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	<title>Comments on: Emptying the Mental Institutions</title>
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		<title>By: Carl</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-85174</link>
		<dc:creator>Carl</dc:creator>
		<pubDate>Thu, 27 Dec 2012 18:00:38 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-85174</guid>
		<description><![CDATA[I&#039;ve worked in mental health as an aide for 35 years. I almost did not read this article. At the beginning I assumed it was going to be just another &quot; Lets close the hospitals, fire all the employees, and let the patients run free!&quot; type of article that I normally see. Truthfully they never really come right out and say that but they may as well because whenever they set out to change things in mental health that is usually what happens.
I must say that I was pleasantly surprised to see that this article has not only told the truth but was also a very sensible article.]]></description>
		<content:encoded><![CDATA[<p>I&#8217;ve worked in mental health as an aide for 35 years. I almost did not read this article. At the beginning I assumed it was going to be just another &#8221; Lets close the hospitals, fire all the employees, and let the patients run free!&#8221; type of article that I normally see. Truthfully they never really come right out and say that but they may as well because whenever they set out to change things in mental health that is usually what happens.<br />
I must say that I was pleasantly surprised to see that this article has not only told the truth but was also a very sensible article.</p>
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		<title>By: A Reader</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84495</link>
		<dc:creator>A Reader</dc:creator>
		<pubDate>Fri, 21 Dec 2012 13:08:51 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84495</guid>
		<description><![CDATA[One aspect discussed here is cost of providing safe institutions - places having some chance of encouraging those with mental illness toward some fulfilling avocation or occupation.  We understand that barren and/or ugly surroundings crush the spirit and add to the problem but do not see a way forward.    

A possibility, one that would require much effort and setup cost, but might succeed is  &quot;protective custody&quot; communities, supervised  places where one would live and work, as in &quot;perform some useful task&quot;.  Light manufacturing, farming, baking, sewing, apprentice work to plumbers, electricians, bricklayers, carpenters - these things would supply community needs and provide items to be sold.  But more important is the fact that they  would provide the work that is necessary to human flourishing and contributes to development of a sense of self.  

The Department of Mental Health in Massachusets (there are probably others) has experimented with this idea on a small scale for both outpatient and inpatient care but though commendable these facilities cannot fulfill the human need for communal life in a place that recognizes the category of goodness as a human possibility of ultimate value and therefore makes sense.]]></description>
		<content:encoded><![CDATA[<p>One aspect discussed here is cost of providing safe institutions &#8211; places having some chance of encouraging those with mental illness toward some fulfilling avocation or occupation.  We understand that barren and/or ugly surroundings crush the spirit and add to the problem but do not see a way forward.    </p>
<p>A possibility, one that would require much effort and setup cost, but might succeed is  &#8220;protective custody&#8221; communities, supervised  places where one would live and work, as in &#8220;perform some useful task&#8221;.  Light manufacturing, farming, baking, sewing, apprentice work to plumbers, electricians, bricklayers, carpenters &#8211; these things would supply community needs and provide items to be sold.  But more important is the fact that they  would provide the work that is necessary to human flourishing and contributes to development of a sense of self.  </p>
<p>The Department of Mental Health in Massachusets (there are probably others) has experimented with this idea on a small scale for both outpatient and inpatient care but though commendable these facilities cannot fulfill the human need for communal life in a place that recognizes the category of goodness as a human possibility of ultimate value and therefore makes sense.</p>
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		<title>By: Adam Baum</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84408</link>
		<dc:creator>Adam Baum</dc:creator>
		<pubDate>Thu, 20 Dec 2012 17:47:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84408</guid>
		<description><![CDATA[&quot;we define liberals as those who believe we should take care of those who cannot adequately care for themselves and conservatives as those who believe we have no obligations along these lines.&quot;

I define liberals as those that believe that their duty to others is satisfied by outsourcing the obligation to others to the state, through political activity, first and foremost, in part because they believe the state is capable, resistant and or immune to corruption and error.

Conservatives believe that the duty of care, inheres to all individuals (even the poor can find someone poorer) and that duty is personal and not tranferrable. There is a consistent pattern (and I realize this is a poor approximation) of inquiries correlating charitable giving positively with polical conservatism. 

I suppose a few radical libertarians believe there are no (positive) obligations that exist outside those created by voluntary contract, but that is a guess, unsupported by any serious evidence.  

In this case, I would favor some state action, simply because before we deprive someone of their liberties-we need due process of law and ultimately, some folks need to be confined. 

However, as in a trial, that &quot;state action&quot; cannot be a mere procedural pretext to a largely predecided outcome, that degenerates to something like the arbirary and capricious action that was portrayed by the librarian (Burgess Meredith) being declared obsolete in a famous &quot;Twilight Zone&quot; episode.  

