least two police shootings involving mentally ill individuals this year.
And this may also partially explain police officer involved killings. When a large proportion of the people you are dealing with are mentally ill and unpredictable, officers may be less hesitant to use deadly force. Here in Columbus we have already had at least two police shootings involving mentally ill individuals this year.
6
I have experienced first hand the frustrations that come with a loved one who has severe mental illness. Though we love them, the families are unequipped to handle these diseases at home. The hospitals and jails are also unequipped and are hampered by laws that give power to the mentally ill to decide for themselves at a time when they are not in a mental state to be making those sort of decisions. Society as whole is failing to provide care and compassion to these people that sorely need help and support. We need to keep examining these issues and thinking of different, creative solutions. Cases like these that are brought to light help people understand the complications that surround giving care to the mentally ill. We need to keep talking and forging forward with potential solutions. This is not the time to become discouraged.
8
I have treated many patients like this in my career as a mental health therapist. They need structured, long term, residential care in a State hospital type of setting that is humane, therapeutically effective and provides meaningful opportunities, such as the arts, gardening, etc. Closing our state mental hospitals has been a huge and very expensive mistake, not to mention has caused horrible suffering for thousands of people and their families. To expect a severely mentally ill person to go from a residential program to living alone, watching TV all day and no structure in their lives is so unrealistic, it amazes me that the system has been trying, unsuccessfully, to achieve this for 50 years. How stupid is that? And taxpayers pay the price over and over again. We can and must do better. Let's get smarter and use better reality-contact in how we care for chronically mentally ill human beings.
6
Incredibly sad that this man has been suffering since age 6 and that not only has society failed him but more tragically HIS OWN FAMILY, namely his mother and father, who clearly have never really been there for him. Perhaps with more family support, he would be in a better position, likely still with mental illness but coping and not in prison. As stated in the article by one of the ACT professionals, for mentally ill patients to have some flicker of hope, they need an anchor: parent, significant other, sibling to constantly look after them. Society alone cannot be responsible for this.
3
Giselle, you're absolutely correct. God bless my family for not leaving me at the mercy of the judges, police, and clinicians.
Unfortunately, stories like Mr. Megginson's are all too familiar. I am a clinical social worker who provides services to people with criminal justice system involvement and a diagnosed mental illness. Permanent housing, social support, and a connection to individualized mental health services are key components to any successful treatment. However, the system of incarcerating people with mental illness fails to meet those key components of critical care.
Public safety is indeed paramount, but systems cannot incarcerate its way towards a safer society. People with mental illness do not find lasting healing in prison or jail; they are merely contained before release back into civilian life. Daily medications, although effective, do not help people who struggle with compliance because they are concurrently dealing with homelessness, a lack of support, or access to regular mental health care.
Perhaps monthly injectable psychiatric medications in conjunction with part-time hospitalization care might prove a more effective approach to treatment and reintegration? In my experience, people with mental illness stand a better chance at living as a productive member of society when they receive dedicated care and a supportive reconnection to society. Why not spend that money on a service, rather than incarceration? The former offers the highest level of care and chances of successful reintegration, while the latter ensures isolation and a door that opens without aftercare?
Public safety is indeed paramount, but systems cannot incarcerate its way towards a safer society. People with mental illness do not find lasting healing in prison or jail; they are merely contained before release back into civilian life. Daily medications, although effective, do not help people who struggle with compliance because they are concurrently dealing with homelessness, a lack of support, or access to regular mental health care.
Perhaps monthly injectable psychiatric medications in conjunction with part-time hospitalization care might prove a more effective approach to treatment and reintegration? In my experience, people with mental illness stand a better chance at living as a productive member of society when they receive dedicated care and a supportive reconnection to society. Why not spend that money on a service, rather than incarceration? The former offers the highest level of care and chances of successful reintegration, while the latter ensures isolation and a door that opens without aftercare?
6
The term mentally ill is a blanket statement. Our system is based on freedom. The USA doesn't have a laws to premeptively arrest people before any crime has been committed. The term mental illness applies to anyone who has depression to someone who is a sociopath. I have worked with many of these violent offenders, and there is no perfect system that will ever exist for many of the mentally ill that are similar to Megginson. I knew of people who killed their neighbor because they thought they were an alien spy. Eventually they will be released and hopefully they comply and take their meds and continue treatment, but of course that isn't guaranteed. Any of these violent mentally ill people who are released can decide at anytime to stop treatment. That's why our system at this point will not work for many of these people and that's what we have to accept in our society. It's the risks we have to consider when we give people freedom to make their own choices, even if they turn out to be destructive.
1
It took the worst of extreme Conservatives and Liberals to make this huge mess.
Conservatives closed down and refuse to fund long term psychiatric hospitals.
Liberals got judges to agree that no severely mentally ill person can be institutionalized if they do not 'wish it', as if their decisions have any basis in reality.
The outcome is that tens of thousands of severely mentally ill patients live in terror and fear on the streets, decimating entire neighborhoods and towns, while prisons are now the default long term psychiatric hospitals.
Good job, Conservatives and Liberals.
Conservatives closed down and refuse to fund long term psychiatric hospitals.
Liberals got judges to agree that no severely mentally ill person can be institutionalized if they do not 'wish it', as if their decisions have any basis in reality.
The outcome is that tens of thousands of severely mentally ill patients live in terror and fear on the streets, decimating entire neighborhoods and towns, while prisons are now the default long term psychiatric hospitals.
Good job, Conservatives and Liberals.
6
Mental illness is a disease and should be treated as one. Unfortunately, there is such stigma against mental illness that it remains almost impossible to completely care for someone who is suffering. Care is always limited, always under review. There are always lingering questions about the moral make-up of a person, particularly if any sort of violent behavior is involved. As a society we are not comfortable with kindness towards the violently ill. I feel tremendous sorrow for this young man. What must it be like to live such a chaotic existence?
3
A far bigger problem is the vast number of mentally ill who are a risk to themselves, but are not violent and do not hurt others. They also lack a support structure, and languish between inpatient admissions.
It is impossible to address these problems unless the State allows facilities where a patient may be monitored to receive outpatient therapy in a controlled environment. Those "asylums" were closed because of the abuses of the past, but if they are operated in a thoughtful and regulated manner, they would provide a much better environment for all of these patients.
It is impossible to address these problems unless the State allows facilities where a patient may be monitored to receive outpatient therapy in a controlled environment. Those "asylums" were closed because of the abuses of the past, but if they are operated in a thoughtful and regulated manner, they would provide a much better environment for all of these patients.
9
There are thousands (if not millions) kids across America enrolled in public schools with analogous situations. And the public schools do not have the resources or staff to deal with these mentally unstable kids. Mr. Megginson's cyclical descent into suicidal behavior and possibly suicide is emblematic of so many kids with genetic and/or cultural imbalance.
8
I worked in a Forensic Unit of a maximum security jail as a psychiatric social worker during he 70's and 80's. I worked with many men with mental illness and violent, delusional behavior. The criminal justice system was never just. The poor , black and hispanic men, young and old ,never had equal access to good legal representation, and served more time than the white patients. It was a revolving door and society has no place for them. They were shuttled between jail, prison and the intensive care psychiatric unit of the local hospital where I worked in the 90's, and which treated the most out of control patients. The same ones
arrived that I knew very well from the jail. Discharge planning was very difficult and fraught with my own anxiety lest this person commit another
act of violence, whether against himself or another. Community programs did not meet their needs and family for the most part were fed up and unwilling to take them home or even see them. An abysmal situation that this article makes clear still exists.
.
arrived that I knew very well from the jail. Discharge planning was very difficult and fraught with my own anxiety lest this person commit another
act of violence, whether against himself or another. Community programs did not meet their needs and family for the most part were fed up and unwilling to take them home or even see them. An abysmal situation that this article makes clear still exists.
.
10
I have treated many patients like this in my career as a mental health therapist. They need structured, long term, residential care in a State hospital type of setting that is humane, therapeutically effective and provides meaningful opportunities, such as the arts, gardening, etc. Closing our state mental hospitals has been a huge and very expensive mistake, not to mention has caused horrible suffering for thousands of people and their families. To expect a severely mentally ill person to go from a residential program to living alone, watching TV all day and no structure in their lives is so unrealistic, it amazes me that the system has been trying, unsuccessfully, to achieve this for 50 years. How stupid is that? And taxpayers pay the price over and over again. We can and must do better. Let's get smarter and use better reality-contact in how we care for chronically mentally ill human beings.
9
Incredibly sad that this man has been suffering since age 6 and that not only has society failed him but more tragically HIS OWN FAMILY, namely his mother and father, who clearly have never really been there for him. Perhaps with more family support, he would be in a better position, likely still with mental illness but coping and not in prison. As stated in the article by one of the ACT professionals, for mentally ill patients to have some flicker of hope, they need an anchor: parent, significant other, sibling to constantly look after them. Society alone cannot be responsible for this.
3
Giselle, you're absolutely correct. God bless my family for not leaving me at the mercy of the judges, police, and clinicians.
Unfortunately, stories like Mr. Megginson's are all too familiar. I am a clinical social worker who provides services to people with criminal justice system involvement and a diagnosed mental illness. Permanent housing, social support, and a connection to individualized mental health services are key components to any successful treatment. However, the system of incarcerating people with mental illness fails to meet those key components of critical care.
Public safety is indeed paramount, but systems cannot incarcerate its way towards a safer society. People with mental illness do not find lasting healing in prison or jail; they are merely contained before release back into civilian life. Daily medications, although effective, do not help people who struggle with compliance because they are concurrently dealing with homelessness, a lack of support, or access to regular mental health care.
Perhaps monthly injectable psychiatric medications in conjunction with part-time hospitalization care might prove a more effective approach to treatment and reintegration? In my experience, people with mental illness stand a better chance at living as a productive member of society when they receive dedicated care and a supportive reconnection to society. Why not spend that money on a service, rather than incarceration? The former offers the highest level of care and chances of successful reintegration, while the latter ensures isolation and a door that opens without aftercare?
Public safety is indeed paramount, but systems cannot incarcerate its way towards a safer society. People with mental illness do not find lasting healing in prison or jail; they are merely contained before release back into civilian life. Daily medications, although effective, do not help people who struggle with compliance because they are concurrently dealing with homelessness, a lack of support, or access to regular mental health care.
Perhaps monthly injectable psychiatric medications in conjunction with part-time hospitalization care might prove a more effective approach to treatment and reintegration? In my experience, people with mental illness stand a better chance at living as a productive member of society when they receive dedicated care and a supportive reconnection to society. Why not spend that money on a service, rather than incarceration? The former offers the highest level of care and chances of successful reintegration, while the latter ensures isolation and a door that opens without aftercare?
7
The term mentally ill is a blanket statement. Our system is based on freedom. The USA doesn't have a laws to premeptively arrest people before any crime has been committed. The term mental illness applies to anyone who has depression to someone who is a sociopath. I have worked with many of these violent offenders, and there is no perfect system that will ever exist for many of the mentally ill that are similar to Megginson. I knew of people who killed their neighbor because they thought they were an alien spy. Eventually they will be released and hopefully they comply and take their meds and continue treatment, but of course that isn't guaranteed. Any of these violent mentally ill people who are released can decide at anytime to stop treatment. That's why our system at this point will not work for many of these people and that's what we have to accept in our society. It's the risks we have to consider when we give people freedom to make their own choices, even if they turn out to be destructive.
1
It took the worst of extreme Conservatives and Liberals to make this huge mess.
Conservatives closed down and refuse to fund long term psychiatric hospitals.
Liberals got judges to agree that no severely mentally ill person can be institutionalized if they do not 'wish it', as if their decisions have any basis in reality.
The outcome is that tens of thousands of severely mentally ill patients live in terror and fear on the streets, decimating entire neighborhoods and towns, while prisons are now the default long term psychiatric hospitals.
Good job, Conservatives and Liberals.
Conservatives closed down and refuse to fund long term psychiatric hospitals.
Liberals got judges to agree that no severely mentally ill person can be institutionalized if they do not 'wish it', as if their decisions have any basis in reality.
The outcome is that tens of thousands of severely mentally ill patients live in terror and fear on the streets, decimating entire neighborhoods and towns, while prisons are now the default long term psychiatric hospitals.
Good job, Conservatives and Liberals.
7
Mental illness is a disease and should be treated as one. Unfortunately, there is such stigma against mental illness that it remains almost impossible to completely care for someone who is suffering. Care is always limited, always under review. There are always lingering questions about the moral make-up of a person, particularly if any sort of violent behavior is involved. As a society we are not comfortable with kindness towards the violently ill. I feel tremendous sorrow for this young man. What must it be like to live such a chaotic existence?
4
A far bigger problem is the vast number of mentally ill who are a risk to themselves, but are not violent and do not hurt others. They also lack a support structure, and languish between inpatient admissions.
It is impossible to address these problems unless the State allows facilities where a patient may be monitored to receive outpatient therapy in a controlled environment. Those "asylums" were closed because of the abuses of the past, but if they are operated in a thoughtful and regulated manner, they would provide a much better environment for all of these patients.
It is impossible to address these problems unless the State allows facilities where a patient may be monitored to receive outpatient therapy in a controlled environment. Those "asylums" were closed because of the abuses of the past, but if they are operated in a thoughtful and regulated manner, they would provide a much better environment for all of these patients.
11
There are thousands (if not millions) kids across America enrolled in public schools with analogous situations. And the public schools do not have the resources or staff to deal with these mentally unstable kids. Mr. Megginson's cyclical descent into suicidal behavior and possibly suicide is emblematic of so many kids with genetic and/or cultural imbalance.
9
I worked in a Forensic Unit of a maximum security jail as a psychiatric social worker during he 70's and 80's. I worked with many men with mental illness and violent, delusional behavior. The criminal justice system was never just. The poor , black and hispanic men, young and old ,never had equal access to good legal representation, and served more time than the white patients. It was a revolving door and society has no place for them. They were shuttled between jail, prison and the intensive care psychiatric unit of the local hospital where I worked in the 90's, and which treated the most out of control patients. The same ones
arrived that I knew very well from the jail. Discharge planning was very difficult and fraught with my own anxiety lest this person commit another
act of violence, whether against himself or another. Community programs did not meet their needs and family for the most part were fed up and unwilling to take them home or even see them. An abysmal situation that this article makes clear still exists.
.
arrived that I knew very well from the jail. Discharge planning was very difficult and fraught with my own anxiety lest this person commit another
act of violence, whether against himself or another. Community programs did not meet their needs and family for the most part were fed up and unwilling to take them home or even see them. An abysmal situation that this article makes clear still exists.
.
13
'''Tranquilizers became the panacea for the mentally ill,' he [former secretary-treasurer of the JCMIH] said. 'The state programs were buying them by the carload, sending the drugged patients back to the community and the psychiatrists never tried to stop this. Local mental health centers were going to be the greatest thing going, but no one wanted to think it through.'''
The quote above is from the October 30, 1984 NYT article "How Release of Mental Patients Began." Beginning in the early 1950s, mental health professionals, politicians and the media were transfixed by claims that chlorpromazine, the prototype of all the anti-psychotic medications, could enable mental patients to live on their own in the community, thereby eliminating the unwanted expenses involved in the maintenance of government mental institutions. Although the patients were released and the institutions closed, at that time no provision had been made for the patients once they were released into the community. '''
The quote above is from the October 30, 1984 NYT article "How Release of Mental Patients Began." Beginning in the early 1950s, mental health professionals, politicians and the media were transfixed by claims that chlorpromazine, the prototype of all the anti-psychotic medications, could enable mental patients to live on their own in the community, thereby eliminating the unwanted expenses involved in the maintenance of government mental institutions. Although the patients were released and the institutions closed, at that time no provision had been made for the patients once they were released into the community. '''
6
The quotation marks at the end of my comment above are in error.
2
'''Tranquilizers became the panacea for the mentally ill,' he [former secretary-treasurer of the JCMIH] said. 'The state programs were buying them by the carload, sending the drugged patients back to the community and the psychiatrists never tried to stop this. Local mental health centers were going to be the greatest thing going, but no one wanted to think it through.'''
The quote above is from the October 30, 1984 NYT article "How Release of Mental Patients Began." Beginning in the early 1950s, mental health professionals, politicians and the media were transfixed by claims that chlorpromazine, the prototype of all the anti-psychotic medications, could enable mental patients to live on their own in the community, thereby eliminating the unwanted expenses involved in the maintenance of government mental institutions. Although the patients were released and the institutions closed, at that time no provision had been made for the patients once they were released into the community. '''
The quote above is from the October 30, 1984 NYT article "How Release of Mental Patients Began." Beginning in the early 1950s, mental health professionals, politicians and the media were transfixed by claims that chlorpromazine, the prototype of all the anti-psychotic medications, could enable mental patients to live on their own in the community, thereby eliminating the unwanted expenses involved in the maintenance of government mental institutions. Although the patients were released and the institutions closed, at that time no provision had been made for the patients once they were released into the community. '''
6
The quotation marks at the end of my comment above are in error.
2
When, when, when are we going to open or re-open psychiatric facilities for these people? These stories are disgraceful, an indictment of every human being in this country. Doesn't anyone remember reading about people needing psychiatric care being chained and treated with firehoses? Left in their own excrement, beaten and starving? Please, someone, tell me where to demonstrate or sign up for the revolution.
16
It is our 'civilized, modern society' which has created prisons and mental hospitals to deal with people who have these kind of problems. And I don't think anyone can say that these institutions have the solutions.
A prison like Rikers is incredibly expensive, damaging to staff and inmates, and only temporarily removes the people from safe neighborhoods.
Mental hospitals can only manage the patients by drugging them.
I think that in much earlier times, when we weren't under the delusion that nature is not in control, the violent and mentally ill would most likely be killed, injured, or shunned.
In my own family there has been death due to accident and cancer. Death is what nature brings when there is such an imbalance. Is that a terrible thing to say?
I also would like for this Michael to not suffer and to find a way to live. But I'm not a believer in the words of politicians and mental health professionals.
A prison like Rikers is incredibly expensive, damaging to staff and inmates, and only temporarily removes the people from safe neighborhoods.
Mental hospitals can only manage the patients by drugging them.
I think that in much earlier times, when we weren't under the delusion that nature is not in control, the violent and mentally ill would most likely be killed, injured, or shunned.
In my own family there has been death due to accident and cancer. Death is what nature brings when there is such an imbalance. Is that a terrible thing to say?
I also would like for this Michael to not suffer and to find a way to live. But I'm not a believer in the words of politicians and mental health professionals.
2
When, when, when are we going to open or re-open psychiatric facilities for these people? These stories are disgraceful, an indictment of every human being in this country. Doesn't anyone remember reading about people needing psychiatric care being chained and treated with firehoses? Left in their own excrement, beaten and starving? Please, someone, tell me where to demonstrate or sign up for the revolution.
18
It is our 'civilized, modern society' which has created prisons and mental hospitals to deal with people who have these kind of problems. And I don't think anyone can say that these institutions have the solutions.
A prison like Rikers is incredibly expensive, damaging to staff and inmates, and only temporarily removes the people from safe neighborhoods.
Mental hospitals can only manage the patients by drugging them.
I think that in much earlier times, when we weren't under the delusion that nature is not in control, the violent and mentally ill would most likely be killed, injured, or shunned.
In my own family there has been death due to accident and cancer. Death is what nature brings when there is such an imbalance. Is that a terrible thing to say?
I also would like for this Michael to not suffer and to find a way to live. But I'm not a believer in the words of politicians and mental health professionals.
A prison like Rikers is incredibly expensive, damaging to staff and inmates, and only temporarily removes the people from safe neighborhoods.
Mental hospitals can only manage the patients by drugging them.
I think that in much earlier times, when we weren't under the delusion that nature is not in control, the violent and mentally ill would most likely be killed, injured, or shunned.
In my own family there has been death due to accident and cancer. Death is what nature brings when there is such an imbalance. Is that a terrible thing to say?
I also would like for this Michael to not suffer and to find a way to live. But I'm not a believer in the words of politicians and mental health professionals.
