The Path to a Humanitarian Disaster on America’s Streets
Letters, May 25, 2022, WSJ
Deinstitutionalization of the mentally ill resulted from a
confluence of factors (“The Mental Illness Pandemic” by
Daniel Henninger, Wonder Land, May 19). Perhaps most
important was the emergence of Thorazine, the revolutionary
antipsychotic medication. This produced the psychiatric
zeitgeist that outpatient treatment of psychotics was
possible and preferred.

Compound this with the government’s desire to reduce spending
on mental hospitals, court decisions regarding the civil
liberties of the involuntarily hospitalized, popular culture
(“One Flew Over the Cuckoo’s Nest”), and some misconceived
compassion and you see how we got here. I commend the
psychiatric profession for later recanting its optimism about
outpatient treatment for all psychotics and recommending a
return to the ability of physicians to hospitalize involuntarily
those who are truly too ill to be out and about in society.
--Greg Polito, M.D., Dallas
-----------------------
In his letter (March 24), Thomas O’Hare states, “We have a
process for deciding if someone is a ‘danger to self and
others.’” Not really. The only process is to ask a mental-health
patient if he has thoughts of harming himself or others. Patients
quickly learn that an affirmative answer will get them confined
against their will, whereas a negative answer results in release
with an outpatient appointment for follow-up.
--Thomas J. Vandiver, Charlotte, N.C.
=======================
Conversation [13 Comments]
robert browder, 26 May, 2022
“ Patients quickly learn that an affirmative answer will get
them confined against their will, whereas a negative answer
results in release with an outpatient appointment for follow-up.”
This is exactly what the murderer in the Buffalo supermarket did
during his day and half evaluation, except there was no followup. ----------------
terri schmidt, 26 May, 2022
I am a psychotherapist in private practice. Some years ago I
was discussing a client who was refusing all medications despite
having a diagnosis of schizophrenia. Locked in the house and
refusing all attempts by professionals trying to offer assistance,
the client was clearly mentally ill.
The psychiatrist said "If we mandated everyone with serious
mental illness to be hospitalized, we would have more people
in hospitals than out of hospitals.
Your thoughts?
---------------
Rebekah Taling, 26 May, 2022
Contrary to your statement, I don't think Mark Twain was a psychiatrist!
"The way it is now, the asylums can hold the sane people, but if
we tried to shut up the insane we should run out of building materials."
----Mark Twain
--------------------
Marian Rosenberg, 25 May, 2022
Ronald Reagan, the ACLU, and Geraldo Rivera have a lot to answer for.
The other day I saw a man sitting on a park-side bench. His lolling
head, bloodshot eyes, angry grumbles at passers by, heavy parka (in
hot weather) and lack of any trousers told the tale.
What is he doing outside when he should be washed, cleaned, and
safely situated in a mental hospital?
---------------
J Whiting, 26 May, 2022
How do you know he is seriously mentally ill and wasn't just drunk or high? ---------------------
GARY MARTON, 26 May, 2022
"[H]e should be washed, cleaned, and safely situated in a mental hospital." Without his consent? Should there not be, before he is confined involuntarily,
some sort of process to determine whether he is a danger to himself of others?
And how much are we prepared to spend doing this for him and others similarly situated, and where is the money to come from?
----------------
lewis guignard, 26 May, 2022
Yes, without his consent.
The issue is whether or not he is able to participate, in a
economically positive manner, in the society within which (s)he
resides. If not, then he needs to be put in a place safe for him,
where he can be taken care of by society in a economically efficient
manner.
---------------
GARY MARTON, 26 May, 2022
Mr. Guignard, Who is going to make that decision? A judge, or a jury?
Will the accused - as you say, of not being able to participate in an economically positive manner in the society - be allowed to contest the charge? And have an advocate to represent him/her? And how long will
this deprivation of his/her liberty last? And can your proposal be implemented in a manner that does not have a disproportionately negative impact on the poor? Or on minorities? On any other categories? Your suggestion would, I think, open a packed Pandora's box. And, if you
have a chance, please look up - it's in Wikipedia - what happened when
such an attempt was made regarding the homeless Billie Boggs a/k/a Joyce Patricia Brown here in NYC some 35 years ago.
----------------
lewis guignard, 26 May, 2022, Replying to GARY MARTON
Mr. Marton,
Who is to make those decisions? Excellent question. I would not
suggest any of them be made lightly, nor that mistakes will never
be made, but to do nothing leaves us where we are now. People live,
if you care to call it that, in some of the most despicable conditions,
with what for food.
Liberty you ask about. I agree, but there is also the right of the
general public to live in a manner which suits them and it is they
who make the rules and pay the bills. This liberty you speak of is
something I highly tout and support but liberty implies and requires
personal responsibility. Can you say different.
There is also the comparison with the various prosecutor's offices.
Not all such are good people. People who don't deserve jail end up
there. People who do don't.
Who suffers by the mistakes? Society in general, individuals in
particular. What then would you suggest?
Would you bring any into your home and keep them warm, fed and
peaceful there? I will not. Please, let me know your suggestion.
-------------
GARY MARTON, 28 May, 2022, Replying to lewis guignard
Mr. Guignard, Thank you for your thoughtful response. You ask:
Can I say different? I don't know whether you would agree, as I do,
with the following: man is condemned to be free. (I believe that
I am quoting Sartre.) Each of us is responsible for the choices that
we make. But the freedom that we have must include, else it is not
freedom, the freedom to be wrong, to make mistakes, even grievous
mistakes, e.g., smoking cigarettes and getting lung cancer. Please
look at the case of Billie Boggs. I think that the courts got that
one right. I am not sure whether you would agree with that; please
let me know. You ask for my suggestion and I will start with this:
let's spend our resources fixing that which we know how to fix.
E.g., removing lead paint from New York City Housing Authority
apartments. Providing heat in the winter to the tenants living in
those projects. There are many other examples that are just as easy
and obvious.
--------------------
lewis guignard, 29 May, 2022, Replying to GARY MARTON
Mr. Marton, First, I always enjoy an argument with someone who
disagrees agreeably. Thank you. We see that seldom here, where
I would expect it more often.
I read part of a news report on Ms. Boggs/Brown.
In it this was said: "In the next decade a resulting depopulation
of mental institutions generated an eruption of homelessness,
particularly in major cities. And those cities, often under
pressure from local businesses, looked desperately for ways to
diminish their presence." This illustrates the problem of society
with 'homeless'.
Yet, as you cite examples of what we could do, I'll give you
examples of what we've done wrong. These are from Charlotte and
North Carolina.
We made housing regulations so strict that cheap housing cannot
be built or kept. Elevators are required where they need not be.
Bathrooms have to be in every apartment instead of down the hall
(as they were even in colleges). - The list goes on.
Without these type requirements, housing which would be affordable
to the less capable - and I've known a few - becomes out of their
reach and they become homeless.
I suppose the question is actually; what is our real purpose?
Are we to be a society of men, accepting that all are not equally
capable, and helping those who are not, be the best they can, or
some other?
----------------
Jason Schripsema, 26 May, 2022
Because mental hospitals cost money and it's cheaper to just let
the crazies buy guns and murder children. And as long as they're
not you're children everything is fine. Sigh.
--------------
lewis guignard, 26 May, 2022
Not exactly the issue, but so long as the government has weapons
of mass murder the people should have them available for their
purchase also.

https://www.wsj.com/articles/deinstitutionalization-homeless-mental-illness-involuntary-confinement-11653431249

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