It&#039;s worth noting that what constitutes a danger to the public is often considered by totalitarian regimes to be a danger to the state.  

Otherwise, I find myself largely in agreement with Mr. Nickol&#039;s premise that there is distinct possibility that eccentricity will be considered mental derangement. We aren&#039;t very far from the stifling conformities of high school that brands the &quot;band&quot;, the &quot;geeks&quot; and others as a lowly and unworthy caste. 

Worse, individuals with great minds often have &quot;mental illness&quot;. Churchill&#039;s &quot;black dogs&quot; are widely considered to have been clinical depression. John Nash&#039;s mathematical talents were accompanied by schizophrenia. Nikola Tesla may have been autistic. We can&#039;t forget the possibility of pleiotropy. 

If  you think this is implausible. Consider the question of whether a &quot;hoarder&quot; is eccentric or mentally ill. The TV shows all portray them as beniggn lunatics. (As an aside, I consider hoarding a problem, but one that has spiritual dimensions as well)]]></description>
		<content:encoded><![CDATA[<p>&#8220;we define liberals as those who believe we should take care of those who cannot adequately care for themselves and conservatives as those who believe we have no obligations along these lines.&#8221;</p>
<p>I define liberals as those that believe that their duty to others is satisfied by outsourcing the obligation to others to the state, through political activity, first and foremost, in part because they believe the state is capable, resistant and or immune to corruption and error.</p>
<p>Conservatives believe that the duty of care, inheres to all individuals (even the poor can find someone poorer) and that duty is personal and not tranferrable. There is a consistent pattern (and I realize this is a poor approximation) of inquiries correlating charitable giving positively with polical conservatism. </p>
<p>I suppose a few radical libertarians believe there are no (positive) obligations that exist outside those created by voluntary contract, but that is a guess, unsupported by any serious evidence.  </p>
<p>In this case, I would favor some state action, simply because before we deprive someone of their liberties-we need due process of law and ultimately, some folks need to be confined. </p>
<p>However, as in a trial, that &#8220;state action&#8221; cannot be a mere procedural pretext to a largely predecided outcome, that degenerates to something like the arbirary and capricious action that was portrayed by the librarian (Burgess Meredith) being declared obsolete in a famous &#8220;Twilight Zone&#8221; episode.  </p>
<p>It&#8217;s worth noting that what constitutes a danger to the public is often considered by totalitarian regimes to be a danger to the state.  </p>
<p>Otherwise, I find myself largely in agreement with Mr. Nickol&#8217;s premise that there is distinct possibility that eccentricity will be considered mental derangement. We aren&#8217;t very far from the stifling conformities of high school that brands the &#8220;band&#8221;, the &#8220;geeks&#8221; and others as a lowly and unworthy caste. </p>
<p>Worse, individuals with great minds often have &#8220;mental illness&#8221;. Churchill&#8217;s &#8220;black dogs&#8221; are widely considered to have been clinical depression. John Nash&#8217;s mathematical talents were accompanied by schizophrenia. Nikola Tesla may have been autistic. We can&#8217;t forget the possibility of pleiotropy. </p>
<p>If  you think this is implausible. Consider the question of whether a &#8220;hoarder&#8221; is eccentric or mentally ill. The TV shows all portray them as beniggn lunatics. (As an aside, I consider hoarding a problem, but one that has spiritual dimensions as well)</p>
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		<title>By: Adam Baum</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84399</link>
		<dc:creator>Adam Baum</dc:creator>
		<pubDate>Thu, 20 Dec 2012 17:05:34 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84399</guid>
		<description><![CDATA[&quot;I would think a great liberal initiative, one that would be applauded at least by some conservatives, would be to create new institutions&quot;

Only if you believe that there is such a thing as &quot;liberalism&quot;. What is contemporarily referred to as liberalism (not at all what was generally proposed by Acton, Hume, Bastiat and the other great liberal thinkers) is in fact something wholly different.

It is statism. Statism succeeds by eliminating non-state mediating institutions and sewing disorder and disharmony (you will note the modern statist attacks on marriage,  the family and the Church) to expose the individual to as much uncertainty and disorder as possible, in order to create a demand for the state order and the guarantees it offers. 

The reality of Newtown is that humanity will always have in it&#039;s midst, some that are sick or evil. 

As an addendum, it is widely being presumed that the individual who committed this heinous act, is ill and it may be true that he was lacking in &quot;mental hygiene&quot;. There&#039;s another possibility, one that in our time is difficult to uttter, because we are conditioned to disbelief. 

There is the possibility that Lanza was just evil. He committed matricide and infanticide and there&#039;s a reason we reserve special disdain for the people that do that. 

His final act was  self-immolation. In this, he resembled that paragon of evil, Adolph Hitler.