2
Why lock up the guy who's been robbed of his money, his childhood, and his dignity? His mom bailed on him and this country's two most deadly systems of law and social norm enforcement, criminal justice and psychiatry, exploited her abandonment of him by squandering his childhood on the surveillance, indoctrinating, and drugging that turned him into the "hopeless monster-in-the-making" that he is today. If we're going to put this man away, then we should round up every one of his perpetrators and make them share his psych ward because they're the whack jobs that started this whole mess.
5
Why lock him up? Ask the people he's victimized why he should be locked up. I'm sure he would share your insight that it's always some other "whack job" that started this whole mess, thus his behavior is not his responsibility. When that attitude is accepted, it becomes infectious.
5
Actually, it is others who started this mess....read the article again.
Fern, this man didn't spring from the womb saddled with all of the disadvantages he's battling today. 25 years of being shunted to the margins of society by his family, the "helping professions", and the criminal "justice" have made him what he is right now. His behaviors are understandable are reactions to oppression, betrayal, and heartbreak which means they can be corrected if a caring, committed, competent community steps up to the plate and pulls this man back from the brink of incarceration or death.
The way we treat our mentally ill is barbaric. Apparently, while we may talk a good game, we just want the mentally ill to go away...not cost us money or care.
6
"The way we treat our mentally ill is barbaric." Please specify which mentally ill people. There are people with a lot of money and or good health insurance who are being treated successfully with talk therapy and or meds, and then there are people like Eric Harris, Adam Lanza, Timothy McVeigh and Andreas Lubitz etc.
I know first hand of several cases of depression where meds are pretty well covered; talk therapy may be partially covered by 4 to 10 visits. Not enough. Then there are those who are severely mentally ill (psychotic?) who will not or cannot be relied on to take their medication who have no one to care for them or may be beyond a family's ability to cope. I could go on, but you can get the picture. The well known you name are probably somewhere in the psychotic range (not so sure)...certainly if you dye your hair orange and mumble a lot and buy guns, there's a probable issue....and the solution is not jail.
Chandler, read Dave Cullen's 2000 book 'Columbine'. It seems pretty evident Eric Harris was psychopathic, not psychotic. Psychopathy is a personality disorder, not a mental illness - the condition of having no conscience. Harris, as far as the available evidence shows, perceived reality accurately and knew right from wrong - he just didn't care. Eventually we will undoubtedly find the neurological basis for psychopathy, the brain malfunction that affects the absence of conscience just as we are finding the parts and functions of the brain for language, fear, and other emotional and intellectual responses. Which will raise still other questions regarding our criminal justice system and whether it is just to imprison a man for his crimes if he can present MRIs to prove he was 'born bad'.
1
Why lock up the guy who's been robbed of his money, his childhood, and his dignity? His mom bailed on him and this country's two most deadly systems of law and social norm enforcement, criminal justice and psychiatry, exploited her abandonment of him by squandering his childhood on the surveillance, indoctrinating, and drugging that turned him into the "hopeless monster-in-the-making" that he is today. If we're going to put this man away, then we should round up every one of his perpetrators and make them share his psych ward because they're the whack jobs that started this whole mess.
6
Why lock him up? Ask the people he's victimized why he should be locked up. I'm sure he would share your insight that it's always some other "whack job" that started this whole mess, thus his behavior is not his responsibility. When that attitude is accepted, it becomes infectious.
7
Actually, it is others who started this mess....read the article again.
Fern, this man didn't spring from the womb saddled with all of the disadvantages he's battling today. 25 years of being shunted to the margins of society by his family, the "helping professions", and the criminal "justice" have made him what he is right now. His behaviors are understandable are reactions to oppression, betrayal, and heartbreak which means they can be corrected if a caring, committed, competent community steps up to the plate and pulls this man back from the brink of incarceration or death.
The way we treat our mentally ill is barbaric. Apparently, while we may talk a good game, we just want the mentally ill to go away...not cost us money or care.
6
"The way we treat our mentally ill is barbaric." Please specify which mentally ill people. There are people with a lot of money and or good health insurance who are being treated successfully with talk therapy and or meds, and then there are people like Eric Harris, Adam Lanza, Timothy McVeigh and Andreas Lubitz etc.
I know first hand of several cases of depression where meds are pretty well covered; talk therapy may be partially covered by 4 to 10 visits. Not enough. Then there are those who are severely mentally ill (psychotic?) who will not or cannot be relied on to take their medication who have no one to care for them or may be beyond a family's ability to cope. I could go on, but you can get the picture. The well known you name are probably somewhere in the psychotic range (not so sure)...certainly if you dye your hair orange and mumble a lot and buy guns, there's a probable issue....and the solution is not jail.
Chandler, read Dave Cullen's 2000 book 'Columbine'. It seems pretty evident Eric Harris was psychopathic, not psychotic. Psychopathy is a personality disorder, not a mental illness - the condition of having no conscience. Harris, as far as the available evidence shows, perceived reality accurately and knew right from wrong - he just didn't care. Eventually we will undoubtedly find the neurological basis for psychopathy, the brain malfunction that affects the absence of conscience just as we are finding the parts and functions of the brain for language, fear, and other emotional and intellectual responses. Which will raise still other questions regarding our criminal justice system and whether it is just to imprison a man for his crimes if he can present MRIs to prove he was 'born bad'.
1
Just one small letter,
and still,
Human
is a light year from
Humane.
and still,
Human
is a light year from
Humane.
6
As a 21 y/o college graduate unfamiliar with mental illness, my wife began her early social work career at Kings Park (Long Island) Psychiatric Center. Her social work associate job as it was explained to her was to arrange for discharge of all the patients in Building 93, a total of 900 + men - women were in another building. No experience, it was pretty overwhelming - and she was the only social worker for the building. She worked there doing just that for 2 years before transferring to an outpatient clinic in NYC - the clinic had the job of caring for the aftermath of all the discharges of warehoused "patients" now in single room occupancy hotels or on the street. Most of the patients she helped to leave Kings Park were not mentally ill - many were sober alcoholics who had "jobs" (for little or no wages) taking care of the grounds, washing cars, cleaning on site staff housing and their own buildings, etc. until this little perk was taken away due to it being termed exploitation. Most of these people were far better off remaining in the hospital - some medicated, some not needing anything at all but the knowledge that they had a single room, food and something with low pressure to keep them busy during the day. Some had been there ten-twenty even thirty years and the hospital was home to them. But this type of situation was deemed too expensive and "wrong" - and now we have what we have today.
16
So the story ended on a good note. Well, we all know how most of these stories really end. A gruesome murder and a NYTimes 2-paragraphs article about police arrested a suspect with a history of mental illness. No follow up article, no epiphany that our lenient punishment for the violent mentally illed are putting innocent in danger.
I simply don't understand why so many people keep thinking money should be waste on the criminally insane. I got calls sometime from people that just find out they have cancer and can no longer work. SSDI and SSI won't kick in for a while and since they are not working, they don't have money for rent/mortgage and co-pay for the hospital bills. They have insurance through their job but the bills still add up to a few thousands a month. If we can put out tax dollar to work to help the deservingly needy, we would help a lot more people.
I simply don't understand why so many people keep thinking money should be waste on the criminally insane. I got calls sometime from people that just find out they have cancer and can no longer work. SSDI and SSI won't kick in for a while and since they are not working, they don't have money for rent/mortgage and co-pay for the hospital bills. They have insurance through their job but the bills still add up to a few thousands a month. If we can put out tax dollar to work to help the deservingly needy, we would help a lot more people.
2
The most important obstacle this man faces in his life is the lack of meaningful social relationships. What little human contact he has is short-term and built around controlling his behavior. Should he ever find a place where he can be treated as a human being, the troubles in his life that are being exploited by the NY times in order to make a monster out of him will surely disappear.
1
As horrible as is the institutional torture of this individual, it is only the tip of the iceberg, and nowhere near the worst example of society's tragic failure to cope with the chronically mentally ill.
In 2002 my sister, herself mentally ill and homeless, was murdered - sexually assaulted and then strangled - by another mentally ill homeless person. Because of Reagan's deinstitutionalization policies - themselves little more than a thinly-veiled gambit to save money on the backs of some of the weakest and least well-represented members of society - our family was unable to get my sister the help she so desperately needed. And so she made her home in a ditch in Santa Monica.
The alleged murderer, whose trial is scheduled to start this summer, was well known by both the police and social services agencies where the murder took place. He is also charged with murdering another woman in a similar fashion a year earlier and will be tried for both crimes. If our country had a rational policy for handling people who suffer from mental illness, both of these women would likely be alive today.
What makes the situation all the more tragic is that the tools for stabilizing many of the maladies which lead to dangerous behavior have come a long way in recent years, and could easily be improved with modest investment.
The primary impediment to solutions are mass denial, a perverse interpretation of civil rights, and penny wise/dollar foolish taxpayers.
Absurd and unconscionable.
In 2002 my sister, herself mentally ill and homeless, was murdered - sexually assaulted and then strangled - by another mentally ill homeless person. Because of Reagan's deinstitutionalization policies - themselves little more than a thinly-veiled gambit to save money on the backs of some of the weakest and least well-represented members of society - our family was unable to get my sister the help she so desperately needed. And so she made her home in a ditch in Santa Monica.
The alleged murderer, whose trial is scheduled to start this summer, was well known by both the police and social services agencies where the murder took place. He is also charged with murdering another woman in a similar fashion a year earlier and will be tried for both crimes. If our country had a rational policy for handling people who suffer from mental illness, both of these women would likely be alive today.
What makes the situation all the more tragic is that the tools for stabilizing many of the maladies which lead to dangerous behavior have come a long way in recent years, and could easily be improved with modest investment.
The primary impediment to solutions are mass denial, a perverse interpretation of civil rights, and penny wise/dollar foolish taxpayers.
Absurd and unconscionable.
16
Try an experiment--if you think you can take it--and spend a day watching what passes for entertainment on numerous television stations. You know, all those courtroom shows, or lie-detector shows, or DNA shows just to start. Count the number of unemployed, disabled, unwed parents, ex-convicts, uninsured or unlicensed drivers, the homeless, the drug-addled. Count the number of bi-polar, schizophrenic individuals who are the meat and potatos for our entertainment pleasure. Note the number of tatooed, pierced, inappropriately dressed. Note, too, the languages employed. Then reflect on what all of this says about the quality of life for millions of the citizens of the world's greatest superpower. Or...just do as many viewers no doubt do and blame the victims.
4
Mental illness is real.
Mental illness is not a crime.
Mental illness needs to be treated.
Mental illness cannot be treated properly within the correctional system.
The correctional system perpetuates mental illness.
Health care is costly. Filling the correctional system with sick people is more costly.
Incarceration is the only legal form of slavery in this country.
End enslavement of the mentally ill now. Restore health. Restore dignity.
Mental illness is not a crime.
Mental illness needs to be treated.
Mental illness cannot be treated properly within the correctional system.
The correctional system perpetuates mental illness.
Health care is costly. Filling the correctional system with sick people is more costly.
Incarceration is the only legal form of slavery in this country.
End enslavement of the mentally ill now. Restore health. Restore dignity.
9
Mental illness is not a crime in itself. Breaking the law, whether you are mentally ill or not is a crime. Of course there are mentally ill who break nonviolent laws and then there are mentally ill who are sociopaths who commit mass murder.
1
This young man is sick, and he is often violent and disgusting. As far as I know, placing him in solitary confinement would only worsen his disease. The beatings certainly can't help either. Throwing feces is something caged monkeys and apes often do. Doesn't that say something about how very ill this man is? I don't think the Psychiatrists really know that much about the practice they preach. Some way, some day, perhaps we'll throw away a lot of the drugs and try pure, old fashioned love, nutrition, rest and meaningful work for these people...with a home some place where they feel safe.
6
Until we are willing to commit resources to people like Mr. Megginson we will never come close to being the country we wish to be. As early as six---a first grader---there were serious signs of mental illness. Almost twenty years later his life has been so horrific it is hard to imagine this is the life of a young adult in America. May each of us do more than shed a tear for him as we read this article. Let us demand from our local, state, and federal legislators that treating mental illness be made a top priority.
2
America spends copious amount of money on mental health research and mental health treatments, yet it has the most number of people with depression, psychosis, aggression problems, alcoholism, drug problems, teen problems, domestic violence, rape, conduct disorder problems...You know why? Americans have forgotten the value of "love, attachment, reliable caring sensitivity, sacrifice for relationships..and good neighborhoods"...that give boys and girls a sense of security, being wanted, being special and being important, needed and having needs met. American society, I saw up close, creates madness, craziness, rage (in women, minorities and immigrants)...when white men have it all and others just struggle, deteriorate, deviate and have to put up with punitiveness. That is why feminists have been saying for a long time, patriarchy destroys...and destroys, destroys and destroys. It is not order, law, discipline or direction...the Western world is about control, authority, compliance and obedience. Mr. Megginson is a Black man, probably more intelligent, more confident and more observant than others his peers and cohorts. So the insults from within, outside, racism, neglect, abuse, verbal abuse, deprivation, depravity, poverty, physical abuse, insensitivity, cruelty, cruelty and more cruelty...would drive anyone mad - literally.
He is sick...because your society, the Western world and the Western man (his thinking, his being and his DNA) are sick.
He is sick...because your society, the Western world and the Western man (his thinking, his being and his DNA) are sick.
5
What? How do you know Mr Megginson is more intelligent, more confident and more observant than others his peers and cohorts? Are you just making up stories to fit your narratives? What if he is a white male from a good family? Your entire made up theory collapse then doesn't it?
3
Really - - -He knocked his mothers teeth out and then tried to stab her . . .
you are missing the point; he needs services due to his mental ilness . not political rhetoric .
you are missing the point; he needs services due to his mental ilness . not political rhetoric .
5
Mark, you were doing great until you let your astute observation of our non-existent standards of social responsibility devolve into a misogynistic rant. "Women" didn't fail this man. We all sealed his fate.
Just one small letter,
and still,
Human
is a light year from
Humane.
and still,
Human
is a light year from
Humane.
7
As a 21 y/o college graduate unfamiliar with mental illness, my wife began her early social work career at Kings Park (Long Island) Psychiatric Center. Her social work associate job as it was explained to her was to arrange for discharge of all the patients in Building 93, a total of 900 + men - women were in another building. No experience, it was pretty overwhelming - and she was the only social worker for the building. She worked there doing just that for 2 years before transferring to an outpatient clinic in NYC - the clinic had the job of caring for the aftermath of all the discharges of warehoused "patients" now in single room occupancy hotels or on the street. Most of the patients she helped to leave Kings Park were not mentally ill - many were sober alcoholics who had "jobs" (for little or no wages) taking care of the grounds, washing cars, cleaning on site staff housing and their own buildings, etc. until this little perk was taken away due to it being termed exploitation. Most of these people were far better off remaining in the hospital - some medicated, some not needing anything at all but the knowledge that they had a single room, food and something with low pressure to keep them busy during the day. Some had been there ten-twenty even thirty years and the hospital was home to them. But this type of situation was deemed too expensive and "wrong" - and now we have what we have today.
17
So the story ended on a good note. Well, we all know how most of these stories really end. A gruesome murder and a NYTimes 2-paragraphs article about police arrested a suspect with a history of mental illness. No follow up article, no epiphany that our lenient punishment for the violent mentally illed are putting innocent in danger.
I simply don't understand why so many people keep thinking money should be waste on the criminally insane. I got calls sometime from people that just find out they have cancer and can no longer work. SSDI and SSI won't kick in for a while and since they are not working, they don't have money for rent/mortgage and co-pay for the hospital bills. They have insurance through their job but the bills still add up to a few thousands a month. If we can put out tax dollar to work to help the deservingly needy, we would help a lot more people.
I simply don't understand why so many people keep thinking money should be waste on the criminally insane. I got calls sometime from people that just find out they have cancer and can no longer work. SSDI and SSI won't kick in for a while and since they are not working, they don't have money for rent/mortgage and co-pay for the hospital bills. They have insurance through their job but the bills still add up to a few thousands a month. If we can put out tax dollar to work to help the deservingly needy, we would help a lot more people.
2
The most important obstacle this man faces in his life is the lack of meaningful social relationships. What little human contact he has is short-term and built around controlling his behavior. Should he ever find a place where he can be treated as a human being, the troubles in his life that are being exploited by the NY times in order to make a monster out of him will surely disappear.
1
As horrible as is the institutional torture of this individual, it is only the tip of the iceberg, and nowhere near the worst example of society's tragic failure to cope with the chronically mentally ill.
In 2002 my sister, herself mentally ill and homeless, was murdered - sexually assaulted and then strangled - by another mentally ill homeless person. Because of Reagan's deinstitutionalization policies - themselves little more than a thinly-veiled gambit to save money on the backs of some of the weakest and least well-represented members of society - our family was unable to get my sister the help she so desperately needed. And so she made her home in a ditch in Santa Monica.
The alleged murderer, whose trial is scheduled to start this summer, was well known by both the police and social services agencies where the murder took place. He is also charged with murdering another woman in a similar fashion a year earlier and will be tried for both crimes. If our country had a rational policy for handling people who suffer from mental illness, both of these women would likely be alive today.
What makes the situation all the more tragic is that the tools for stabilizing many of the maladies which lead to dangerous behavior have come a long way in recent years, and could easily be improved with modest investment.
The primary impediment to solutions are mass denial, a perverse interpretation of civil rights, and penny wise/dollar foolish taxpayers.
Absurd and unconscionable.
In 2002 my sister, herself mentally ill and homeless, was murdered - sexually assaulted and then strangled - by another mentally ill homeless person. Because of Reagan's deinstitutionalization policies - themselves little more than a thinly-veiled gambit to save money on the backs of some of the weakest and least well-represented members of society - our family was unable to get my sister the help she so desperately needed. And so she made her home in a ditch in Santa Monica.
The alleged murderer, whose trial is scheduled to start this summer, was well known by both the police and social services agencies where the murder took place. He is also charged with murdering another woman in a similar fashion a year earlier and will be tried for both crimes. If our country had a rational policy for handling people who suffer from mental illness, both of these women would likely be alive today.
What makes the situation all the more tragic is that the tools for stabilizing many of the maladies which lead to dangerous behavior have come a long way in recent years, and could easily be improved with modest investment.
The primary impediment to solutions are mass denial, a perverse interpretation of civil rights, and penny wise/dollar foolish taxpayers.
Absurd and unconscionable.
23
Try an experiment--if you think you can take it--and spend a day watching what passes for entertainment on numerous television stations. You know, all those courtroom shows, or lie-detector shows, or DNA shows just to start. Count the number of unemployed, disabled, unwed parents, ex-convicts, uninsured or unlicensed drivers, the homeless, the drug-addled. Count the number of bi-polar, schizophrenic individuals who are the meat and potatos for our entertainment pleasure. Note the number of tatooed, pierced, inappropriately dressed. Note, too, the languages employed. Then reflect on what all of this says about the quality of life for millions of the citizens of the world's greatest superpower. Or...just do as many viewers no doubt do and blame the victims.
4
Mental illness is real.
Mental illness is not a crime.
Mental illness needs to be treated.
Mental illness cannot be treated properly within the correctional system.
The correctional system perpetuates mental illness.
Health care is costly. Filling the correctional system with sick people is more costly.
Incarceration is the only legal form of slavery in this country.
End enslavement of the mentally ill now. Restore health. Restore dignity.
Mental illness is not a crime.
Mental illness needs to be treated.
Mental illness cannot be treated properly within the correctional system.
The correctional system perpetuates mental illness.
Health care is costly. Filling the correctional system with sick people is more costly.
Incarceration is the only legal form of slavery in this country.
End enslavement of the mentally ill now. Restore health. Restore dignity.
12
Mental illness is not a crime in itself. Breaking the law, whether you are mentally ill or not is a crime. Of course there are mentally ill who break nonviolent laws and then there are mentally ill who are sociopaths who commit mass murder.
