Witch Hunting

The Minneapolis Star Tribune reported on 9/7/08 that the cost of health care for people in jail (the article focused on Henn.Co, but included references to other Minnesota jails experiencing similar problems) is way up, driven by the demand for mental health care. The head nurse says the "mental health system is breaking down."

"IS breaking down"? Doesn't that imply that the health care system has been working and is only recently beginning to not work? The health care system has been broken down.

• Hospital capacity has been shrinking by 10% every year since 1980
• Shelters have been turned into psych wards
• According to Minneapolis Police Chief Olson, 40% of their calls were related to some sort of mental illness but hospitals are full so the only place for them to go is to jail.

Does that sound like a broken down system? It has not worked.

Most cops, though well-intentioned, have had only a few hours of sensitivity training, but they aren't mental health professionals and can't dispense meds - the only tool they have is to haul the preson to jail. This doesn't solve anyone's problems, least of all the person suffering from mental illness.

I would like to think that our society has progressed since the days of witch hunts but from the looks of it, we really haven't.

It's a Hoax. Part II

A few weeks ago, I responded to a Minneapolis Star Tribune series regarding Minnesota's Sex Offender Program (MSOP) which is located in Moose Lake.  The Strib says that the facts raise the question, "Is MSOP really mental health treatment, or just permanent incarceration?" This is a good question but I can think of some much better questions:

QUESTION 1 - Who gets "committed" to MSOP, and why?

• Eerily similar to Guantanamo, the Strib could only identify two-thirds of detainees.
  
• A couple, identified by the Strib, seem like pretty bad dudes:
  
• Dennis Linehan, famous enough that the Strib had a stock photo of him, bears, with missing teeth, a strikin resemblance to Hannibal Lechter.
  
• Lorenzo Sanchez raped and murdered a 12 year-old.  Why doesn't that deserve an old fashioned "life without parole" sentence to prison?

But others identified seem odd choices for a life sentence:

• 10 percent were juveniles when they committed their crime.
  
• Ben Alverson was in his early 20's when he had "consensual" sex with two girls ages 13 & 14. Where's the pathology here?  When I was 20, I was attracted to teenage girls who looked older than they really were.  Yes I understand there is no such thing as consensual sex between a 22 year old and a 13 year old (in this state) we have defined such acts as crimes (which is why I backed away when I found out how old the girls were).  But Alverson, now 32 years old, already served his prison sentence for said crime.
  
• Dwane Peterson was convicted of kidnapping an elderly man (the Strib didn't mention a motive, but it did not involve sex) and served his prison sentence for said crime.  Then, despite never having committed a sex crime, he was committed to MSOP because of fantasies he admitted to during therapy.
• Isaiah Swedeen was committed to MSOP after disclosing, during treatment, a vaguely homosexual incident from his past, unrelated to any crime he had been charged with.  And treatment officials admit that Swedeen doesn't respond to psycho-tropic meds - presumably because he doesn't have mental illness.

The legislature has the right, under the constitution to make kidnapping or sex with under age girls a capital offense.  But lets keep this debate in the criminal justice arena where it belongs.  Do we really want to live in a society where people can be confined indefinitely because of impure thoughts.  The Strib appropriately quoted Tom Paine on the subject, they could have just as easily quoted Solzhenitsyn.  

QUESTION 2 - Who Works at MSOP?

Stay tuned... 

Cycle of Criminalization

Our society tends toward confusion regarding the needs of people with mental illness; unnecessarily, because it isn’t really so complicated. Even those with serious mental illnesses, like schizophrenia, want, first and foremost, to be normal. They want a good job, a comfortable home, and friends – they want what you want.

Unfortunately, the good job has become almost unattainable, not only because of the very real disability, but also because of numerous barriers our society has created, including the stigma created by Hollywood and a system of financial dis-incentives which penalize a person for entering the work force. Punishing and locking up those with mental illness is not a new idea. .But the most pernicious barrier is the criminalization of mental illness.

We like to imagine that we provide “community treatment” in lieu of hospitalization, and for a small percentage, effective community treatment is a fortunate reality. But has anyone noticed that as the hospital population shrinks, the prison population grows? Does anyone seriously think that’s a coincidence? The National Alliance on Mental Illness (NAMI) reports that, on any given day, there are four times as many people with mental illness in jails and prisons than in hospitals and one in seven inmates in U.S. prisons and jails has a mental illness.

How did they get there? Well, if you call 911 to report a friend or relative experiencing a psychiatric crisis, they don’t send a social worker, they send a cop. It has been explained to me that sending a social worker would be prohibitively expensive. Odd, considering that cops earn more per-hour than social workers. It has also been explained that it would be much too complicated to determine when to dispatch a social worker versus a cop. Odd, considering that when my power goes out, they never send a plumber.

Minneapolis’s Chief of Police brags that 15 percent of his force have had a full week of mental health training. Is that adequate since they report that 40 percent of the calls involve mental illness. And even if a cop has sufficient training to distinguish a mental health crisis from criminal intent, where will he/she take the person? (Hint: the hospitals are always full.)

About 50 years ago, we realized that asylums were a flawed (and expensive) approach, and started closing them. Today, there is less than one-tenth the number of psychiatric hospital beds per-capita than 50 years ago. Does anyone think we have less mental illness? Mental illness, in fact, is on the rise. And yet, resources have decreased. In Minnesota, people who need psychiatric hospitalization are routinely turned away for lack of space.

I know that some will argue that America doesn’t put people in prison unless they actually commit a crime. Okay let’s go with that. But imagine that you were homeless, unemployed, friendless, confused and scared, so you sought help at your local hospital, only to be turned away because your condition didn’t seem as severe as that of others in the waiting room. After a few years, do you think you might commit a crime?

If it were me, and I am thinking fairly straight, I would try for a “victimless” crime – hmmm, I don’t have $4300, so I guess Spitzer’s friend is out. Maybe I could jaywalk or something. But here is a surprising fact: most people experiencing a mental health crisis are not thinking real straight. So they steal food, or they buy drugs, or they scream and holler, or they drive their car into bridge abutments. Whatever it takes…

So now that gaining admittance into any form of health-care facility has become increasingly difficult, and acquiring a criminal record has become increasingly easy, and a criminal record of any kind prevents one from obtaining employment, the circle is complete. If you have schizophrenia, we’re never going to let you have a job. I wonder if that will help with your mental illness?

So, we find ourselves in a peculiar predicament. Mental illnesses are on the rise in our country and adequate resources are diminishing so those who have mental illness can only access varying types of help if they commit crimes. Does that make any sense? There has to be a better way to help those suffering from these very real diseases. There has to be a better way to break this cycle of criminalization and give them the treatment that works so that they can have what all of want: a good job, a comfortable home, and friends.