He slaughtered the innocent and then himself and nobody ever thinks of Him as mentally ill.]]></description>
		<content:encoded><![CDATA[<p>&#8220;I would think a great liberal initiative, one that would be applauded at least by some conservatives, would be to create new institutions&#8221;</p>
<p>Only if you believe that there is such a thing as &#8220;liberalism&#8221;. What is contemporarily referred to as liberalism (not at all what was generally proposed by Acton, Hume, Bastiat and the other great liberal thinkers) is in fact something wholly different.</p>
<p>It is statism. Statism succeeds by eliminating non-state mediating institutions and sewing disorder and disharmony (you will note the modern statist attacks on marriage,  the family and the Church) to expose the individual to as much uncertainty and disorder as possible, in order to create a demand for the state order and the guarantees it offers. </p>
<p>The reality of Newtown is that humanity will always have in it&#8217;s midst, some that are sick or evil. </p>
<p>As an addendum, it is widely being presumed that the individual who committed this heinous act, is ill and it may be true that he was lacking in &#8220;mental hygiene&#8221;. There&#8217;s another possibility, one that in our time is difficult to uttter, because we are conditioned to disbelief. </p>
<p>There is the possibility that Lanza was just evil. He committed matricide and infanticide and there&#8217;s a reason we reserve special disdain for the people that do that. </p>
<p>His final act was  self-immolation. In this, he resembled that paragon of evil, Adolph Hitler.</p>
<p>He slaughtered the innocent and then himself and nobody ever thinks of Him as mentally ill.</p>
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		<title>By: jim</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84373</link>
		<dc:creator>jim</dc:creator>
		<pubDate>Thu, 20 Dec 2012 15:22:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84373</guid>
		<description><![CDATA[Prior to the massacre on Friday, what had Adam Lanza done that would have resulted in his being institutionalized? 

I am thrilled that more money will be spent to treat mental illness.  (I&#039;d suggest a 100% tax on guns, a 100% tax on gun permits, and a 200% tax on ammunition to start filling the coffers to fund such treatments.)  But young men with an emerging psychotic disorder, groomed on violent video games, and with easy access to guns (through their own legal purchase or through their family), will escape treatment no matter how much $ is thrown at the mental health industry.]]></description>
		<content:encoded><![CDATA[<p>Prior to the massacre on Friday, what had Adam Lanza done that would have resulted in his being institutionalized? </p>
<p>I am thrilled that more money will be spent to treat mental illness.  (I&#8217;d suggest a 100% tax on guns, a 100% tax on gun permits, and a 200% tax on ammunition to start filling the coffers to fund such treatments.)  But young men with an emerging psychotic disorder, groomed on violent video games, and with easy access to guns (through their own legal purchase or through their family), will escape treatment no matter how much $ is thrown at the mental health industry.</p>
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		<title>By: Mike Walsh, MM</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84363</link>
		<dc:creator>Mike Walsh, MM</dc:creator>
		<pubDate>Thu, 20 Dec 2012 13:42:19 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84363</guid>
		<description><![CDATA[A similar argument is offered for the legalization of drugs:  money being spent on interdiction and imprisonment would be better spent on rehabilitation.  Fat chance of that happening, and for the same reason that led to the de-institutionalization of the mentally ill:  politicians see all that money going to waste, when they could be buying themselves votes with it.]]></description>
		<content:encoded><![CDATA[<p>A similar argument is offered for the legalization of drugs:  money being spent on interdiction and imprisonment would be better spent on rehabilitation.  Fat chance of that happening, and for the same reason that led to the de-institutionalization of the mentally ill:  politicians see all that money going to waste, when they could be buying themselves votes with it.</p>
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		<title>By: AnneG</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84330</link>
		<dc:creator>AnneG</dc:creator>
		<pubDate>Thu, 20 Dec 2012 01:54:23 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84330</guid>
		<description><![CDATA[Regarding subsidiarity and de-institutionalization: I was a young nurse in the early &#039;70&#039;s and was taught that with &quot;modern&quot; treatment modalities and meds we would not need institutions. Nobody considered that patients would refuse to take meds and because they were psychotic they had no insight into their illnesses. The Church probably did not step in because leaders believed they were not needed and that psychiatry had the answers.
According to research I&#039;ve read this is not a new problem. Institutions were started in the early 19th century because of the dangers posed to the community by uncontrolled psychotic family members.
It is probably time we reconsider what we are doing. The standard of danger to self and others is a valid standard. Not all mentally ill people are dangerous but the public, family members and the person himself certainly deserve better protection, care and control than we have now. It is worth the investment.]]></description>
		<content:encoded><![CDATA[<p>Regarding subsidiarity and de-institutionalization: I was a young nurse in the early &#8217;70&#8242;s and was taught that with &#8220;modern&#8221; treatment modalities and meds we would not need institutions. Nobody considered that patients would refuse to take meds and because they were psychotic they had no insight into their illnesses. The Church probably did not step in because leaders believed they were not needed and that psychiatry had the answers.<br />
According to research I&#8217;ve read this is not a new problem. Institutions were started in the early 19th century because of the dangers posed to the community by uncontrolled psychotic family members.<br />
It is probably time we reconsider what we are doing. The standard of danger to self and others is a valid standard. Not all mentally ill people are dangerous but the public, family members and the person himself certainly deserve better protection, care and control than we have now. It is worth the investment.</p>
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		<title>By: David Nickol</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84329</link>
		<dc:creator>David Nickol</dc:creator>
		<pubDate>Thu, 20 Dec 2012 01:35:04 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84329</guid>
		<description><![CDATA[&lt;i&gt;Dave, most MD’s will be able to discern the saints who prefer to walk barefoot in the snow. Let’s begin with the ones who are crying out for real help.&lt;/i&gt;