2
This young man is sick, and he is often violent and disgusting. As far as I know, placing him in solitary confinement would only worsen his disease. The beatings certainly can't help either. Throwing feces is something caged monkeys and apes often do. Doesn't that say something about how very ill this man is? I don't think the Psychiatrists really know that much about the practice they preach. Some way, some day, perhaps we'll throw away a lot of the drugs and try pure, old fashioned love, nutrition, rest and meaningful work for these people...with a home some place where they feel safe.
10
Until we are willing to commit resources to people like Mr. Megginson we will never come close to being the country we wish to be. As early as six---a first grader---there were serious signs of mental illness. Almost twenty years later his life has been so horrific it is hard to imagine this is the life of a young adult in America. May each of us do more than shed a tear for him as we read this article. Let us demand from our local, state, and federal legislators that treating mental illness be made a top priority.
2
America spends copious amount of money on mental health research and mental health treatments, yet it has the most number of people with depression, psychosis, aggression problems, alcoholism, drug problems, teen problems, domestic violence, rape, conduct disorder problems...You know why? Americans have forgotten the value of "love, attachment, reliable caring sensitivity, sacrifice for relationships..and good neighborhoods"...that give boys and girls a sense of security, being wanted, being special and being important, needed and having needs met. American society, I saw up close, creates madness, craziness, rage (in women, minorities and immigrants)...when white men have it all and others just struggle, deteriorate, deviate and have to put up with punitiveness. That is why feminists have been saying for a long time, patriarchy destroys...and destroys, destroys and destroys. It is not order, law, discipline or direction...the Western world is about control, authority, compliance and obedience. Mr. Megginson is a Black man, probably more intelligent, more confident and more observant than others his peers and cohorts. So the insults from within, outside, racism, neglect, abuse, verbal abuse, deprivation, depravity, poverty, physical abuse, insensitivity, cruelty, cruelty and more cruelty...would drive anyone mad - literally.
He is sick...because your society, the Western world and the Western man (his thinking, his being and his DNA) are sick.
He is sick...because your society, the Western world and the Western man (his thinking, his being and his DNA) are sick.
5
What? How do you know Mr Megginson is more intelligent, more confident and more observant than others his peers and cohorts? Are you just making up stories to fit your narratives? What if he is a white male from a good family? Your entire made up theory collapse then doesn't it?
3
Really - - -He knocked his mothers teeth out and then tried to stab her . . .
you are missing the point; he needs services due to his mental ilness . not political rhetoric .
you are missing the point; he needs services due to his mental ilness . not political rhetoric .
5
Mark, you were doing great until you let your astute observation of our non-existent standards of social responsibility devolve into a misogynistic rant. "Women" didn't fail this man. We all sealed his fate.
1
De institutionalizing and shutting down mental care facilities was a "cost cutting." measure. How'd that turn out?
Now the mentally ill are thrown in jail at $50 K a year much more than when they were in mental health. Proving once again that policy makers have absolutely NO idea about the outcomes of their decisions. Just look at the Seattle "Big Bertha Drill" catastrophe which I am certain in the end will actually bankrupt the Emerald City.
Now the mentally ill are thrown in jail at $50 K a year much more than when they were in mental health. Proving once again that policy makers have absolutely NO idea about the outcomes of their decisions. Just look at the Seattle "Big Bertha Drill" catastrophe which I am certain in the end will actually bankrupt the Emerald City.
3
After spending 18+% GDP on our national medical expenses and still left with horrible care for tens of millions I have come to the obvious conclusion that we need socialized medical care paid for by a VAT and capped at 15% GDP. After the initial shock to our mindsets, we would all sleep better knowing that everyone will be taken care of, including Mr. Megginson.
3
What is missing is a strong advocacy organization for the mentally ill, from the worker who is depressed and doesn't have adequate insurance coverage for a psychiatrist, to people with Medicaid who don't have adequate care available at community clinics, to the chronically mentally ill and complex, like Mr. Megginson. The voluntary hospitals and most psychiatrists in private practice want to serve people with commercial insurance or who pay "out of pocket." The public systems respond to political decisions that give money. There is virtually no meaningful political pressure brought to bear on state and city decision-makers who could assist the mental health systems. As a result, crucial services are absent and those that exist are shrinking. The bell is tolling; no one is listening.
5
This story could almost be our family's.
How is a mentally ill person able to decide for themselves if the organ they need to make that decision is the organ that is not functioning properly?
That is frankly, insane.
In order to get anyone mental health assistance, they need to be so out of touch with reality, that once they go past that invisible line, there is no possible way to reach them in order for them to make a sensible decision for themselves.
My child is in the mid 30's and for the last 20 years, it's been a life of extreme ups and downs, stints in jail, countless hospital admissions, homelessness, severe depression, inability to relate to others, paranoia, bouts of schizophrenia, poor decision making, inability to hold down any type of job, short frustration level, poor self esteem, etc. The list is endless.
Can you imagine having a chronic disease for over 20 years? How incredibly difficult and tiring that must be with no end in sight?
The mental health community and society at large must change the way the mentally ill person is treated. It must be pro-active. It must communicate with family members who wish to be involved (we always have and even now we are never called when something goes right or wrong) and there must be long-term hospital stays for those with severe disabilities.
I sincerely hope something is done soon to change the method we treat the mentally ill because throwing them in jail is not the answer.
How is a mentally ill person able to decide for themselves if the organ they need to make that decision is the organ that is not functioning properly?
That is frankly, insane.
In order to get anyone mental health assistance, they need to be so out of touch with reality, that once they go past that invisible line, there is no possible way to reach them in order for them to make a sensible decision for themselves.
My child is in the mid 30's and for the last 20 years, it's been a life of extreme ups and downs, stints in jail, countless hospital admissions, homelessness, severe depression, inability to relate to others, paranoia, bouts of schizophrenia, poor decision making, inability to hold down any type of job, short frustration level, poor self esteem, etc. The list is endless.
Can you imagine having a chronic disease for over 20 years? How incredibly difficult and tiring that must be with no end in sight?
The mental health community and society at large must change the way the mentally ill person is treated. It must be pro-active. It must communicate with family members who wish to be involved (we always have and even now we are never called when something goes right or wrong) and there must be long-term hospital stays for those with severe disabilities.
I sincerely hope something is done soon to change the method we treat the mentally ill because throwing them in jail is not the answer.
11
The one thing America is apparently still good at is locking people up for profit; with crime rates falling to historic lows we still have over 2 million people in custody. Why because it profitable to keep people in prison and even the mentally ill will do, bodies guilty or innocent caught up in the system equates to jobs, construction, and profit. It’s not a war on drugs; it’s actually a war on the American people especially the poor that can’t afford good representation.
3
Mothers abandoned by husbands. Leaving children vulnerable. But this is the thing that goes into the heart. Men don't see this moment but men should know it. The price of indifference is your child. Woman cannot take responsibility. It is up to the man.
“She says a lot of hurtful things, disrespectful things,” he said, “like ‘Oh I wish you wasn’t my son,’ or ‘I wish I got, you know, I almost got an abortion when you was born, I should’ve did it.’ ”
His mother disputed this, saying she was thrilled when she found out she was having a boy.
“She says a lot of hurtful things, disrespectful things,” he said, “like ‘Oh I wish you wasn’t my son,’ or ‘I wish I got, you know, I almost got an abortion when you was born, I should’ve did it.’ ”
His mother disputed this, saying she was thrilled when she found out she was having a boy.
I think you may not have much experience with the mentally ill. They do not always perceive reality. Many times over the years I and my parents were shocked and dismayed to hear my sister say we 'said' or 'did' something that we knew we had not said or done, but which she had seen or heard from someone else and attributed to us - for instance, she might have seen a picture of a woman playing a harp and go into a sudden screaming tirade about how Mum or I had told her she had to learn to play the harp or she wouldn't be a feminine woman. What? huh? It's entirely possible this poor man is attributing to her things said by others, or by his own inner insecurities.
People who don't live with mental illness don't know and there's no way to explain.
People who don't live with mental illness don't know and there's no way to explain.
6
The tragedy is that 1950 mental hospitals were kinder than the modern day freedom gibberish we accept now. We need a vast hospital system.
13
Many of the mental health institutions which were closed have been characterized as "snake pits," no less destructive to the individual psyche as Rikers Island. The sad, unalterable reality is that our prisons and jail have become the mental institutions of last resort for the homeless and indigent, and they are no less "snake pits," than the institutions which they replaced!
In Pennsylvania there were two administrative efforts one under former Gov. Tom Ridge and another under Gov. Rendell. Both of these men were responding to the criticism of the day suggesting the clinical care in a private setting could be more effective than state operated mental facilities. The Republicans wanted to reduce the cost of the state hospitals and believed, wrongly, that private organizations would be available and well funded enough to take care of long term mental and otherwise incapacitated persons. The Democrats offered the hope that better treatment would result from people removed from permanent incarceration at state cost and would give people more freedom and opportunity as well as reduced costs to the state budgets.
Both view points were tragically wrong and misguided. Worse, people who were arrested for mental or drug abuse problems were ordered to prisons, rather than state hospitals. The prisons of course, had no experience and no means to treat people with mental, drug or other non-criminal disorders. The result was abuse, neglect and destruction of lives and hope. The exact opposite of what was promised by politicians.
We need to restore state facilities and reform the criminal judicial process and system. We must educate prosecutors, judges and lawyers about the special needs and special handling that must be available and administered by those unfortunate enough to be thrown unjustly into the criminal justice system with no alternative.
Both view points were tragically wrong and misguided. Worse, people who were arrested for mental or drug abuse problems were ordered to prisons, rather than state hospitals. The prisons of course, had no experience and no means to treat people with mental, drug or other non-criminal disorders. The result was abuse, neglect and destruction of lives and hope. The exact opposite of what was promised by politicians.
We need to restore state facilities and reform the criminal judicial process and system. We must educate prosecutors, judges and lawyers about the special needs and special handling that must be available and administered by those unfortunate enough to be thrown unjustly into the criminal justice system with no alternative.
10
A pill is not enough. These people need to be constantly monitored and counseled. So many do not take their medications, especially if they want to consume alcoholic beverages; others might overdose. We do not know the long-term side effects of these potent drugs. Having been in the ER tratment area several times recently, I've observed a recidivistic cycle. It's so sad that the front-line people just shrug their shoulders with their facial expressions saying "not him again".
3
Thanks to the New York Times for focusing on mental illness over the last several months. This is an excellent well researched article highlighting the issues of mental illness. It is a complex problem and while community programs such as ACT, which is all over the world now having originated in the 70's in Wisconsin, are fantastic and have done a lot of good for many people there are also instances when hospitalization must be used instead to restore mental health. And what society needs to realize is that mental illness is life long often having major incidents as what has been described in this article which then require intensive therapy. Hospitalization may be what is necessary to get the individual back on track. Jail is not the answer but psychiatric institutions do require specialized facilities and approaches for people who are also violent or displaying severe psychosis with the aim of returning to the community and leading productive lives.
1
If you want the background on how the our country ended up closing our mental institutions, at least the bulk of them, NYT has a very well written and researched article, link listed below. Simply stated, they where closed to save money. No finger pointing on this one, bipartisan support for the closures.
http://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients...
I have a dog in this hunt. I cared for my brother Clifford until his passing for over 25 years. Diagnosed as paranoid schizophrenic and mentally challenged he spent his life in marginal nursing homes, some jail time and rarely, in two week stints in hospital psych units as insurance would allow. Conditions in the nursing homes would range from marginal to disgraceful. It was a constant and albeit expensive battle to find him facilities that would even accept him, much less care for him, even in a minimalist fashion. Our mentally ill citizens deserve far better treatment than we are providing them. Pardon my French, but, its a goddamn travesty how the wealthiest country on earth treats its mentally ill. We have it backwards here in the good ole US of A. Our representatives need to redirect OUR tax dollars away from building new prisons, stockpiling equipment and weapons with our law enforcement, funding corporate owned nursing homes and prisons and direct funds to building facilities that can provide a better quality of life for our neediest.
http://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients...
I have a dog in this hunt. I cared for my brother Clifford until his passing for over 25 years. Diagnosed as paranoid schizophrenic and mentally challenged he spent his life in marginal nursing homes, some jail time and rarely, in two week stints in hospital psych units as insurance would allow. Conditions in the nursing homes would range from marginal to disgraceful. It was a constant and albeit expensive battle to find him facilities that would even accept him, much less care for him, even in a minimalist fashion. Our mentally ill citizens deserve far better treatment than we are providing them. Pardon my French, but, its a goddamn travesty how the wealthiest country on earth treats its mentally ill. We have it backwards here in the good ole US of A. Our representatives need to redirect OUR tax dollars away from building new prisons, stockpiling equipment and weapons with our law enforcement, funding corporate owned nursing homes and prisons and direct funds to building facilities that can provide a better quality of life for our neediest.
23
"For the last four decades, the push in the mental health field has been to close these hospitals. Since a 1970s Supreme Court ruling that was meant to protect civil liberties, only the very sickest patients can be involuntarily held for an extended period."
This policy needs to be re-visited. We have been talking about this for years and every time there is another incident it comes up again. Throwing the mentally ill in prison is the real crime. I know people who are mentally ill and not violent and when they have psychotic episodes they sometime have to wait days or weeks to even get a bed in a medical facility where they can be stabilized. The longer it takes to find a place for them, the worse they get. The amount it costs to treat a person later rather than sooner, is far greater that what it would cost to build proper mental health facilities. Imagine if there had been a bed for Adam Lanza or the Aurora shooter. Family members generally do all they can, as in this case, where he was hospitalized as young as 6, but there just aren't facilities to help them, until they end up in the criminal justice system.
This policy needs to be re-visited. We have been talking about this for years and every time there is another incident it comes up again. Throwing the mentally ill in prison is the real crime. I know people who are mentally ill and not violent and when they have psychotic episodes they sometime have to wait days or weeks to even get a bed in a medical facility where they can be stabilized. The longer it takes to find a place for them, the worse they get. The amount it costs to treat a person later rather than sooner, is far greater that what it would cost to build proper mental health facilities. Imagine if there had been a bed for Adam Lanza or the Aurora shooter. Family members generally do all they can, as in this case, where he was hospitalized as young as 6, but there just aren't facilities to help them, until they end up in the criminal justice system.
11
It is so sad that, as the demand for "beds" continues, the new governor of the Commonwealth of Massachusetts, Charlie Baker, is slashing the budget of the only treatment facility we have in this region.
8
This is just heartbreaking. Aghh, just so sad and depressing how systemic this problem is. Prayers for this young men.
9
De institutionalizing and shutting down mental care facilities was a "cost cutting." measure. How'd that turn out?
Now the mentally ill are thrown in jail at $50 K a year much more than when they were in mental health. Proving once again that policy makers have absolutely NO idea about the outcomes of their decisions. Just look at the Seattle "Big Bertha Drill" catastrophe which I am certain in the end will actually bankrupt the Emerald City.
Now the mentally ill are thrown in jail at $50 K a year much more than when they were in mental health. Proving once again that policy makers have absolutely NO idea about the outcomes of their decisions. Just look at the Seattle "Big Bertha Drill" catastrophe which I am certain in the end will actually bankrupt the Emerald City.
3
After spending 18+% GDP on our national medical expenses and still left with horrible care for tens of millions I have come to the obvious conclusion that we need socialized medical care paid for by a VAT and capped at 15% GDP. After the initial shock to our mindsets, we would all sleep better knowing that everyone will be taken care of, including Mr. Megginson.
3
What is missing is a strong advocacy organization for the mentally ill, from the worker who is depressed and doesn't have adequate insurance coverage for a psychiatrist, to people with Medicaid who don't have adequate care available at community clinics, to the chronically mentally ill and complex, like Mr. Megginson. The voluntary hospitals and most psychiatrists in private practice want to serve people with commercial insurance or who pay "out of pocket." The public systems respond to political decisions that give money. There is virtually no meaningful political pressure brought to bear on state and city decision-makers who could assist the mental health systems. As a result, crucial services are absent and those that exist are shrinking. The bell is tolling; no one is listening.
5
This story could almost be our family's.
How is a mentally ill person able to decide for themselves if the organ they need to make that decision is the organ that is not functioning properly?
That is frankly, insane.
In order to get anyone mental health assistance, they need to be so out of touch with reality, that once they go past that invisible line, there is no possible way to reach them in order for them to make a sensible decision for themselves.
My child is in the mid 30's and for the last 20 years, it's been a life of extreme ups and downs, stints in jail, countless hospital admissions, homelessness, severe depression, inability to relate to others, paranoia, bouts of schizophrenia, poor decision making, inability to hold down any type of job, short frustration level, poor self esteem, etc. The list is endless.
Can you imagine having a chronic disease for over 20 years? How incredibly difficult and tiring that must be with no end in sight?
The mental health community and society at large must change the way the mentally ill person is treated. It must be pro-active. It must communicate with family members who wish to be involved (we always have and even now we are never called when something goes right or wrong) and there must be long-term hospital stays for those with severe disabilities.
I sincerely hope something is done soon to change the method we treat the mentally ill because throwing them in jail is not the answer.
How is a mentally ill person able to decide for themselves if the organ they need to make that decision is the organ that is not functioning properly?
That is frankly, insane.
In order to get anyone mental health assistance, they need to be so out of touch with reality, that once they go past that invisible line, there is no possible way to reach them in order for them to make a sensible decision for themselves.
My child is in the mid 30's and for the last 20 years, it's been a life of extreme ups and downs, stints in jail, countless hospital admissions, homelessness, severe depression, inability to relate to others, paranoia, bouts of schizophrenia, poor decision making, inability to hold down any type of job, short frustration level, poor self esteem, etc. The list is endless.
Can you imagine having a chronic disease for over 20 years? How incredibly difficult and tiring that must be with no end in sight?
The mental health community and society at large must change the way the mentally ill person is treated. It must be pro-active. It must communicate with family members who wish to be involved (we always have and even now we are never called when something goes right or wrong) and there must be long-term hospital stays for those with severe disabilities.
I sincerely hope something is done soon to change the method we treat the mentally ill because throwing them in jail is not the answer.
13
The one thing America is apparently still good at is locking people up for profit; with crime rates falling to historic lows we still have over 2 million people in custody. Why because it profitable to keep people in prison and even the mentally ill will do, bodies guilty or innocent caught up in the system equates to jobs, construction, and profit. It’s not a war on drugs; it’s actually a war on the American people especially the poor that can’t afford good representation.
3
Mothers abandoned by husbands. Leaving children vulnerable. But this is the thing that goes into the heart. Men don't see this moment but men should know it. The price of indifference is your child. Woman cannot take responsibility. It is up to the man.
“She says a lot of hurtful things, disrespectful things,” he said, “like ‘Oh I wish you wasn’t my son,’ or ‘I wish I got, you know, I almost got an abortion when you was born, I should’ve did it.’ ”
His mother disputed this, saying she was thrilled when she found out she was having a boy.
“She says a lot of hurtful things, disrespectful things,” he said, “like ‘Oh I wish you wasn’t my son,’ or ‘I wish I got, you know, I almost got an abortion when you was born, I should’ve did it.’ ”
His mother disputed this, saying she was thrilled when she found out she was having a boy.
1
I think you may not have much experience with the mentally ill. They do not always perceive reality. Many times over the years I and my parents were shocked and dismayed to hear my sister say we 'said' or 'did' something that we knew we had not said or done, but which she had seen or heard from someone else and attributed to us - for instance, she might have seen a picture of a woman playing a harp and go into a sudden screaming tirade about how Mum or I had told her she had to learn to play the harp or she wouldn't be a feminine woman. What? huh? It's entirely possible this poor man is attributing to her things said by others, or by his own inner insecurities.
People who don't live with mental illness don't know and there's no way to explain.
People who don't live with mental illness don't know and there's no way to explain.
8
The tragedy is that 1950 mental hospitals were kinder than the modern day freedom gibberish we accept now. We need a vast hospital system.
13
Many of the mental health institutions which were closed have been characterized as "snake pits," no less destructive to the individual psyche as Rikers Island. The sad, unalterable reality is that our prisons and jail have become the mental institutions of last resort for the homeless and indigent, and they are no less "snake pits," than the institutions which they replaced!
1
In Pennsylvania there were two administrative efforts one under former Gov. Tom Ridge and another under Gov. Rendell. Both of these men were responding to the criticism of the day suggesting the clinical care in a private setting could be more effective than state operated mental facilities. The Republicans wanted to reduce the cost of the state hospitals and believed, wrongly, that private organizations would be available and well funded enough to take care of long term mental and otherwise incapacitated persons. The Democrats offered the hope that better treatment would result from people removed from permanent incarceration at state cost and would give people more freedom and opportunity as well as reduced costs to the state budgets.
Both view points were tragically wrong and misguided. Worse, people who were arrested for mental or drug abuse problems were ordered to prisons, rather than state hospitals. The prisons of course, had no experience and no means to treat people with mental, drug or other non-criminal disorders. The result was abuse, neglect and destruction of lives and hope. The exact opposite of what was promised by politicians.
We need to restore state facilities and reform the criminal judicial process and system. We must educate prosecutors, judges and lawyers about the special needs and special handling that must be available and administered by those unfortunate enough to be thrown unjustly into the criminal justice system with no alternative.
Both view points were tragically wrong and misguided. Worse, people who were arrested for mental or drug abuse problems were ordered to prisons, rather than state hospitals. The prisons of course, had no experience and no means to treat people with mental, drug or other non-criminal disorders. The result was abuse, neglect and destruction of lives and hope. The exact opposite of what was promised by politicians.
We need to restore state facilities and reform the criminal judicial process and system. We must educate prosecutors, judges and lawyers about the special needs and special handling that must be available and administered by those unfortunate enough to be thrown unjustly into the criminal justice system with no alternative.
11
A pill is not enough. These people need to be constantly monitored and counseled. So many do not take their medications, especially if they want to consume alcoholic beverages; others might overdose. We do not know the long-term side effects of these potent drugs. Having been in the ER tratment area several times recently, I've observed a recidivistic cycle. It's so sad that the front-line people just shrug their shoulders with their facial expressions saying "not him again".
3
Thanks to the New York Times for focusing on mental illness over the last several months. This is an excellent well researched article highlighting the issues of mental illness. It is a complex problem and while community programs such as ACT, which is all over the world now having originated in the 70's in Wisconsin, are fantastic and have done a lot of good for many people there are also instances when hospitalization must be used instead to restore mental health. And what society needs to realize is that mental illness is life long often having major incidents as what has been described in this article which then require intensive therapy. Hospitalization may be what is necessary to get the individual back on track. Jail is not the answer but psychiatric institutions do require specialized facilities and approaches for people who are also violent or displaying severe psychosis with the aim of returning to the community and leading productive lives.
1
If you want the background on how the our country ended up closing our mental institutions, at least the bulk of them, NYT has a very well written and researched article, link listed below. Simply stated, they where closed to save money. No finger pointing on this one, bipartisan support for the closures.
http://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients...
I have a dog in this hunt. I cared for my brother Clifford until his passing for over 25 years. Diagnosed as paranoid schizophrenic and mentally challenged he spent his life in marginal nursing homes, some jail time and rarely, in two week stints in hospital psych units as insurance would allow. Conditions in the nursing homes would range from marginal to disgraceful. It was a constant and albeit expensive battle to find him facilities that would even accept him, much less care for him, even in a minimalist fashion. Our mentally ill citizens deserve far better treatment than we are providing them. Pardon my French, but, its a goddamn travesty how the wealthiest country on earth treats its mentally ill. We have it backwards here in the good ole US of A. Our representatives need to redirect OUR tax dollars away from building new prisons, stockpiling equipment and weapons with our law enforcement, funding corporate owned nursing homes and prisons and direct funds to building facilities that can provide a better quality of life for our neediest.
http://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients...
I have a dog in this hunt. I cared for my brother Clifford until his passing for over 25 years. Diagnosed as paranoid schizophrenic and mentally challenged he spent his life in marginal nursing homes, some jail time and rarely, in two week stints in hospital psych units as insurance would allow. Conditions in the nursing homes would range from marginal to disgraceful. It was a constant and albeit expensive battle to find him facilities that would even accept him, much less care for him, even in a minimalist fashion. Our mentally ill citizens deserve far better treatment than we are providing them. Pardon my French, but, its a goddamn travesty how the wealthiest country on earth treats its mentally ill. We have it backwards here in the good ole US of A. Our representatives need to redirect OUR tax dollars away from building new prisons, stockpiling equipment and weapons with our law enforcement, funding corporate owned nursing homes and prisons and direct funds to building facilities that can provide a better quality of life for our neediest.
32
"For the last four decades, the push in the mental health field has been to close these hospitals. Since a 1970s Supreme Court ruling that was meant to protect civil liberties, only the very sickest patients can be involuntarily held for an extended period."
This policy needs to be re-visited. We have been talking about this for years and every time there is another incident it comes up again. Throwing the mentally ill in prison is the real crime. I know people who are mentally ill and not violent and when they have psychotic episodes they sometime have to wait days or weeks to even get a bed in a medical facility where they can be stabilized. The longer it takes to find a place for them, the worse they get. The amount it costs to treat a person later rather than sooner, is far greater that what it would cost to build proper mental health facilities. Imagine if there had been a bed for Adam Lanza or the Aurora shooter. Family members generally do all they can, as in this case, where he was hospitalized as young as 6, but there just aren't facilities to help them, until they end up in the criminal justice system.
This policy needs to be re-visited. We have been talking about this for years and every time there is another incident it comes up again. Throwing the mentally ill in prison is the real crime. I know people who are mentally ill and not violent and when they have psychotic episodes they sometime have to wait days or weeks to even get a bed in a medical facility where they can be stabilized. The longer it takes to find a place for them, the worse they get. The amount it costs to treat a person later rather than sooner, is far greater that what it would cost to build proper mental health facilities. Imagine if there had been a bed for Adam Lanza or the Aurora shooter. Family members generally do all they can, as in this case, where he was hospitalized as young as 6, but there just aren't facilities to help them, until they end up in the criminal justice system.
13
It is so sad that, as the demand for "beds" continues, the new governor of the Commonwealth of Massachusetts, Charlie Baker, is slashing the budget of the only treatment facility we have in this region.
8
This is just heartbreaking. Aghh, just so sad and depressing how systemic this problem is. Prayers for this young men.
9
This country has a serious need for long term, permanent, mental health commitments. Until this country recognizes that fact, then people in the situation like this poor guy will be drifting in and out of jail, prison and mental health institutions, because no one wants to care for anyone who cannot care for themselves anymore. Drugs are fine, but if the person can not be trusted to self medicate themselves, how can they be put back onto the streets, until the eventual occurs and they kill someone or are killed themselves.
24
This country has a serious need for long term, permanent, mental health commitments. Until this country recognizes that fact, then people in the situation like this poor guy will be drifting in and out of jail, prison and mental health institutions, because no one wants to care for anyone who cannot care for themselves anymore. Drugs are fine, but if the person can not be trusted to self medicate themselves, how can they be put back onto the streets, until the eventual occurs and they kill someone or are killed themselves.
35
We all know what happened. We closed the mental hospitals and told folks to go home and self medicate. Now we have stuffed our prisons with the mentally ill and the drug addicts.
57
Mental hospitals, historic shock and strap horror pits, are not the answer either. In a capitalist driven society these lost souls are just collateral damage. I doubt there is a human alternative possible in our society. Another way of saying this is that what we have is our social solution.
1
We all know what happened. We closed the mental hospitals and told folks to go home and self medicate. Now we have stuffed our prisons with the mentally ill and the drug addicts.
69
Mental hospitals, historic shock and strap horror pits, are not the answer either. In a capitalist driven society these lost souls are just collateral damage. I doubt there is a human alternative possible in our society. Another way of saying this is that what we have is our social solution.
2
I'd ask many of the commenters here if you've ever worked in prisons or psyche wards and had to actually deal with and try to solve these kinds of problems.
I've had ongoing contact with some of the mentally ill inside the walls, and of course know other professionals that try and deal with these challenges daily; it's incredibly difficult and challenging, and medicine is not an exact science and there is never, ever enough money to offer the best treatment, medicines, counseling, rehab programs, housing and so forth.
Not at all saying we shouldn't try to do better, we should. But simplistic platitudes about our punitive efforts to treat the mentally ill reflect no real world understanding or experience in these matters. Lobby your gov representatives for more money, staff and facilities, if inclined.
I've had ongoing contact with some of the mentally ill inside the walls, and of course know other professionals that try and deal with these challenges daily; it's incredibly difficult and challenging, and medicine is not an exact science and there is never, ever enough money to offer the best treatment, medicines, counseling, rehab programs, housing and so forth.
Not at all saying we shouldn't try to do better, we should. But simplistic platitudes about our punitive efforts to treat the mentally ill reflect no real world understanding or experience in these matters. Lobby your gov representatives for more money, staff and facilities, if inclined.
38
I totally agree.
I wonder how many people with conditions as alarming as Mr. Megginson's ever are able to mange a productive life? We all know of too many cases of them
causing pain and suffering to others, as well as ending up dead after the police get called in to respond to their psychotic breaks. Expecting prison guards and the police to deal with this problem is not working, and is not really fair to them or the mentally ill. There has to be a better option than jail, but in a general sense, this seems like a problem that we could throw a lot of money at for truly marginal returns. I am picturing a secure facility in rural Idaho, with fresh air and high walls...
I wonder how many people with conditions as alarming as Mr. Megginson's ever are able to mange a productive life? We all know of too many cases of them
causing pain and suffering to others, as well as ending up dead after the police get called in to respond to their psychotic breaks. Expecting prison guards and the police to deal with this problem is not working, and is not really fair to them or the mentally ill. There has to be a better option than jail, but in a general sense, this seems like a problem that we could throw a lot of money at for truly marginal returns. I am picturing a secure facility in rural Idaho, with fresh air and high walls...
2
I agree. It's really distressing that so the authors and so many commenters are so callous/dismissive about the safety concerns for the correctional officers/health care workers/other inmates.
http://caselaw.findlaw.com/us-9th-circuit/1241138.html
Court rulings like Freitag v. Ayers had made it clear that correctional officers deserve a safe and non-hostile working environment just like everybody else. If it take put people like Megginson in solitary confinement with spit mask, so be it.
http://caselaw.findlaw.com/us-9th-circuit/1241138.html
Court rulings like Freitag v. Ayers had made it clear that correctional officers deserve a safe and non-hostile working environment just like everybody else. If it take put people like Megginson in solitary confinement with spit mask, so be it.
1
I'd ask many of the commenters here if you've ever worked in prisons or psyche wards and had to actually deal with and try to solve these kinds of problems.
I've had ongoing contact with some of the mentally ill inside the walls, and of course know other professionals that try and deal with these challenges daily; it's incredibly difficult and challenging, and medicine is not an exact science and there is never, ever enough money to offer the best treatment, medicines, counseling, rehab programs, housing and so forth.
Not at all saying we shouldn't try to do better, we should. But simplistic platitudes about our punitive efforts to treat the mentally ill reflect no real world understanding or experience in these matters. Lobby your gov representatives for more money, staff and facilities, if inclined.
I've had ongoing contact with some of the mentally ill inside the walls, and of course know other professionals that try and deal with these challenges daily; it's incredibly difficult and challenging, and medicine is not an exact science and there is never, ever enough money to offer the best treatment, medicines, counseling, rehab programs, housing and so forth.
Not at all saying we shouldn't try to do better, we should. But simplistic platitudes about our punitive efforts to treat the mentally ill reflect no real world understanding or experience in these matters. Lobby your gov representatives for more money, staff and facilities, if inclined.
45
I totally agree.
I wonder how many people with conditions as alarming as Mr. Megginson's ever are able to mange a productive life? We all know of too many cases of them
causing pain and suffering to others, as well as ending up dead after the police get called in to respond to their psychotic breaks. Expecting prison guards and the police to deal with this problem is not working, and is not really fair to them or the mentally ill. There has to be a better option than jail, but in a general sense, this seems like a problem that we could throw a lot of money at for truly marginal returns. I am picturing a secure facility in rural Idaho, with fresh air and high walls...
I wonder how many people with conditions as alarming as Mr. Megginson's ever are able to mange a productive life? We all know of too many cases of them
causing pain and suffering to others, as well as ending up dead after the police get called in to respond to their psychotic breaks. Expecting prison guards and the police to deal with this problem is not working, and is not really fair to them or the mentally ill. There has to be a better option than jail, but in a general sense, this seems like a problem that we could throw a lot of money at for truly marginal returns. I am picturing a secure facility in rural Idaho, with fresh air and high walls...
2
I agree. It's really distressing that so the authors and so many commenters are so callous/dismissive about the safety concerns for the correctional officers/health care workers/other inmates.
http://caselaw.findlaw.com/us-9th-circuit/1241138.html
Court rulings like Freitag v. Ayers had made it clear that correctional officers deserve a safe and non-hostile working environment just like everybody else. If it take put people like Megginson in solitary confinement with spit mask, so be it.
http://caselaw.findlaw.com/us-9th-circuit/1241138.html
Court rulings like Freitag v. Ayers had made it clear that correctional officers deserve a safe and non-hostile working environment just like everybody else. If it take put people like Megginson in solitary confinement with spit mask, so be it.
2
You suggest that we lobby "our", government, but the biggest lobbyist in the United States in the pharmaceutical industry. Do you think that this industry would lobby for anything that didn't result in the increased use of medications?
3
It's very unfortunate that mental illness is not understood as a complex disorder with many manifestations as other medical conditions such as cancer. Just as science is learning that there is no standard treatment for cancer and there are different treatments for different types of cancer, the same applies to mental illness. There are different forms and types of mental disorders and there are consequently different treatments. And since it is a biopsychosocial disorder treatment involves each of these arenas. For some long term treatment in a specialty hospital is necessary, for others group living and for the majority outpatient treatment. Individuals should be able to move between each type based on their needs at a given point in time. Until
each are given equal value and attention to multiple treatment modalities of medication, counseling and psychosocial supports, there will be more cases like this reported. We accept and embrace this concept in other medical conditions, why not for mental illness ?
each are given equal value and attention to multiple treatment modalities of medication, counseling and psychosocial supports, there will be more cases like this reported. We accept and embrace this concept in other medical conditions, why not for mental illness ?
2
Because the mentally ill tend to be a black hole for resources, and produce very little benefit to society in return. Someday we may get the brain science figured out, but until then, our options are not great.
1
There are some people who just require a lifetime of full time management.
Here in the USA, we as society do not perform this task at all.
Prison is no place to treat the severely mentally ill. We should be able to do better, but as a society we are unwilling to provide the necessary funds to do so. Were the United States to have a true system of universal health care that could properly care for all of us regardless of our illnesses, we would all be healthier, mentally, physically and economically.
Here in the USA, we as society do not perform this task at all.
Prison is no place to treat the severely mentally ill. We should be able to do better, but as a society we are unwilling to provide the necessary funds to do so. Were the United States to have a true system of universal health care that could properly care for all of us regardless of our illnesses, we would all be healthier, mentally, physically and economically.
13
Anne, nobody needs "management". This man's been "managed" up the wazoo and look at where it's gotten him! What he needs is loyalty, love, and a clean slate.
No, we would all be broke if we care for everyone to the maximum extend possible becuase that's simply impossible. It already takes about 10-42 tax payers to keep 1 inmate in prison. If we spend as much on regular inmate as we did on the criminally insane, your state will either have to shut down all other programs or triple your taxes. Do you want to send all your money to care for the criminally insane? Every dollar spend on him is a dollar out of your pocket to care for yourself and your family.
The most tragic thing about this story is that this young man, who has been failed by everyone around him since his birth, still has hope that things can be better for him. Surely if he still has hope for himself, as a society we cannot give up on him, or on the idea that we can do better for the most vulnerable and challenged among us.
22
I believe most those incarcerated probably suffer from some form of mental illness. Perhaps someday in the future, when we have both a better understanding of mental illness and a greater compassion for our fellow sick human beings, we will find a way to treat these individuals. The way we treat them today is very primitive.
6
Yes, but I have also seen many people with emergent mental illnesses refuse to practice good mental hygiene at a time in their illness when it could make a difference. We need to get these folks into an institution that will strongly encourage them to develop healthy habits before it is too late.
I heartily agree. I think we have the science to tell us that we need the criminal justice system to have people who are trained in psychology and psychiatry first and then the law. It's the only way to build a more humane system.
I for one do not want to see another judge without a thorough understanding of the mentally ill putting these people away to suffer more in prison.
I for one do not want to see another judge without a thorough understanding of the mentally ill putting these people away to suffer more in prison.
Mr. Megginson's story is powerful and compelling, drawing attention to the relatively few people that could seemingly benefit tremendously from mental institutions. The authors wisely recognize that institutions before the 1970s also sometimes skirted civil liberties. After forty years, however, we should be better positioned as a society to navigate a middle ground that safeguards personal freedom while providing a uniquely powerful treatment platform.
On a separate note, while Mr. Meggino's story is both terrifying and touching, I found myself most moved by the journalistic detail: "The New York Times spent 10 months examining Mr. Megginson’s troubled life, conducting hours of interviews with him as well as his family members, doctors and lawyers. With his permission, The Times also reviewed thousands of pages of medical, disciplinary and legal records from his time at Rikers and in hospitals, community programs and supervised housing." Bravo, Michael Winerip and Michael Schwirtz, for giving a voice to someone that I would never hear in my daily life, for painting a portrait I would never see. Together, we can continue moving this issue forward and making things better.
On a separate note, while Mr. Meggino's story is both terrifying and touching, I found myself most moved by the journalistic detail: "The New York Times spent 10 months examining Mr. Megginson’s troubled life, conducting hours of interviews with him as well as his family members, doctors and lawyers. With his permission, The Times also reviewed thousands of pages of medical, disciplinary and legal records from his time at Rikers and in hospitals, community programs and supervised housing." Bravo, Michael Winerip and Michael Schwirtz, for giving a voice to someone that I would never hear in my daily life, for painting a portrait I would never see. Together, we can continue moving this issue forward and making things better.
18
The man wants out of life as the rest of us have planned it for him. Do you blame him? The inmates often run our asylums, make our laws and set our lives on courses they see as sane--usually insane. The normals work at an abnormal pace and lack of sensitivity to undo the "abnormals".
2
Ah, Saint Ronnie's closing of the state-run institutions (okay, but jail or the street are preferable alternatives?): the gift that keeps on giving.
28
Actually, Mr. Brando, the movement to close state institutions for the mentally ill began under Kennedy, in the early 60s. I was one of the social workers employed to encourage patients to transition from hospitals to "group homes". The rationale was that new psychotropic drugs had been developed, hence mental illness could now be controlled. However, you're right in the sense that the "we love lower taxes" movement could not have been more pleased.
5
The left fell in love with that stupid movie 'Cuckoo's Nest' and 'King of Hearts,' and got the idea that there is no such thing as mental illness - it's just a sane response to a crazy world, a label the repressive society uses to stigmatise nonconformist free spirits, blah blah kumbaya. Yet another toxic legacy of the Sixties - that decade was, indeed, the gift that keeps on giving.
Stupidity is bipartisan.
Stupidity is bipartisan.
Ridiculous comment. If community psychiatric clinics had been funded as originally intended, this problem would not exist. But politicians didn't care about anything beyond being given credit for closing those 'awful' state-run institutions. It is ridiculous blame a single person. You ignorant liberals didn't follow-up either. Welcome to the real world.
It is time, or far past time, to recognize and accept the dynamics of mental illness. Mental health treatment is clearly lagging other medical fields in both diagnosis and treatment as clearly and sadly demonstrated in the case of Mr. Megginson. Mental health science will progress, although slowly, but as important as scientific progress, is social progress. Mental illness has to be recognized and accepted as a personality changing disorder and a blameless disorder. No one chooses mental illness. To conflate aberrant behavior coming out of a mind that is tormented and distorted by mental illness with clear-headed criminal choice is wrong. To incarcerate the mentally ill because there is not a more appropriate care facility is criminal, a social crime committed with supposedly clear-headed thinking. Seven members of an ACT team meeting for "several hours" to discuss 68 patients, while good hearted, is criminal in its insufficiency. No, Mr. Megginson is not the criminal, society is.