KM,

I couldn&#039;t agree more. But Austin Ruse said, &quot;. . . . where these hopeless cases could be committed, yes committed.&quot; The emphasis on &quot;committed&quot; was his. And that means institutionalizing people against their will. I am not necessarily saying it would be the wrong thing to do, but it presents great problems. 

And here&#039;s another problem. Nobody wants homeless shelters, halfway houses, drug treatment facilities, and so on, to be located anywhere near where they live. Not in my backyard. 

I would support spending more money on the homeless and the mentally ill. But even if you can get the money allocated, there are still significant problems to be solved. By all means, let&#039;s allocate the money and solve the problems, but especially in this economic climate, let&#039;s not pretend it is easy. It is difficult to do more in any area at all when the cry is for budget cuts and no increase in taxes.]]></description>
		<content:encoded><![CDATA[<p><i>Dave, most MD’s will be able to discern the saints who prefer to walk barefoot in the snow. Let’s begin with the ones who are crying out for real help.</i></p>
<p>KM,</p>
<p>I couldn&#8217;t agree more. But Austin Ruse said, &#8220;. . . . where these hopeless cases could be committed, yes committed.&#8221; The emphasis on &#8220;committed&#8221; was his. And that means institutionalizing people against their will. I am not necessarily saying it would be the wrong thing to do, but it presents great problems. </p>
<p>And here&#8217;s another problem. Nobody wants homeless shelters, halfway houses, drug treatment facilities, and so on, to be located anywhere near where they live. Not in my backyard. </p>
<p>I would support spending more money on the homeless and the mentally ill. But even if you can get the money allocated, there are still significant problems to be solved. By all means, let&#8217;s allocate the money and solve the problems, but especially in this economic climate, let&#8217;s not pretend it is easy. It is difficult to do more in any area at all when the cry is for budget cuts and no increase in taxes.</p>
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		<title>By: TXW</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84312</link>
		<dc:creator>TXW</dc:creator>
		<pubDate>Wed, 19 Dec 2012 23:27:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84312</guid>
		<description><![CDATA[There&#039;s a chapter in Jon Ronson&#039;s book, &quot;The Psychopath Test&quot;, that describes the release of dangerous mentally ill patients under the presumption that they were healed.  Many killed again.  

Eccentricity doesn&#039;t necessarily entail harm to self or others.]]></description>
		<content:encoded><![CDATA[<p>There&#8217;s a chapter in Jon Ronson&#8217;s book, &#8220;The Psychopath Test&#8221;, that describes the release of dangerous mentally ill patients under the presumption that they were healed.  Many killed again.  </p>
<p>Eccentricity doesn&#8217;t necessarily entail harm to self or others.</p>
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		<title>By: KM</title>
		<link>http://www.firstthings.com/blogs/firstthoughts/2012/12/19/the-emptying-of-the-mental-institutions/comment-page-1/#comment-84310</link>
		<dc:creator>KM</dc:creator>
		<pubDate>Wed, 19 Dec 2012 23:04:49 +0000</pubDate>
		<guid isPermaLink="false">http://www.firstthings.com/blogs/firstthoughts/?p=53643#comment-84310</guid>
		<description><![CDATA[A shocking number of the homeless living on the street are mentally ill and need health care, including good residential treatment.    Ask any physician who works with that population.  Yes, good treatment is expensive, and for many reasons,  government needs to provide major assistance.   Dave, most MD&#039;s will be able to discern the saints who prefer to walk barefoot in the snow.   Let&#039;s begin with the ones who are crying out for real help.]]></description>
		<content:encoded><![CDATA[<p>A shocking number of the homeless living on the street are mentally ill and need health care, including good residential treatment.    Ask any physician who works with that population.  Yes, good treatment is expensive, and for many reasons,  government needs to provide major assistance.   Dave, most MD&#8217;s will be able to discern the saints who prefer to walk barefoot in the snow.   Let&#8217;s begin with the ones who are crying out for real help.</p>
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