23
Drug use, substances abuse, physical trauma especially those to the head and irregular schedule are all proven to cause psychological episodes. Keep it up and the person will develop mental illness. It is time the mentally ill take some responsibility for their action.
Legally, I agree with the nytimes, he should be released, just not in my neighborhood. Still one can be pretty sure that when released he will be shot by the police, most likely by a black officer.
4
It is clear that some people DO need to be in a long term care facilities. The prison system is clearly not the right place for some folks but the alternatives including medical facilities are not safe either. I work in an ER and often think this person is way too violent and disturbed to be next to the elderly woman with a heart attack or the pregnant woman. But where do they belong? By default they shuffle through psychiatric and correctional facilities at enormous costs to taxpayers and no benefit to the individual. Our state hospital (NH) is chronically underfunded and patients wait days to get into Concord only to be released to repeat the cycle or end up in jail or int the ER for days to go back to the state hospital! Legislators continue to underfund psychiatric services (these folks are not likely to vote or fund a superpac). We fail to realize that we are actually spending way more on these individuals than long term psych facilities would cost. Oh and by the way there is the individual to consider.
29
You are right on the mark. In particular, "We fail to realize that we are actually spending way more on these individuals than long term psych facilities would cost."
3
And how often do we see the mentally ill producing offspring with the same illnesses, who go on to wreak havoc in the public schools. In my line of work, I see the mentally ill producing many more children per capita than stable, productive people. I am not sure why we think that this makes sense for the future of our species and planet.
It's very unfortunate that mental illness is not understood as a complex disorder with many manifestations as other medical conditions such as cancer. Just as science is learning that there is no standard treatment for cancer and there are different treatments for different types of cancer, the same applies to mental illness. There are different forms and types of mental disorders and there are consequently different treatments. And since it is a biopsychosocial disorder treatment involves each of these arenas. For some long term treatment in a specialty hospital is necessary, for others group living and for the majority outpatient treatment. Individuals should be able to move between each type based on their needs at a given point in time. Until
each are given equal value and attention to multiple treatment modalities of medication, counseling and psychosocial supports, there will be more cases like this reported. We accept and embrace this concept in other medical conditions, why not for mental illness ?
each are given equal value and attention to multiple treatment modalities of medication, counseling and psychosocial supports, there will be more cases like this reported. We accept and embrace this concept in other medical conditions, why not for mental illness ?
3
Because the mentally ill tend to be a black hole for resources, and produce very little benefit to society in return. Someday we may get the brain science figured out, but until then, our options are not great.
1
There are some people who just require a lifetime of full time management.
Here in the USA, we as society do not perform this task at all.
Prison is no place to treat the severely mentally ill. We should be able to do better, but as a society we are unwilling to provide the necessary funds to do so. Were the United States to have a true system of universal health care that could properly care for all of us regardless of our illnesses, we would all be healthier, mentally, physically and economically.
Here in the USA, we as society do not perform this task at all.
Prison is no place to treat the severely mentally ill. We should be able to do better, but as a society we are unwilling to provide the necessary funds to do so. Were the United States to have a true system of universal health care that could properly care for all of us regardless of our illnesses, we would all be healthier, mentally, physically and economically.
16
Anne, nobody needs "management". This man's been "managed" up the wazoo and look at where it's gotten him! What he needs is loyalty, love, and a clean slate.
No, we would all be broke if we care for everyone to the maximum extend possible becuase that's simply impossible. It already takes about 10-42 tax payers to keep 1 inmate in prison. If we spend as much on regular inmate as we did on the criminally insane, your state will either have to shut down all other programs or triple your taxes. Do you want to send all your money to care for the criminally insane? Every dollar spend on him is a dollar out of your pocket to care for yourself and your family.
The most tragic thing about this story is that this young man, who has been failed by everyone around him since his birth, still has hope that things can be better for him. Surely if he still has hope for himself, as a society we cannot give up on him, or on the idea that we can do better for the most vulnerable and challenged among us.
24
I believe most those incarcerated probably suffer from some form of mental illness. Perhaps someday in the future, when we have both a better understanding of mental illness and a greater compassion for our fellow sick human beings, we will find a way to treat these individuals. The way we treat them today is very primitive.
6
Yes, but I have also seen many people with emergent mental illnesses refuse to practice good mental hygiene at a time in their illness when it could make a difference. We need to get these folks into an institution that will strongly encourage them to develop healthy habits before it is too late.
I heartily agree. I think we have the science to tell us that we need the criminal justice system to have people who are trained in psychology and psychiatry first and then the law. It's the only way to build a more humane system.
I for one do not want to see another judge without a thorough understanding of the mentally ill putting these people away to suffer more in prison.
I for one do not want to see another judge without a thorough understanding of the mentally ill putting these people away to suffer more in prison.
Mr. Megginson's story is powerful and compelling, drawing attention to the relatively few people that could seemingly benefit tremendously from mental institutions. The authors wisely recognize that institutions before the 1970s also sometimes skirted civil liberties. After forty years, however, we should be better positioned as a society to navigate a middle ground that safeguards personal freedom while providing a uniquely powerful treatment platform.
On a separate note, while Mr. Meggino's story is both terrifying and touching, I found myself most moved by the journalistic detail: "The New York Times spent 10 months examining Mr. Megginson’s troubled life, conducting hours of interviews with him as well as his family members, doctors and lawyers. With his permission, The Times also reviewed thousands of pages of medical, disciplinary and legal records from his time at Rikers and in hospitals, community programs and supervised housing." Bravo, Michael Winerip and Michael Schwirtz, for giving a voice to someone that I would never hear in my daily life, for painting a portrait I would never see. Together, we can continue moving this issue forward and making things better.
On a separate note, while Mr. Meggino's story is both terrifying and touching, I found myself most moved by the journalistic detail: "The New York Times spent 10 months examining Mr. Megginson’s troubled life, conducting hours of interviews with him as well as his family members, doctors and lawyers. With his permission, The Times also reviewed thousands of pages of medical, disciplinary and legal records from his time at Rikers and in hospitals, community programs and supervised housing." Bravo, Michael Winerip and Michael Schwirtz, for giving a voice to someone that I would never hear in my daily life, for painting a portrait I would never see. Together, we can continue moving this issue forward and making things better.
27
The man wants out of life as the rest of us have planned it for him. Do you blame him? The inmates often run our asylums, make our laws and set our lives on courses they see as sane--usually insane. The normals work at an abnormal pace and lack of sensitivity to undo the "abnormals".
2
Ah, Saint Ronnie's closing of the state-run institutions (okay, but jail or the street are preferable alternatives?): the gift that keeps on giving.
32
Actually, Mr. Brando, the movement to close state institutions for the mentally ill began under Kennedy, in the early 60s. I was one of the social workers employed to encourage patients to transition from hospitals to "group homes". The rationale was that new psychotropic drugs had been developed, hence mental illness could now be controlled. However, you're right in the sense that the "we love lower taxes" movement could not have been more pleased.
5
The left fell in love with that stupid movie 'Cuckoo's Nest' and 'King of Hearts,' and got the idea that there is no such thing as mental illness - it's just a sane response to a crazy world, a label the repressive society uses to stigmatise nonconformist free spirits, blah blah kumbaya. Yet another toxic legacy of the Sixties - that decade was, indeed, the gift that keeps on giving.
Stupidity is bipartisan.
Stupidity is bipartisan.
Ridiculous comment. If community psychiatric clinics had been funded as originally intended, this problem would not exist. But politicians didn't care about anything beyond being given credit for closing those 'awful' state-run institutions. It is ridiculous blame a single person. You ignorant liberals didn't follow-up either. Welcome to the real world.
It is time, or far past time, to recognize and accept the dynamics of mental illness. Mental health treatment is clearly lagging other medical fields in both diagnosis and treatment as clearly and sadly demonstrated in the case of Mr. Megginson. Mental health science will progress, although slowly, but as important as scientific progress, is social progress. Mental illness has to be recognized and accepted as a personality changing disorder and a blameless disorder. No one chooses mental illness. To conflate aberrant behavior coming out of a mind that is tormented and distorted by mental illness with clear-headed criminal choice is wrong. To incarcerate the mentally ill because there is not a more appropriate care facility is criminal, a social crime committed with supposedly clear-headed thinking. Seven members of an ACT team meeting for "several hours" to discuss 68 patients, while good hearted, is criminal in its insufficiency. No, Mr. Megginson is not the criminal, society is.
28
Drug use, substances abuse, physical trauma especially those to the head and irregular schedule are all proven to cause psychological episodes. Keep it up and the person will develop mental illness. It is time the mentally ill take some responsibility for their action.
Legally, I agree with the nytimes, he should be released, just not in my neighborhood. Still one can be pretty sure that when released he will be shot by the police, most likely by a black officer.
4
It is clear that some people DO need to be in a long term care facilities. The prison system is clearly not the right place for some folks but the alternatives including medical facilities are not safe either. I work in an ER and often think this person is way too violent and disturbed to be next to the elderly woman with a heart attack or the pregnant woman. But where do they belong? By default they shuffle through psychiatric and correctional facilities at enormous costs to taxpayers and no benefit to the individual. Our state hospital (NH) is chronically underfunded and patients wait days to get into Concord only to be released to repeat the cycle or end up in jail or int the ER for days to go back to the state hospital! Legislators continue to underfund psychiatric services (these folks are not likely to vote or fund a superpac). We fail to realize that we are actually spending way more on these individuals than long term psych facilities would cost. Oh and by the way there is the individual to consider.
35
You are right on the mark. In particular, "We fail to realize that we are actually spending way more on these individuals than long term psych facilities would cost."
3
And how often do we see the mentally ill producing offspring with the same illnesses, who go on to wreak havoc in the public schools. In my line of work, I see the mentally ill producing many more children per capita than stable, productive people. I am not sure why we think that this makes sense for the future of our species and planet.
1
I find it unbelievably sad that this man has been suffering since age 6 and has not had a dedicated team of professionals treating him. That he doesn't have a diagnosis that can be agreed upon is also disturbing. Deinstitutionalization was an excuse for fiscal conservatives to cut costs. We have to wake up to the fact that there is a subset of the mentally I'll that need long-term if not permanent and humane confinement when they fail to comply with outpatient treatment programs. By using the prison system we are complicit in human rights violations of these vulnerable people. Truly sickening. Imagine what we could've done with the money wasted thus far in overseas adventures in helping these vulnerable people who need a lifetime of compassionate care.
43
I agree with you that it is unbelievably sad that this man has suffered so long. On the other hand, I don't think the money spent on those programs was wasted. They helped to some degree. All we need to do is improve those programs -- make them last longer, add more types of treatment until we get truly therapeutic programs. Do not need to go back to the old ways, we just need a legal and medical solution that helps the mentally ill, but doesn't leave them in jail, and even worse, in solitary confinement which is quite harmful.
LMC: Incarceration in a psychiatric institution is inhumane, no matter how many bells and whistles you slap on it. Nobody should be locked up just because their family throws them away. People who've been removed from a group as instrumental to health and societal integration as the nuclear family should have voluntary, long-term alternatives for the support they should be receiving from their kin.
1
Did we read the same article?
LMC wrote: "I find it unbelievably sad that this man ... has not had a dedicated team of professionals treating him.
The article's authors wrote: "Mr. Megginson was repeatedly released from state hospitals against his doctors’ wishes because he did not meet legal requirements for involuntary commitment. His treatment has cost millions of dollars in public funds. Outside of hospitals, he was enrolled in some of the most successful outpatient and community programs in the mental health field. He failed out of all of them."
Sounds to me like Mr. Megginson absolutely has had "a dedicated team of professionals treating him" -- actually, several such teams.
The question this article is asking is: what do we do with citizens who are "untreatable" BEFORE they commit crimes that land them in prison (where they simply get worse).
LMC wrote: "I find it unbelievably sad that this man ... has not had a dedicated team of professionals treating him.
The article's authors wrote: "Mr. Megginson was repeatedly released from state hospitals against his doctors’ wishes because he did not meet legal requirements for involuntary commitment. His treatment has cost millions of dollars in public funds. Outside of hospitals, he was enrolled in some of the most successful outpatient and community programs in the mental health field. He failed out of all of them."
Sounds to me like Mr. Megginson absolutely has had "a dedicated team of professionals treating him" -- actually, several such teams.
The question this article is asking is: what do we do with citizens who are "untreatable" BEFORE they commit crimes that land them in prison (where they simply get worse).
2
I find it unbelievably sad that this man has been suffering since age 6 and has not had a dedicated team of professionals treating him. That he doesn't have a diagnosis that can be agreed upon is also disturbing. Deinstitutionalization was an excuse for fiscal conservatives to cut costs. We have to wake up to the fact that there is a subset of the mentally I'll that need long-term if not permanent and humane confinement when they fail to comply with outpatient treatment programs. By using the prison system we are complicit in human rights violations of these vulnerable people. Truly sickening. Imagine what we could've done with the money wasted thus far in overseas adventures in helping these vulnerable people who need a lifetime of compassionate care.
57
I agree with you that it is unbelievably sad that this man has suffered so long. On the other hand, I don't think the money spent on those programs was wasted. They helped to some degree. All we need to do is improve those programs -- make them last longer, add more types of treatment until we get truly therapeutic programs. Do not need to go back to the old ways, we just need a legal and medical solution that helps the mentally ill, but doesn't leave them in jail, and even worse, in solitary confinement which is quite harmful.
LMC: Incarceration in a psychiatric institution is inhumane, no matter how many bells and whistles you slap on it. Nobody should be locked up just because their family throws them away. People who've been removed from a group as instrumental to health and societal integration as the nuclear family should have voluntary, long-term alternatives for the support they should be receiving from their kin.
1
Did we read the same article?
LMC wrote: "I find it unbelievably sad that this man ... has not had a dedicated team of professionals treating him.
The article's authors wrote: "Mr. Megginson was repeatedly released from state hospitals against his doctors’ wishes because he did not meet legal requirements for involuntary commitment. His treatment has cost millions of dollars in public funds. Outside of hospitals, he was enrolled in some of the most successful outpatient and community programs in the mental health field. He failed out of all of them."
Sounds to me like Mr. Megginson absolutely has had "a dedicated team of professionals treating him" -- actually, several such teams.
The question this article is asking is: what do we do with citizens who are "untreatable" BEFORE they commit crimes that land them in prison (where they simply get worse).
LMC wrote: "I find it unbelievably sad that this man ... has not had a dedicated team of professionals treating him.
The article's authors wrote: "Mr. Megginson was repeatedly released from state hospitals against his doctors’ wishes because he did not meet legal requirements for involuntary commitment. His treatment has cost millions of dollars in public funds. Outside of hospitals, he was enrolled in some of the most successful outpatient and community programs in the mental health field. He failed out of all of them."
Sounds to me like Mr. Megginson absolutely has had "a dedicated team of professionals treating him" -- actually, several such teams.
The question this article is asking is: what do we do with citizens who are "untreatable" BEFORE they commit crimes that land them in prison (where they simply get worse).
2
I am the mother of a twenty-two year old man who's story has many similarities to Mr. Megginson's. I have done everything in my power to help my son. He cannot live with me because he has attacked me and injured me. There are no hospitals that will hold him for more than a few months. He continues to lack insight into his illness, and wants only to be free to smoke marijuana (which he considers his strongest connection to God.) He cycles in and out of jail, ER rooms, hospitals, and the street. I love him with all my heart and would move mountains for him, if I could. He is the dirty, foul-smelling, mumbling man you pass on the street. He has been repeatedly assaulted in jail and on the street. He is a homeless person, an ill person, and a person with a criminal record on public assistance. But he is also a beloved brother and son. He deserves better. We all deserve better. Thank you to the NYTimes for publishing this article.
94
I have a 32 year old stepson who is in the same predicament as your son only he doesn't use marijuana, alcohol, or any other drug. He, in fact, spends his life trying to figure out how to save the world. We do what we can for him, but he cycles between independence, jail and the state mental hospital. It is heart breaking because he is a brilliant and loving person -- just severely bipolar/
Thank you so much for sharing your story. I agree 100% with everything you said. I have a slightly dissimilar but equally disheartening situation with mental illness in my own family. The grip of mental illness runs deep not only within the family structure but within our society as a whole, just like you said. I wish so much that I could help you and relieve some of your pain. There's not much I can do other than to keep you in my thoughts, which I will do. Thank you for your courage, strength, and willingness to tell us what you have been through.
I am the mother of a twenty-two year old man who's story has many similarities to Mr. Megginson's. I have done everything in my power to help my son. He cannot live with me because he has attacked me and injured me. There are no hospitals that will hold him for more than a few months. He continues to lack insight into his illness, and wants only to be free to smoke marijuana (which he considers his strongest connection to God.) He cycles in and out of jail, ER rooms, hospitals, and the street. I love him with all my heart and would move mountains for him, if I could. He is the dirty, foul-smelling, mumbling man you pass on the street. He has been repeatedly assaulted in jail and on the street. He is a homeless person, an ill person, and a person with a criminal record on public assistance. But he is also a beloved brother and son. He deserves better. We all deserve better. Thank you to the NYTimes for publishing this article.
124
I have a 32 year old stepson who is in the same predicament as your son only he doesn't use marijuana, alcohol, or any other drug. He, in fact, spends his life trying to figure out how to save the world. We do what we can for him, but he cycles between independence, jail and the state mental hospital. It is heart breaking because he is a brilliant and loving person -- just severely bipolar/
Thank you so much for sharing your story. I agree 100% with everything you said. I have a slightly dissimilar but equally disheartening situation with mental illness in my own family. The grip of mental illness runs deep not only within the family structure but within our society as a whole, just like you said. I wish so much that I could help you and relieve some of your pain. There's not much I can do other than to keep you in my thoughts, which I will do. Thank you for your courage, strength, and willingness to tell us what you have been through.
1
Shame on our culture for treating our most vulnerable in such an inhumane way.
As much we and as his mother may hope, Michael Megginson and others like him cannot live on their own. They are one missed pill away from a violent psychotic break. We did not do the mentally ill any favors by throwing open the doors of the nation's mental hospitals without adequate treatment and support for them in their communities.
6
Yeah, tell that to Elyn Saks or Lori Schiller.
Too often the judicial system makes decisions on abstract concepts that seem right in theory, but in fact are very wrong in practice. There were likely many abuses when individuals were involuntarily committed by family members who saw someone as inconvenient or unorthodox, but overwhelming, the practice of involuntary hospitalizations helped the families and definitely were the appropriate form of care for the patient. Today our judicial system continues to turn its backs on the real life consequences of their decisions. Possessing and showing empathy should not be considered a negative attribute in our judges. The decisions made from the bench have a real impact on real people, like Michael Megginson and millions of others who are jailed instead of helped.
3
I am glad that the New York Times continues to focus on the treatment of the mentally ill in the judicial system, Rikers' in particular and our society as whole. The mentally ill should not be brutalized and incarcerated in prisons where they are brutalized by correction officers.
Mental illness is a national public health problem that should be the preview of the Surgeon General. However, New York City has one of the best public health systems in the country. The Mayor should allow his qualified public health officials along with psychologists and psychiatrists dictate the policy to treat the mentally ill before and after they become entangled in the judicial system, not uninformed brutal correction officials.
I hope that there will be systems in place to support Mr. Megginson after he is released. It is the only way that he can succeed at being compliant with his medication. He also needs to continue therapy to help him cope on a daily basis.
I wish Mr. Megginson good health and peace as he continues his journey.
Mental illness is a national public health problem that should be the preview of the Surgeon General. However, New York City has one of the best public health systems in the country. The Mayor should allow his qualified public health officials along with psychologists and psychiatrists dictate the policy to treat the mentally ill before and after they become entangled in the judicial system, not uninformed brutal correction officials.
I hope that there will be systems in place to support Mr. Megginson after he is released. It is the only way that he can succeed at being compliant with his medication. He also needs to continue therapy to help him cope on a daily basis.
I wish Mr. Megginson good health and peace as he continues his journey.
Firstly, Mr. Megginson assaulted clinicians at various hospitals. This type of crime is now a felony in tne state of New York. Mr. Megginson should have been arrested and prosecuted for these assaults. Too often, violence against mental health workers has been overlooked as "part of the job". Patients such as Mr. Megginson have been given free reign to kick, bite, and punch healthcare workers.
The tide is changing. I am a MD who was recently savagely punched repeatedly in the head by a patient at the Hudson Valley-area hospital where I work. I suffered a concussion and a subdural hematoma. I now am experiencing multiple neurological symptoms. The patient who attacked me? She was arrested on discharge, and charged with a felony. The case is being handled by the manor crimes unit. If any of you readers were savagely beaten by some random mentally ill person I am sure you would waant to see the perpetrator arrested. Well, we healthcare workers feel the same.
The tide is changing. I am a MD who was recently savagely punched repeatedly in the head by a patient at the Hudson Valley-area hospital where I work. I suffered a concussion and a subdural hematoma. I now am experiencing multiple neurological symptoms. The patient who attacked me? She was arrested on discharge, and charged with a felony. The case is being handled by the manor crimes unit. If any of you readers were savagely beaten by some random mentally ill person I am sure you would waant to see the perpetrator arrested. Well, we healthcare workers feel the same.
9
You want the patient charged and jailed even if she wasn't in her right mind at the time? In other words she's responsible no matter what her state of mind was when she assaulted you. You haven't even provided enough information for us to know if the patient was mentally ill, in her right mind, or what was going on. Without that your comment is meaningless.
Hen3ry - you do not understand the criminal justice sytem, do you. It is not the victim of a violent crime nor the arresting officer's duty to judje the perpetrator's "state of mind". That falls to the perpetrator's attorney, the judge, and a jury of the perpetrator's peers.
There's another side to this story that is not mentioned at all. That side involves the very threatening world of the health care providers in prisons dealing with many of these mentally ill inmates (ref: http://www.nytimes.com/2014/05/22/nyregion/rising-hazard-for-civilian-st.... Recently a young female intern had her jaw broken in an attack, and nurses are frequently the target of physical violence in these prisons.
And why? Why are violent episodes so much worse outside of hospitals. Much stems from the truly ridiculous notion that a mentally ill patient in the throws of delusion can refuse to take medication. This has been a problem since the closure of the horrible mental hospitals. You see, part of the argument for closing the mental hospitals involves the discovery of new and potent anti-psychotic medicine. The problem of course with all medicine is that it only works if you take it. At some point in society, we have to understand that there is balance between patient rights, and the right of the rest of society. Many of the violent outbursts in prisons (as described in an opinion piece written in this paper one year ago by a prison psychiatrist) can be traced to patietns refusing treatment.
And why? Why are violent episodes so much worse outside of hospitals. Much stems from the truly ridiculous notion that a mentally ill patient in the throws of delusion can refuse to take medication. This has been a problem since the closure of the horrible mental hospitals. You see, part of the argument for closing the mental hospitals involves the discovery of new and potent anti-psychotic medicine. The problem of course with all medicine is that it only works if you take it. At some point in society, we have to understand that there is balance between patient rights, and the right of the rest of society. Many of the violent outbursts in prisons (as described in an opinion piece written in this paper one year ago by a prison psychiatrist) can be traced to patietns refusing treatment.
8
I agree that there is a place for involuntary confinement of the mentally ill with violent tendencies and that their caregivers deserve protection, especially those who are non-compliant with treatment.
But don't put them in jail. That's all we are saying. It benefits no one: not the mentally ill person, not the prison system, not their families and not greater society.
But don't put them in jail. That's all we are saying. It benefits no one: not the mentally ill person, not the prison system, not their families and not greater society.
Thanks Reagan. Mental Health facilities were just another government abuse, and had to be shut down (privatized). These people should pull themselves up by their bootstraps, and take personal accountability! Like welfare, just take it away, and the poor and mentally disturbed will be forced to fix themselves. Right? Of course, not much profit in taking care of these people, so.... off to expensive privatized jails. Ugh.
3
I think there's no way around the fact that it's going to be expensive to treat all these people with both dignity and firmness. Large-scale mental institutions have never been kind - not in the Middle Ages, and not in the 1970s - because lets' face it, no one really knows what to do with people who have such serious mental problems that they can't care for themselves.
There's a punitive element to all of it, with an either/or mindset: is he nuts, not responsible, and thus worthy of pity and aid, or is he a criminal, someone who knows better, in need of punishment? In the real world the same person could, at various times, be both.
Of course, we could address unemployment by training and staffing up on mental health counseling and such, since there's such a need for it. That would require government dollars, which politicians don't want to spend on such "undeserving" people - they'd really like for all the mentally ill folks to crawl off and die in a corner, elsewhere, or be housed in large institutions where efficient per-capita spending is the only measure of success.
There's a punitive element to all of it, with an either/or mindset: is he nuts, not responsible, and thus worthy of pity and aid, or is he a criminal, someone who knows better, in need of punishment? In the real world the same person could, at various times, be both.
Of course, we could address unemployment by training and staffing up on mental health counseling and such, since there's such a need for it. That would require government dollars, which politicians don't want to spend on such "undeserving" people - they'd really like for all the mentally ill folks to crawl off and die in a corner, elsewhere, or be housed in large institutions where efficient per-capita spending is the only measure of success.
3
The Department of Corrections's response to this entire series has been twofold: 1) we are working on it, and 2) the problem is limited to Rikers, but Bellvue and other facilities are working. This installment proves the lie there as well. The failures of the DOC are spawned by decades of neglect, not least because inmates have no political voice and no one has ever cast a mayoral or city council vote based on Corrections Reform. The question to voters is whether we will do so now. Have we turned a corner and created political will to change anything, or will we fold our papers, go back to our breakfasts, and lament what a shame it all is?
2
Mr. Meggison could be the next Adam Lanza. Prisons need more space and better conditions, zero tolerance for inmate abuse, a system of secure psychiatric facilities that allow for treatment to occur in conjunction with incarceration, strict financial oversight and education programs for inmates.
If we owe it to our kids to keep the Adam Lanza's from doing harm, we owe it to those who we require incarcerated to be treated humanely. The current system is an abysmal failure, and I would support any politician who made it a top priority.
If we owe it to our kids to keep the Adam Lanza's from doing harm, we owe it to those who we require incarcerated to be treated humanely. The current system is an abysmal failure, and I would support any politician who made it a top priority.
4
It seems that the US should have mental institutions. The problems that caused mental institutions to go out of existence were basically poor management and staff as well as improperly maintained physical structures. The staff at these closed dilapidated mental institutions treated the patients inhumanly. After many more decades of study since then, both the medical profession and non-medical people have a better understanding of mental illness and are treating it as the serious medical condition that it is. That being said, it is time to build state of the art mental institutions in each State, for those who are in need institutionalization, as determined by a panel of competent physicians to need that service.
2
What makes you so sure that at least 30 million people will let themselves be tossed away in psychiatric gulags again? Have you ever discussed the issue of reinstitutionalization with a Mad person? If you would fight to the death in order to keep your freedom, what makes you think we would do any different?
Oh, how the tables have turned! 40 years ago, all of well-meaning do-gooders wanted the long-term mental hospitals closed because they wanted to give people with mental health problems more self-determination. Well, they got it. Missed appointments, medications refused, coping skills not used. And now that we're reaping the whirlwind of our good intentions, everyone wants the hospitals reopened. Good idea, folks. Would have been a fantastic idea 30 years ago.
As for this gentleman, I'm not sure there *is* a good answer. Sending him to prison was a terrible idea, yes. But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it. I work in a rural area. I can think of a dozen families off the top of my head that would kill for the kinds of resources this man received. Yes, he's sick. And he needs help. But he people going to bat for him (though not his family much, unfortunately), and it wasn't enough.
As for this gentleman, I'm not sure there *is* a good answer. Sending him to prison was a terrible idea, yes. But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it. I work in a rural area. I can think of a dozen families off the top of my head that would kill for the kinds of resources this man received. Yes, he's sick. And he needs help. But he people going to bat for him (though not his family much, unfortunately), and it wasn't enough.
11
"But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it."
Blaming the victim of mental illness is making him or her a victim twice. It diverts attention from the fact that the mental health system is an abject failure.
Blaming the victim of mental illness is making him or her a victim twice. It diverts attention from the fact that the mental health system is an abject failure.
11
I found the story upsetting too. It sounds like you are very angry at a lot of people: the "do gooders," the system, the family, the mentally-ill man who got expensive care but "blew it." But have you considered that there may not be anybody to blame? Sometimes people are just born very sick, and we still don't know why it happens, how to prevent it, or what to do to make them well.
When the Libertarian Thomas Szasz brought up emptying the mental hospitals for political theory, the politician jumped on saving the money. Now they spend it on jail. A system worthy of the old Soviet Mental Health System for sure. Are Republicans and Libertarians secretly envious of tyranny as a system rather than what they call "Secular Humanism?" We are in a culture war for the soul of the American people. The people running this system are evil pure and simple and no biblical story about love or liberty will save their souls. People who advocate jail for mental illness rather than treatment and private enterprise for jail or bad people with nothing but old fashioned greed and cynicism for a philosophy and religion.
4
yes
The saddest failures in public policy are when the pendulum swings and gets stuck at one end. Look how prescient Moynihan's report on the impact of family breakdown was, and how long it took us to realize that stable family really was incredibly, fundamentally important to society. (The difference being that our conception of family now extends beyond a standard paterfamilias, wife and kids.)
The policy of closing down mental health institutions and attempting care in the community has been an unmitigated disaster. We need to recognize it as such and nudge the pendulum free again.
The policy of closing down mental health institutions and attempting care in the community has been an unmitigated disaster. We need to recognize it as such and nudge the pendulum free again.
9
I suggest the work of Michel Foucault, especially his seminal treatise Madness and Civilization, as a way to understand this "problem." Thank you.
1
This will be thought unserious, but when we consider why there is so much more mental illness in the past decades, does anyone think of diet? Our food supply - except for those who can afford nourishing high-quality food and are committed to eating that way - lacks essential nutrients and contains so much sugar and corn syrup and who knows what else what should be fuel becomes half-poisonous. Some research would show that a truly healthy diet can help with mental illness. It is now a near impossibility to effect the kind of changes in the diet of the poor people described here that would be necessary to see if a difference could be made.
As for Rikers, can't there be a specialized unit for these sickest of the sick, to at least keep them safe?
As for Rikers, can't there be a specialized unit for these sickest of the sick, to at least keep them safe?
1
"so much more mental illness in the past decades"
Do you have the actual number to back that statement up? The numbers is actually the reverse.
http://www.nytimes.com/2007/01/15/opinion/15harcourt.html
The US's combined prison/mental hospital population is at the same place as before the deinstitutionalization. So I don't think we have more mental illness, just that deinstitutionalization make them become visible instead of being sweep under the rug.
Do you have the actual number to back that statement up? The numbers is actually the reverse.
http://www.nytimes.com/2007/01/15/opinion/15harcourt.html
The US's combined prison/mental hospital population is at the same place as before the deinstitutionalization. So I don't think we have more mental illness, just that deinstitutionalization make them become visible instead of being sweep under the rug.
Prison provide better food than you can affordablely get on the outside. It is federal mandates and they even have nutritionist making sure it is balanced. Frankly, I think the finger should be pointed at drugs (including soft drugs and self-medication), alcohol and super dose of caffeine in energy drink such as Mountain Dew and Monster.
There is not more mental illness. There only seems to be more because of the following factors:
1. They are visible. Up until recently, the mentally ill were locked away. If you saw them, it was only as a visitor seeking entertainment - visiting Bedlam to gawp and laugh at the loonies was once a fashionable pastime. If they weren't institutionalized, families hid them, like Rochester's first wife in Jane Eyre, the madwoman in the cellar or attic. And they tended to die young, falling into wells (or being pushed).
2. The terminology has changed. We no longer have such categories as 'possessed by demons', at least not in the US. It is interesting to contemplate what doctors of three or four centuries - or even the turn of the last century - would have made of Michael Megginson.
1. They are visible. Up until recently, the mentally ill were locked away. If you saw them, it was only as a visitor seeking entertainment - visiting Bedlam to gawp and laugh at the loonies was once a fashionable pastime. If they weren't institutionalized, families hid them, like Rochester's first wife in Jane Eyre, the madwoman in the cellar or attic. And they tended to die young, falling into wells (or being pushed).
2. The terminology has changed. We no longer have such categories as 'possessed by demons', at least not in the US. It is interesting to contemplate what doctors of three or four centuries - or even the turn of the last century - would have made of Michael Megginson.
The current model for treating mentally ill inmates is clearly broken. Unless city and state officials have a better plan, they ought to give Mr. Greenburger's pilot project an opportunity to demonstrate its effectiveness. Inaction is inexcusable.
3
How about some kind of program with input from folks in other countries who do this better than us to get some new ideas about mental health for the vulnerable.
6
What countries would those be? I don't know of any, at least not any systems that bear close examination.
"In his 18 months there, he was constantly involved in some kind of disturbance, his records show. He fought with other inmates and officers; spit and threw urine at them; smashed windows and furniture and once stabbed an officer in the back of the head with a piece of glass."
Sounds like a nice guy. I can't imagine why he wouldn't be in a hospital setting where he'd have access to hurt innocent people.
Sounds like a nice guy. I can't imagine why he wouldn't be in a hospital setting where he'd have access to hurt innocent people.
8
Spraying someone with pepper spray to calm them down. Who would think this is a good idea? Putting someone in solitary confinement when they are released from the hospital for punishment long after the incident. Would that not make anyone more angry? What happened to common sense?
8
What is your solution? Please hurry in your response.
Have you ever met a violent psychotic person? What is a prison guard suppose to do if this violent person is attacking others or himself?
Have you ever met a violent psychotic person? What is a prison guard suppose to do if this violent person is attacking others or himself?
2
You should pay a visit to one of those maximum security prisons and see if your opinion change.
1
Mr. Greenberger's proposal sounds like a reasonable, humane and fair approach to this seemingly unsolvable problem. I hope that the "powers that be" at least give it a chance to succeed. If it works, it could potentially save millions of dollars and even more importantly, it could save lives.
3
Shame on our culture for treating our most vulnerable in such an inhumane way.
1
As much we and as his mother may hope, Michael Megginson and others like him cannot live on their own. They are one missed pill away from a violent psychotic break. We did not do the mentally ill any favors by throwing open the doors of the nation's mental hospitals without adequate treatment and support for them in their communities.
8
Yeah, tell that to Elyn Saks or Lori Schiller.
Too often the judicial system makes decisions on abstract concepts that seem right in theory, but in fact are very wrong in practice. There were likely many abuses when individuals were involuntarily committed by family members who saw someone as inconvenient or unorthodox, but overwhelming, the practice of involuntary hospitalizations helped the families and definitely were the appropriate form of care for the patient. Today our judicial system continues to turn its backs on the real life consequences of their decisions. Possessing and showing empathy should not be considered a negative attribute in our judges. The decisions made from the bench have a real impact on real people, like Michael Megginson and millions of others who are jailed instead of helped.
4
I am glad that the New York Times continues to focus on the treatment of the mentally ill in the judicial system, Rikers' in particular and our society as whole. The mentally ill should not be brutalized and incarcerated in prisons where they are brutalized by correction officers.
Mental illness is a national public health problem that should be the preview of the Surgeon General. However, New York City has one of the best public health systems in the country. The Mayor should allow his qualified public health officials along with psychologists and psychiatrists dictate the policy to treat the mentally ill before and after they become entangled in the judicial system, not uninformed brutal correction officials.
I hope that there will be systems in place to support Mr. Megginson after he is released. It is the only way that he can succeed at being compliant with his medication. He also needs to continue therapy to help him cope on a daily basis.
I wish Mr. Megginson good health and peace as he continues his journey.
Mental illness is a national public health problem that should be the preview of the Surgeon General. However, New York City has one of the best public health systems in the country. The Mayor should allow his qualified public health officials along with psychologists and psychiatrists dictate the policy to treat the mentally ill before and after they become entangled in the judicial system, not uninformed brutal correction officials.
I hope that there will be systems in place to support Mr. Megginson after he is released. It is the only way that he can succeed at being compliant with his medication. He also needs to continue therapy to help him cope on a daily basis.
I wish Mr. Megginson good health and peace as he continues his journey.
Firstly, Mr. Megginson assaulted clinicians at various hospitals. This type of crime is now a felony in tne state of New York. Mr. Megginson should have been arrested and prosecuted for these assaults. Too often, violence against mental health workers has been overlooked as "part of the job". Patients such as Mr. Megginson have been given free reign to kick, bite, and punch healthcare workers.
The tide is changing. I am a MD who was recently savagely punched repeatedly in the head by a patient at the Hudson Valley-area hospital where I work. I suffered a concussion and a subdural hematoma. I now am experiencing multiple neurological symptoms. The patient who attacked me? She was arrested on discharge, and charged with a felony. The case is being handled by the manor crimes unit. If any of you readers were savagely beaten by some random mentally ill person I am sure you would waant to see the perpetrator arrested. Well, we healthcare workers feel the same.
The tide is changing. I am a MD who was recently savagely punched repeatedly in the head by a patient at the Hudson Valley-area hospital where I work. I suffered a concussion and a subdural hematoma. I now am experiencing multiple neurological symptoms. The patient who attacked me? She was arrested on discharge, and charged with a felony. The case is being handled by the manor crimes unit. If any of you readers were savagely beaten by some random mentally ill person I am sure you would waant to see the perpetrator arrested. Well, we healthcare workers feel the same.
11
You want the patient charged and jailed even if she wasn't in her right mind at the time? In other words she's responsible no matter what her state of mind was when she assaulted you. You haven't even provided enough information for us to know if the patient was mentally ill, in her right mind, or what was going on. Without that your comment is meaningless.
Hen3ry - you do not understand the criminal justice sytem, do you. It is not the victim of a violent crime nor the arresting officer's duty to judje the perpetrator's "state of mind". That falls to the perpetrator's attorney, the judge, and a jury of the perpetrator's peers.
There's another side to this story that is not mentioned at all. That side involves the very threatening world of the health care providers in prisons dealing with many of these mentally ill inmates (ref: http://www.nytimes.com/2014/05/22/nyregion/rising-hazard-for-civilian-st.... Recently a young female intern had her jaw broken in an attack, and nurses are frequently the target of physical violence in these prisons.
And why? Why are violent episodes so much worse outside of hospitals. Much stems from the truly ridiculous notion that a mentally ill patient in the throws of delusion can refuse to take medication. This has been a problem since the closure of the horrible mental hospitals. You see, part of the argument for closing the mental hospitals involves the discovery of new and potent anti-psychotic medicine. The problem of course with all medicine is that it only works if you take it. At some point in society, we have to understand that there is balance between patient rights, and the right of the rest of society. Many of the violent outbursts in prisons (as described in an opinion piece written in this paper one year ago by a prison psychiatrist) can be traced to patietns refusing treatment.
And why? Why are violent episodes so much worse outside of hospitals. Much stems from the truly ridiculous notion that a mentally ill patient in the throws of delusion can refuse to take medication. This has been a problem since the closure of the horrible mental hospitals. You see, part of the argument for closing the mental hospitals involves the discovery of new and potent anti-psychotic medicine. The problem of course with all medicine is that it only works if you take it. At some point in society, we have to understand that there is balance between patient rights, and the right of the rest of society. Many of the violent outbursts in prisons (as described in an opinion piece written in this paper one year ago by a prison psychiatrist) can be traced to patietns refusing treatment.
10
I agree that there is a place for involuntary confinement of the mentally ill with violent tendencies and that their caregivers deserve protection, especially those who are non-compliant with treatment.
But don't put them in jail. That's all we are saying. It benefits no one: not the mentally ill person, not the prison system, not their families and not greater society.
But don't put them in jail. That's all we are saying. It benefits no one: not the mentally ill person, not the prison system, not their families and not greater society.
Thanks Reagan. Mental Health facilities were just another government abuse, and had to be shut down (privatized). These people should pull themselves up by their bootstraps, and take personal accountability! Like welfare, just take it away, and the poor and mentally disturbed will be forced to fix themselves. Right? Of course, not much profit in taking care of these people, so.... off to expensive privatized jails. Ugh.
4
I think there's no way around the fact that it's going to be expensive to treat all these people with both dignity and firmness. Large-scale mental institutions have never been kind - not in the Middle Ages, and not in the 1970s - because lets' face it, no one really knows what to do with people who have such serious mental problems that they can't care for themselves.
There's a punitive element to all of it, with an either/or mindset: is he nuts, not responsible, and thus worthy of pity and aid, or is he a criminal, someone who knows better, in need of punishment? In the real world the same person could, at various times, be both.
Of course, we could address unemployment by training and staffing up on mental health counseling and such, since there's such a need for it. That would require government dollars, which politicians don't want to spend on such "undeserving" people - they'd really like for all the mentally ill folks to crawl off and die in a corner, elsewhere, or be housed in large institutions where efficient per-capita spending is the only measure of success.
There's a punitive element to all of it, with an either/or mindset: is he nuts, not responsible, and thus worthy of pity and aid, or is he a criminal, someone who knows better, in need of punishment? In the real world the same person could, at various times, be both.
Of course, we could address unemployment by training and staffing up on mental health counseling and such, since there's such a need for it. That would require government dollars, which politicians don't want to spend on such "undeserving" people - they'd really like for all the mentally ill folks to crawl off and die in a corner, elsewhere, or be housed in large institutions where efficient per-capita spending is the only measure of success.
4
The Department of Corrections's response to this entire series has been twofold: 1) we are working on it, and 2) the problem is limited to Rikers, but Bellvue and other facilities are working. This installment proves the lie there as well. The failures of the DOC are spawned by decades of neglect, not least because inmates have no political voice and no one has ever cast a mayoral or city council vote based on Corrections Reform. The question to voters is whether we will do so now. Have we turned a corner and created political will to change anything, or will we fold our papers, go back to our breakfasts, and lament what a shame it all is?
2
Mr. Meggison could be the next Adam Lanza. Prisons need more space and better conditions, zero tolerance for inmate abuse, a system of secure psychiatric facilities that allow for treatment to occur in conjunction with incarceration, strict financial oversight and education programs for inmates.
If we owe it to our kids to keep the Adam Lanza's from doing harm, we owe it to those who we require incarcerated to be treated humanely. The current system is an abysmal failure, and I would support any politician who made it a top priority.
If we owe it to our kids to keep the Adam Lanza's from doing harm, we owe it to those who we require incarcerated to be treated humanely. The current system is an abysmal failure, and I would support any politician who made it a top priority.
5
It seems that the US should have mental institutions. The problems that caused mental institutions to go out of existence were basically poor management and staff as well as improperly maintained physical structures. The staff at these closed dilapidated mental institutions treated the patients inhumanly. After many more decades of study since then, both the medical profession and non-medical people have a better understanding of mental illness and are treating it as the serious medical condition that it is. That being said, it is time to build state of the art mental institutions in each State, for those who are in need institutionalization, as determined by a panel of competent physicians to need that service.
2
What makes you so sure that at least 30 million people will let themselves be tossed away in psychiatric gulags again? Have you ever discussed the issue of reinstitutionalization with a Mad person? If you would fight to the death in order to keep your freedom, what makes you think we would do any different?
Oh, how the tables have turned! 40 years ago, all of well-meaning do-gooders wanted the long-term mental hospitals closed because they wanted to give people with mental health problems more self-determination. Well, they got it. Missed appointments, medications refused, coping skills not used. And now that we're reaping the whirlwind of our good intentions, everyone wants the hospitals reopened. Good idea, folks. Would have been a fantastic idea 30 years ago.
As for this gentleman, I'm not sure there *is* a good answer. Sending him to prison was a terrible idea, yes. But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it. I work in a rural area. I can think of a dozen families off the top of my head that would kill for the kinds of resources this man received. Yes, he's sick. And he needs help. But he people going to bat for him (though not his family much, unfortunately), and it wasn't enough.
As for this gentleman, I'm not sure there *is* a good answer. Sending him to prison was a terrible idea, yes. But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it. I work in a rural area. I can think of a dozen families off the top of my head that would kill for the kinds of resources this man received. Yes, he's sick. And he needs help. But he people going to bat for him (though not his family much, unfortunately), and it wasn't enough.
12
"But even when he was getting appropriate mental health services when he wasn't in prison, he couldn't hold it together. He got the best the system has to offer, and he blew it."
Blaming the victim of mental illness is making him or her a victim twice. It diverts attention from the fact that the mental health system is an abject failure.
Blaming the victim of mental illness is making him or her a victim twice. It diverts attention from the fact that the mental health system is an abject failure.
14
I found the story upsetting too. It sounds like you are very angry at a lot of people: the "do gooders," the system, the family, the mentally-ill man who got expensive care but "blew it." But have you considered that there may not be anybody to blame? Sometimes people are just born very sick, and we still don't know why it happens, how to prevent it, or what to do to make them well.
When the Libertarian Thomas Szasz brought up emptying the mental hospitals for political theory, the politician jumped on saving the money. Now they spend it on jail. A system worthy of the old Soviet Mental Health System for sure. Are Republicans and Libertarians secretly envious of tyranny as a system rather than what they call "Secular Humanism?" We are in a culture war for the soul of the American people. The people running this system are evil pure and simple and no biblical story about love or liberty will save their souls. People who advocate jail for mental illness rather than treatment and private enterprise for jail or bad people with nothing but old fashioned greed and cynicism for a philosophy and religion.
4
yes
The saddest failures in public policy are when the pendulum swings and gets stuck at one end. Look how prescient Moynihan's report on the impact of family breakdown was, and how long it took us to realize that stable family really was incredibly, fundamentally important to society. (The difference being that our conception of family now extends beyond a standard paterfamilias, wife and kids.)
The policy of closing down mental health institutions and attempting care in the community has been an unmitigated disaster. We need to recognize it as such and nudge the pendulum free again.
The policy of closing down mental health institutions and attempting care in the community has been an unmitigated disaster. We need to recognize it as such and nudge the pendulum free again.
9
I suggest the work of Michel Foucault, especially his seminal treatise Madness and Civilization, as a way to understand this "problem." Thank you.
2
This will be thought unserious, but when we consider why there is so much more mental illness in the past decades, does anyone think of diet? Our food supply - except for those who can afford nourishing high-quality food and are committed to eating that way - lacks essential nutrients and contains so much sugar and corn syrup and who knows what else what should be fuel becomes half-poisonous. Some research would show that a truly healthy diet can help with mental illness. It is now a near impossibility to effect the kind of changes in the diet of the poor people described here that would be necessary to see if a difference could be made.
As for Rikers, can't there be a specialized unit for these sickest of the sick, to at least keep them safe?
As for Rikers, can't there be a specialized unit for these sickest of the sick, to at least keep them safe?
1
"so much more mental illness in the past decades"
Do you have the actual number to back that statement up? The numbers is actually the reverse.
http://www.nytimes.com/2007/01/15/opinion/15harcourt.html
The US's combined prison/mental hospital population is at the same place as before the deinstitutionalization. So I don't think we have more mental illness, just that deinstitutionalization make them become visible instead of being sweep under the rug.
Do you have the actual number to back that statement up? The numbers is actually the reverse.
http://www.nytimes.com/2007/01/15/opinion/15harcourt.html
The US's combined prison/mental hospital population is at the same place as before the deinstitutionalization. So I don't think we have more mental illness, just that deinstitutionalization make them become visible instead of being sweep under the rug.
Prison provide better food than you can affordablely get on the outside. It is federal mandates and they even have nutritionist making sure it is balanced. Frankly, I think the finger should be pointed at drugs (including soft drugs and self-medication), alcohol and super dose of caffeine in energy drink such as Mountain Dew and Monster.
There is not more mental illness. There only seems to be more because of the following factors:
1. They are visible. Up until recently, the mentally ill were locked away. If you saw them, it was only as a visitor seeking entertainment - visiting Bedlam to gawp and laugh at the loonies was once a fashionable pastime. If they weren't institutionalized, families hid them, like Rochester's first wife in Jane Eyre, the madwoman in the cellar or attic. And they tended to die young, falling into wells (or being pushed).
2. The terminology has changed. We no longer have such categories as 'possessed by demons', at least not in the US. It is interesting to contemplate what doctors of three or four centuries - or even the turn of the last century - would have made of Michael Megginson.
1. They are visible. Up until recently, the mentally ill were locked away. If you saw them, it was only as a visitor seeking entertainment - visiting Bedlam to gawp and laugh at the loonies was once a fashionable pastime. If they weren't institutionalized, families hid them, like Rochester's first wife in Jane Eyre, the madwoman in the cellar or attic. And they tended to die young, falling into wells (or being pushed).
2. The terminology has changed. We no longer have such categories as 'possessed by demons', at least not in the US. It is interesting to contemplate what doctors of three or four centuries - or even the turn of the last century - would have made of Michael Megginson.
1
The current model for treating mentally ill inmates is clearly broken. Unless city and state officials have a better plan, they ought to give Mr. Greenburger's pilot project an opportunity to demonstrate its effectiveness. Inaction is inexcusable.
3
How about some kind of program with input from folks in other countries who do this better than us to get some new ideas about mental health for the vulnerable.
6
What countries would those be? I don't know of any, at least not any systems that bear close examination.
"In his 18 months there, he was constantly involved in some kind of disturbance, his records show. He fought with other inmates and officers; spit and threw urine at them; smashed windows and furniture and once stabbed an officer in the back of the head with a piece of glass."
Sounds like a nice guy. I can't imagine why he wouldn't be in a hospital setting where he'd have access to hurt innocent people.
Sounds like a nice guy. I can't imagine why he wouldn't be in a hospital setting where he'd have access to hurt innocent people.
9
Spraying someone with pepper spray to calm them down. Who would think this is a good idea? Putting someone in solitary confinement when they are released from the hospital for punishment long after the incident. Would that not make anyone more angry? What happened to common sense?
9
What is your solution? Please hurry in your response.
Have you ever met a violent psychotic person? What is a prison guard suppose to do if this violent person is attacking others or himself?
Have you ever met a violent psychotic person? What is a prison guard suppose to do if this violent person is attacking others or himself?
3
You should pay a visit to one of those maximum security prisons and see if your opinion change.
1
Mr. Greenberger's proposal sounds like a reasonable, humane and fair approach to this seemingly unsolvable problem. I hope that the "powers that be" at least give it a chance to succeed. If it works, it could potentially save millions of dollars and even more importantly, it could save lives.
4
The callous dumping of mental patients onto the streets and ultimately into prison is no less shameful than the conditions in 18th-century asylums.
Despite what the article says, this is not something that is favored by clinicians with whom I have spoken. It is a consequence of misguided civil liberties laws and the failure of politicians to fund mental hospitals and halfway care. It makes no sense from the perspective of the mentally ill, their suffering families, society, or the state budget, given that dumped mental patients frequently become addicted to street drugs or end up in prison at great expense.
Clearly, we need a two part approach: half-way housing and supervision for those patients whose symptoms can be controlled through medication, and commitment and institutionalization for those who are dangerous or whose symptoms can't be controlled, with special facilities for those with a history of violence. Anything less is barbaric and cruel.
Despite what the article says, this is not something that is favored by clinicians with whom I have spoken. It is a consequence of misguided civil liberties laws and the failure of politicians to fund mental hospitals and halfway care. It makes no sense from the perspective of the mentally ill, their suffering families, society, or the state budget, given that dumped mental patients frequently become addicted to street drugs or end up in prison at great expense.
Clearly, we need a two part approach: half-way housing and supervision for those patients whose symptoms can be controlled through medication, and commitment and institutionalization for those who are dangerous or whose symptoms can't be controlled, with special facilities for those with a history of violence. Anything less is barbaric and cruel.
21
An unholy alliance between the ACLU and Ronald Reagan resulted in the closure of all of our mental institutions in the 1980s. Their intentions may have been good--to provide an opportunity for those whose mental illnesses could be managed on an outpatient basis to rejoin the community, and to save money on the unnecessary institutionalization of people who were capable of living on their own or with family. More than thirty years of experience, however, has shown us that these policies have resulted in large increases in homelessness, crime, and the victimization of mentally ill people living on the street, resulting in a large net reduction in their civil liberties and ours, and a huge increase in the cost of dealing with the chronically mentally ill in terms of criminal acts, imprisonment, and repeated, unsuccessful outpatient treatment. We need to adopt a "multiple strikes" approach for chronically mentally ill people who may not pose an immediate threat to themselves or others, but whose frequent contacts with the mental health system and the criminal justice system show them to be in need of care for a term of years.
2
The callous dumping of mental patients onto the streets and ultimately into prison is no less shameful than the conditions in 18th-century asylums.
Despite what the article says, this is not something that is favored by clinicians with whom I have spoken. It is a consequence of misguided civil liberties laws and the failure of politicians to fund mental hospitals and halfway care. It makes no sense from the perspective of the mentally ill, their suffering families, society, or the state budget, given that dumped mental patients frequently become addicted to street drugs or end up in prison at great expense.
Clearly, we need a two part approach: half-way housing and supervision for those patients whose symptoms can be controlled through medication, and commitment and institutionalization for those who are dangerous or whose symptoms can't be controlled, with special facilities for those with a history of violence. Anything less is barbaric and cruel.
Despite what the article says, this is not something that is favored by clinicians with whom I have spoken. It is a consequence of misguided civil liberties laws and the failure of politicians to fund mental hospitals and halfway care. It makes no sense from the perspective of the mentally ill, their suffering families, society, or the state budget, given that dumped mental patients frequently become addicted to street drugs or end up in prison at great expense.
Clearly, we need a two part approach: half-way housing and supervision for those patients whose symptoms can be controlled through medication, and commitment and institutionalization for those who are dangerous or whose symptoms can't be controlled, with special facilities for those with a history of violence. Anything less is barbaric and cruel.
22
An unholy alliance between the ACLU and Ronald Reagan resulted in the closure of all of our mental institutions in the 1980s. Their intentions may have been good--to provide an opportunity for those whose mental illnesses could be managed on an outpatient basis to rejoin the community, and to save money on the unnecessary institutionalization of people who were capable of living on their own or with family. More than thirty years of experience, however, has shown us that these policies have resulted in large increases in homelessness, crime, and the victimization of mentally ill people living on the street, resulting in a large net reduction in their civil liberties and ours, and a huge increase in the cost of dealing with the chronically mentally ill in terms of criminal acts, imprisonment, and repeated, unsuccessful outpatient treatment. We need to adopt a "multiple strikes" approach for chronically mentally ill people who may not pose an immediate threat to themselves or others, but whose frequent contacts with the mental health system and the criminal justice system show them to be in need of care for a term of years.
2
Americans are stuck in the middle ages in their understanding of mental health. Children should be educated -- as part of their health classes, in the diseases of the mind. Only that will help us move beyond punitive handling of the mentally ill, which includes many of the homeless in our cities.
7
Americans are stuck in the middle ages in their understanding of mental health. Children should be educated -- as part of their health classes, in the diseases of the mind. Only that will help us move beyond punitive handling of the mentally ill, which includes many of the homeless in our cities.
10
It sounds as if Mr. Megginson needs a program that keeps him under pretty tight supervision all the time. Unfortunately, due to how things have worked with deinstitutionalization, the only program is to put him in prison which deprives him of his freedom and can make him worse. It would be less expensive to provide him with a place to live in a well run program with well trained counselors than it is to keep him in prison with no programs to help him. However, in America, we prefer to imprison mentally ill people rather than provide programs that could keep them out of prison and productive. In prison they are not our problem. They are out of our sight. It's also easier to call the police on them than it is to provide supervision they need to live in society or survive outside of prison.
I would suggest that we need to look at how we treat all mental illnesses but especially those that make it difficult for the person to function in society without some supervision. We are rich enough to provide them with safe living environments, a way to earn a living, and a place at the common table. We just have to want to.
I would suggest that we need to look at how we treat all mental illnesses but especially those that make it difficult for the person to function in society without some supervision. We are rich enough to provide them with safe living environments, a way to earn a living, and a place at the common table. We just have to want to.
21
After all the years people have been trying to get help for mentally ill relatives, I just don't know how you can say we just don't want to help them. It's in the news all the time! This man had every opportunity and still couldn't make it work. Yet, we cannot put him in a mental hospital, even if his doctors want him there, if he does not want to be there. No one wants to imprison mentally ill people, or have them become homeless, yet we are constrained from involuntarily hospitalizing them until they are a danger to themselves or others. Please find another theme, the one you are using has gotten very old.
1
Did you read what I wrote? Our society doesn't want to spend money on the mentally ill because we view it as their problem, a character problem, a moral problem. We don't have enough beds for mentally ill people. We don't allow involuntary hospitalization unless they are a danger to themselves or others. And even then we don't keep them in the hospital long enough to stabilize them and make sure that they have a place to go. As a society we don't care. I didn't say that you personally don't care, just that our society doesn't.
It sounds as if Mr. Megginson needs a program that keeps him under pretty tight supervision all the time. Unfortunately, due to how things have worked with deinstitutionalization, the only program is to put him in prison which deprives him of his freedom and can make him worse. It would be less expensive to provide him with a place to live in a well run program with well trained counselors than it is to keep him in prison with no programs to help him. However, in America, we prefer to imprison mentally ill people rather than provide programs that could keep them out of prison and productive. In prison they are not our problem. They are out of our sight. It's also easier to call the police on them than it is to provide supervision they need to live in society or survive outside of prison.
I would suggest that we need to look at how we treat all mental illnesses but especially those that make it difficult for the person to function in society without some supervision. We are rich enough to provide them with safe living environments, a way to earn a living, and a place at the common table. We just have to want to.
I would suggest that we need to look at how we treat all mental illnesses but especially those that make it difficult for the person to function in society without some supervision. We are rich enough to provide them with safe living environments, a way to earn a living, and a place at the common table. We just have to want to.
23
After all the years people have been trying to get help for mentally ill relatives, I just don't know how you can say we just don't want to help them. It's in the news all the time! This man had every opportunity and still couldn't make it work. Yet, we cannot put him in a mental hospital, even if his doctors want him there, if he does not want to be there. No one wants to imprison mentally ill people, or have them become homeless, yet we are constrained from involuntarily hospitalizing them until they are a danger to themselves or others. Please find another theme, the one you are using has gotten very old.
1
Did you read what I wrote? Our society doesn't want to spend money on the mentally ill because we view it as their problem, a character problem, a moral problem. We don't have enough beds for mentally ill people. We don't allow involuntary hospitalization unless they are a danger to themselves or others. And even then we don't keep them in the hospital long enough to stabilize them and make sure that they have a place to go. As a society we don't care. I didn't say that you personally don't care, just that our society doesn't.
The system is broken because the professionals who are trained to treat the mentally ill are trained to be incompetent.
5
That's the purest nonsense. It's broken because of civil liberties laws and cheap politicians.
8
As someone who has lifelong experience with mentally ill family members, I think your remark is glib, insulting, and uninformed.
A little experience with the Sisyphean despair and futility that attends the daily dealing with intractable, inexplicable, incurable mental illness might humble as well as inform you. Especially when only a few centuries ago - for most of human history - we were diagnosing mental illness as 'demonic possession' (in some Third World countries they still do) and our only treatments were barbaric, I'm stunned that they can get up in the morning and face this voluntarily, because for six decades now it's been all I can do to face it unavoidably.
Thank God for these people. And thank God for medications - they may not be perfect, but I've seen the difference between 'medicated' and 'off his/her meds'.
A little experience with the Sisyphean despair and futility that attends the daily dealing with intractable, inexplicable, incurable mental illness might humble as well as inform you. Especially when only a few centuries ago - for most of human history - we were diagnosing mental illness as 'demonic possession' (in some Third World countries they still do) and our only treatments were barbaric, I'm stunned that they can get up in the morning and face this voluntarily, because for six decades now it's been all I can do to face it unavoidably.
Thank God for these people. And thank God for medications - they may not be perfect, but I've seen the difference between 'medicated' and 'off his/her meds'.
4
Workerbee, what exactly do you mean when you say that mental health professionals are "trained to be incompetent," and what is your evidence for it? Are you referring to psychiatrists, psychologists, social workers, mental health counselors, marriage and family therapists, creative arts therapists, psychiatric nurses, psychiatric nurse practitioners, or all of the above? Note that they're not all trained in the same way, so it's not really helpful to generalize about them. And what would be your suggestions for better training? Do you believe the system would work just fine if all these professionals received this training, but no additional funds or resources were devoted to caring for the mentally ill, no additional support were given to their families, and no changes were made to the laws concerning involuntary psychiatric commitment?
2
The system is broken because the professionals who are trained to treat the mentally ill are trained to be incompetent.
5
That's the purest nonsense. It's broken because of civil liberties laws and cheap politicians.
8
As someone who has lifelong experience with mentally ill family members, I think your remark is glib, insulting, and uninformed.
A little experience with the Sisyphean despair and futility that attends the daily dealing with intractable, inexplicable, incurable mental illness might humble as well as inform you. Especially when only a few centuries ago - for most of human history - we were diagnosing mental illness as 'demonic possession' (in some Third World countries they still do) and our only treatments were barbaric, I'm stunned that they can get up in the morning and face this voluntarily, because for six decades now it's been all I can do to face it unavoidably.
Thank God for these people. And thank God for medications - they may not be perfect, but I've seen the difference between 'medicated' and 'off his/her meds'.
A little experience with the Sisyphean despair and futility that attends the daily dealing with intractable, inexplicable, incurable mental illness might humble as well as inform you. Especially when only a few centuries ago - for most of human history - we were diagnosing mental illness as 'demonic possession' (in some Third World countries they still do) and our only treatments were barbaric, I'm stunned that they can get up in the morning and face this voluntarily, because for six decades now it's been all I can do to face it unavoidably.
Thank God for these people. And thank God for medications - they may not be perfect, but I've seen the difference between 'medicated' and 'off his/her meds'.
5
Workerbee, what exactly do you mean when you say that mental health professionals are "trained to be incompetent," and what is your evidence for it? Are you referring to psychiatrists, psychologists, social workers, mental health counselors, marriage and family therapists, creative arts therapists, psychiatric nurses, psychiatric nurse practitioners, or all of the above? Note that they're not all trained in the same way, so it's not really helpful to generalize about them. And what would be your suggestions for better training? Do you believe the system would work just fine if all these professionals received this training, but no additional funds or resources were devoted to caring for the mentally ill, no additional support were given to their families, and no changes were made to the laws concerning involuntary psychiatric commitment?
3
If this story were written in the early 70s it would be a good argument to keep mental facilities open. As reported hospitals are no place for this man The story reports that the mental profession has no diagnosis, much less treatment. It's all very sad. I suspect his condition was a result of severe child abuse. I hope he gets well and finds peace.
8
Your comment re "result of sever child abuse" may not be accurate.
My own child mimics alot of what this story writes about except for the extreme violence. While the mother admits hitting her child at age 19, it's more likely that mental illness runs in his family and whatever chemical imbalance he had just became worse without treatment.
And for the record, the closing of all mental health facilities was the biggest mistake because then the mentally sick had no where to go at all.
My own child mimics alot of what this story writes about except for the extreme violence. While the mother admits hitting her child at age 19, it's more likely that mental illness runs in his family and whatever chemical imbalance he had just became worse without treatment.
And for the record, the closing of all mental health facilities was the biggest mistake because then the mentally sick had no where to go at all.
1
Unfortunately for those who suffer from severe mental illness, we never "de-institutionalized" them . We simply changed the type of institution that we place them into. This is a tragic failure on our part to appropriately care for our most vulnerable community members.
57
We did deinstitutionalise them, but we placed them on the street. This was a bipartisan failure. The right saw it simply as an opportunity to save money by throwing them back on the families, or, if/when the families were overwhelmed or there was no family, to fend for themselves, under a 'libertarian' banner. The left, seduced by the rubbish of Ken Kesey, Ivan Illich, and similar ideologues spawned by the 1960s valorisation of illogic, characterised mental illness as mere nonconformity rebelling against an uptight society, and embraced the fairy tale that if you just let everyone out, everything would be butterflies and kittens. These two delusions converged in the botched deinstitutionalisation movement, the equivalent of pet owners who drive Fluffy and Fido out into the woods, kick them out of the car crying 'follow your nature, run free!' and drive off as fast as possible, leaving the poor critters to starve, freeze, or get eaten by coyotes or hit by cars.
6
Thank You New York Times for continuing to bring awareness to a system that is broken. Perhaps this individual could benefit from a series of Neurofeedback sessions. I am not a clinician but, it seems that he could benefit as a result of what looks like a great deal of brain dysregulation/hyper arousal and even perhaps under arousal issues. I have known many people who have benefited from Neurofeedback for a variety of issues. Fortunately there is a tremendous amount of research available & the results are promising/lasting. Perhaps the time has come for the prison system as well as the mental health system to incorporate this holistic approach into the lives of those in need. There is no need for this level of suffering when there are treatment modalities available that could provide a greater level of stabilization. The military is using Neurofeedback for soldiers w PTSD. School systems are using it for students w ADD/ADHD. Schools are also noticing that many children diagnosed w ADD/ADHD have major attachment issues/PTSD that can mimic ADD. Hospitals and clinics are utilizing it for people with sleep disorders. There are obvious concerns here related to psychotic episodes as well however, his impulse control problems could potentially be reduced dramatically. Michael Megginson & all those like him are suffering greatly & deserve so much better than what they are getting. I applaud our new Mayor & all those who are committed to helping them..
5
If this story were written in the early 70s it would be a good argument to keep mental facilities open. As reported hospitals are no place for this man The story reports that the mental profession has no diagnosis, much less treatment. It's all very sad. I suspect his condition was a result of severe child abuse. I hope he gets well and finds peace.
8
Your comment re "result of sever child abuse" may not be accurate.
My own child mimics alot of what this story writes about except for the extreme violence. While the mother admits hitting her child at age 19, it's more likely that mental illness runs in his family and whatever chemical imbalance he had just became worse without treatment.
And for the record, the closing of all mental health facilities was the biggest mistake because then the mentally sick had no where to go at all.
My own child mimics alot of what this story writes about except for the extreme violence. While the mother admits hitting her child at age 19, it's more likely that mental illness runs in his family and whatever chemical imbalance he had just became worse without treatment.
And for the record, the closing of all mental health facilities was the biggest mistake because then the mentally sick had no where to go at all.
2
Unfortunately for those who suffer from severe mental illness, we never "de-institutionalized" them . We simply changed the type of institution that we place them into. This is a tragic failure on our part to appropriately care for our most vulnerable community members.
68
We did deinstitutionalise them, but we placed them on the street. This was a bipartisan failure. The right saw it simply as an opportunity to save money by throwing them back on the families, or, if/when the families were overwhelmed or there was no family, to fend for themselves, under a 'libertarian' banner. The left, seduced by the rubbish of Ken Kesey, Ivan Illich, and similar ideologues spawned by the 1960s valorisation of illogic, characterised mental illness as mere nonconformity rebelling against an uptight society, and embraced the fairy tale that if you just let everyone out, everything would be butterflies and kittens. These two delusions converged in the botched deinstitutionalisation movement, the equivalent of pet owners who drive Fluffy and Fido out into the woods, kick them out of the car crying 'follow your nature, run free!' and drive off as fast as possible, leaving the poor critters to starve, freeze, or get eaten by coyotes or hit by cars.
7
Correct. We "trans-institutionalized" them.
Thank You New York Times for continuing to bring awareness to a system that is broken. Perhaps this individual could benefit from a series of Neurofeedback sessions. I am not a clinician but, it seems that he could benefit as a result of what looks like a great deal of brain dysregulation/hyper arousal and even perhaps under arousal issues. I have known many people who have benefited from Neurofeedback for a variety of issues. Fortunately there is a tremendous amount of research available & the results are promising/lasting. Perhaps the time has come for the prison system as well as the mental health system to incorporate this holistic approach into the lives of those in need. There is no need for this level of suffering when there are treatment modalities available that could provide a greater level of stabilization. The military is using Neurofeedback for soldiers w PTSD. School systems are using it for students w ADD/ADHD. Schools are also noticing that many children diagnosed w ADD/ADHD have major attachment issues/PTSD that can mimic ADD. Hospitals and clinics are utilizing it for people with sleep disorders. There are obvious concerns here related to psychotic episodes as well however, his impulse control problems could potentially be reduced dramatically. Michael Megginson & all those like him are suffering greatly & deserve so much better than what they are getting. I applaud our new Mayor & all those who are committed to helping them..
5
This was an extraordinarily difficult story to read. I have worked with patients with genetic disease (Huntington) that have some of these characteristics, some of the time; I have worked with people with schizophrenia and bipolar disorder that have some of these characteristics; I have read about and studied many of these patients… and I do not see an alternative other than long term hospitalization, therapy, medication and intervention. Civilization has its discontents, and perhaps foremost among these are the inability of some to adjust to its strictures. The patients mentioned in this article are among those who cannot or are not now able to adjust. The obligation of society is to provide them the best life that they are capable of living, given their extreme disability. If we believe that life is sacrosanct, the economics of care for these patients should be a minor consideration.
72
My husbsnd is bipolar and has been in jail (Rikers). Fortunately he did get medical help there. But it had happened again. I just want to say mental illness is a problem for those suffering and family around them I love my husband so much that I basically destroyed relationships with family members because they refused to respond to us. They blame him as a loser.
1
Yes, the extremely mentally disabled deserves the same dollars as, say, a cancer patient who requires surgery, radiation and chemotherapy.
1
How can we get around the ACLU and involuntary confinement?
2
Beyond ridiculous. Unnecessary millions spent. Violent outbursts resulting in beatings and solitary confinement. Other inmates and correctional staff threatened.
Do you think that a competency hearing might be held ? That a responsible family member or court lawyer be given power of attorney ? That this man be placed in an appropriate setting ?
Clearly he is non compos mentis and not responsible. Is this what we do with the mentally ill ? Beat and imprison them and then beat them some more ?
A significant portion of prison inmates in America suffer from mental ailments and disabilities. More money is allocated to the prison systems than for education, and yet preposterous anomalies like this are ignored at the cost of life, limb, and outrageous sums of money.
The penal system in America is medieval. Rehabilitation is practically non-existent and such Dickensian atrocities as described in this piece have become an every day story.
Why ? Society must not shirk its responsibilities to that which it spawns and, in the end, do what is right, expedient, and makes the most sense. Mentally unfit humans do not belong in a dungeon.
Do you think that a competency hearing might be held ? That a responsible family member or court lawyer be given power of attorney ? That this man be placed in an appropriate setting ?
Clearly he is non compos mentis and not responsible. Is this what we do with the mentally ill ? Beat and imprison them and then beat them some more ?
A significant portion of prison inmates in America suffer from mental ailments and disabilities. More money is allocated to the prison systems than for education, and yet preposterous anomalies like this are ignored at the cost of life, limb, and outrageous sums of money.
The penal system in America is medieval. Rehabilitation is practically non-existent and such Dickensian atrocities as described in this piece have become an every day story.
Why ? Society must not shirk its responsibilities to that which it spawns and, in the end, do what is right, expedient, and makes the most sense. Mentally unfit humans do not belong in a dungeon.
52
Yes, it's what we do with the mentally ill, for the simple reason that misguided civil liberties laws prevent us from committing them to mental hospitals, and penny-wise pound-foolish politicians won't pay for half-way care for those whose symptoms can be controlled without hospitalization.
9
Please re-read the article. Several competency hearings were held. Mr. Megginson, while before the Court, didn't display the symptoms that would lead to an involuntary, long-term hospitalization, and that's the the standard of proof in this type of hearing. Testimony about the behavior that led prison officials and medical personnel to bring him before the Court is insufficient if he isn't displaying psychotic behavior in court.
While fully appreciating your sentiment about failure in Mr. Meggison's case, the article makes clear that the full range of available approaches have thus far been attempted, failed and that this is one case , among many, awaiting a solution.
While fully appreciating your sentiment about failure in Mr. Meggison's case, the article makes clear that the full range of available approaches have thus far been attempted, failed and that this is one case , among many, awaiting a solution.
4
Why does the NYT report the restraining of inmates as "beatings". when inmates are as violent as this man having a psychotic episode, how does one protect themselves and at that same time restrain the inmate? When inmates or the mentally ill resist being protected from hurting themselves or others it is not a "beating". What would the average person do if someone on the street threw urine on feces on them? Call the cops ? Let's be real. When police try to restrain a person on the street and they are fighting back, it is called resisting arrest. When a psychotic inmate is holding a shard of glass waiting to attack a correction's officer or another inmate, it is called a beating ?.... think about it folks. Is it ok for the mentally ill or any violent person for that matter to be left to their own devices? Other inmates have as much right to be protected from violence as the officers that work there. Officers are trained to deal with these type of incidents. Here's the choice: if someone having a psychotic break is coming at you with a shard of glass do you just stand there and let them attack you? or do you try to stop them?...the end result is someone's going to get hurt ..do you want it to be you?
4
There are so many more questions than answers for Mr. Megginson and other like him.
One place to start looking would be why the theft of a cellphone lands one on Rikers Island. Certainly the punishment does not fit the crime. Granted it is a small step, but it is a step.
One place to start looking would be why the theft of a cellphone lands one on Rikers Island. Certainly the punishment does not fit the crime. Granted it is a small step, but it is a step.
27
Stealing a cellphone likely wouldn't land a first-offender on Riker's Island, but it sounds like Mr. Megginson has a lengthy criminal history, and that is something that many judges consider in imposing sentence.
1
This was an extraordinarily difficult story to read. I have worked with patients with genetic disease (Huntington) that have some of these characteristics, some of the time; I have worked with people with schizophrenia and bipolar disorder that have some of these characteristics; I have read about and studied many of these patients… and I do not see an alternative other than long term hospitalization, therapy, medication and intervention. Civilization has its discontents, and perhaps foremost among these are the inability of some to adjust to its strictures. The patients mentioned in this article are among those who cannot or are not now able to adjust. The obligation of society is to provide them the best life that they are capable of living, given their extreme disability. If we believe that life is sacrosanct, the economics of care for these patients should be a minor consideration.
84
My husbsnd is bipolar and has been in jail (Rikers). Fortunately he did get medical help there. But it had happened again. I just want to say mental illness is a problem for those suffering and family around them I love my husband so much that I basically destroyed relationships with family members because they refused to respond to us. They blame him as a loser.
1
Yes, the extremely mentally disabled deserves the same dollars as, say, a cancer patient who requires surgery, radiation and chemotherapy.
4
How can we get around the ACLU and involuntary confinement?
2
Beyond ridiculous. Unnecessary millions spent. Violent outbursts resulting in beatings and solitary confinement. Other inmates and correctional staff threatened.
Do you think that a competency hearing might be held ? That a responsible family member or court lawyer be given power of attorney ? That this man be placed in an appropriate setting ?
Clearly he is non compos mentis and not responsible. Is this what we do with the mentally ill ? Beat and imprison them and then beat them some more ?
A significant portion of prison inmates in America suffer from mental ailments and disabilities. More money is allocated to the prison systems than for education, and yet preposterous anomalies like this are ignored at the cost of life, limb, and outrageous sums of money.
The penal system in America is medieval. Rehabilitation is practically non-existent and such Dickensian atrocities as described in this piece have become an every day story.
Why ? Society must not shirk its responsibilities to that which it spawns and, in the end, do what is right, expedient, and makes the most sense. Mentally unfit humans do not belong in a dungeon.
Do you think that a competency hearing might be held ? That a responsible family member or court lawyer be given power of attorney ? That this man be placed in an appropriate setting ?
Clearly he is non compos mentis and not responsible. Is this what we do with the mentally ill ? Beat and imprison them and then beat them some more ?
A significant portion of prison inmates in America suffer from mental ailments and disabilities. More money is allocated to the prison systems than for education, and yet preposterous anomalies like this are ignored at the cost of life, limb, and outrageous sums of money.
The penal system in America is medieval. Rehabilitation is practically non-existent and such Dickensian atrocities as described in this piece have become an every day story.
Why ? Society must not shirk its responsibilities to that which it spawns and, in the end, do what is right, expedient, and makes the most sense. Mentally unfit humans do not belong in a dungeon.
61
Yes, it's what we do with the mentally ill, for the simple reason that misguided civil liberties laws prevent us from committing them to mental hospitals, and penny-wise pound-foolish politicians won't pay for half-way care for those whose symptoms can be controlled without hospitalization.
9
Please re-read the article. Several competency hearings were held. Mr. Megginson, while before the Court, didn't display the symptoms that would lead to an involuntary, long-term hospitalization, and that's the the standard of proof in this type of hearing. Testimony about the behavior that led prison officials and medical personnel to bring him before the Court is insufficient if he isn't displaying psychotic behavior in court.
While fully appreciating your sentiment about failure in Mr. Meggison's case, the article makes clear that the full range of available approaches have thus far been attempted, failed and that this is one case , among many, awaiting a solution.
While fully appreciating your sentiment about failure in Mr. Meggison's case, the article makes clear that the full range of available approaches have thus far been attempted, failed and that this is one case , among many, awaiting a solution.
4
Why does the NYT report the restraining of inmates as "beatings". when inmates are as violent as this man having a psychotic episode, how does one protect themselves and at that same time restrain the inmate? When inmates or the mentally ill resist being protected from hurting themselves or others it is not a "beating". What would the average person do if someone on the street threw urine on feces on them? Call the cops ? Let's be real. When police try to restrain a person on the street and they are fighting back, it is called resisting arrest. When a psychotic inmate is holding a shard of glass waiting to attack a correction's officer or another inmate, it is called a beating ?.... think about it folks. Is it ok for the mentally ill or any violent person for that matter to be left to their own devices? Other inmates have as much right to be protected from violence as the officers that work there. Officers are trained to deal with these type of incidents. Here's the choice: if someone having a psychotic break is coming at you with a shard of glass do you just stand there and let them attack you? or do you try to stop them?...the end result is someone's going to get hurt ..do you want it to be you?
5
There are so many more questions than answers for Mr. Megginson and other like him.
One place to start looking would be why the theft of a cellphone lands one on Rikers Island. Certainly the punishment does not fit the crime. Granted it is a small step, but it is a step.
One place to start looking would be why the theft of a cellphone lands one on Rikers Island. Certainly the punishment does not fit the crime. Granted it is a small step, but it is a step.
31
Stealing a cellphone likely wouldn't land a first-offender on Riker's Island, but it sounds like Mr. Megginson has a lengthy criminal history, and that is something that many judges consider in imposing sentence.
1
When we began to systematically close mental institutions is when the prisons became crowded with people who shouldn't be there. Mental institutions served a real purpose in this country and many that can be should be reopened. Some have been left abandoned or repurposed, like near me, Wingdale, a former mental health campus that is now becoming a college.
99
When we began to systematically close mental institutions is when the prisons became crowded with people who shouldn't be there. Mental institutions served a real purpose in this country and many that can be should be reopened. Some have been left abandoned or repurposed, like near me, Wingdale, a former mental health campus that is now becoming a college.
116
These mental institutions were not much better than prisons, and they were also not effective. If we are going to open more mental health institutions, they need to be run way way better than they were before. We know the types of systems that we need. Take a look at Norway's prison system for example. The issue is that we don't have the political and economic will. We don't care about these people; we just want them to go away.
1