Innocence

I follow a group on Twitter called The Innocence Project, which states that its "mission is nothing less than to free the staggering numbers of innocent people who remain incarcerated and to bring substantive reform to the system responsible for their unjust imprisonment."

I'm cynical. For one thing, they seem to think the magic button is DNA testing. Certainly if this is done correctly, and there's a 99.999% chance that the defendant in some case was not the rapist, or whatever, well, that's a valuable tool. But science will never provide any infallible test to replace human reason and honest human desire for justice. Trial by a jury of one's peers was far more of a breakthrough than DNA testing.

For another thing, it often seems to me as though The Innocence Project is run by people whose real motive for proving convicts innocent is merely to shame us into abolishing the death penalty. I don't see a lot of value in the death penalty - but I don't believe that death is so final or terrible that it's an "ultimate punishment" either. Imprisonment, for some people, and under some conditions, becomes as bad as death or worse.

Why should I feel any more guilty for wrongfully executing a fellow human being than I would for wrongfully locking him up at Elgin Mental Health Center and forcing him to take neuroleptics?

I definitely know people who would rather die than participate in their own degradation and dehumanization at the hands of state psychiatrists. Maybe if The Innocence Project showed an interest in human dignity, beyond mere techinical biological "life", I'd identify with their cause.

But then they'd have to call for a wall of separation between psychiatry and the state. That's a hell of a project.

Dear Abby, you're killing us!

Feels like I'm showing my age, or betraying my generation or something, by even commenting on or noticing what Abigail Van Buren says. But so what, this one really gets to me....

Today, a writer asks Dear Abby for guidance because her friend "Sally" calls all the time and cries to her over the phone. Sally's been seeing a psychiatrist and taking meds for at least 15 years for profound depression. Abby says the writer should stop letting Sally vent, because she probably needs her meds adjusted, and only the psychiatrist can offer the tools she needs to improve.

My God! This has to be almost the ultimate in denial of individual responsibility, an utter degradation of human relations and human value.

Let me get this straight. Dear Abby says lay people can't really help each other. In fact, they should refuse to help each other in any other way than by calling the psychiatrist, because only the psychiatrist can really help anyone -- and only with meds, of course.

Geez Abby, let's just shoot each other. After all, we're nothing but inconsequential, meaningless chemical reactions. Our only duty is to look in the mirror each morning and profess our dead certainty that we're staring at a machine, pure and simple, fully controllable and fully explainable without reference to any concept of soul, ethics, purpose, friendship, nobility, aesthetics or love. We deserve and we should expect nothing but that answering salute to the gladiators, those who are about to die.

This is a pitiful, ultramaterialistic, and antisocial point of view. Abigail Van Buren should be shunned, like the Ku Klux Klan or neo-Nazi groups, by the media. She's not entertaining or helpful, but some kind of anti-human ... porno. She should not be in the papers.

Lisa Madigan: WAKE UP!

I've written previously on the nursing home problem in Chicago and the infantile media coverage. Grandma gets raped and Grandpa gets beat up by the violent felon who has fraudulently transformed himself into a "patient" to live in the next room at Summerset Place. The front page of today's Chicago Tribune features more grim details.

Supposedly Illinois Attorney General Lisa Madigan was dismayed and angered by the "safety breaches" the Trib has uncovered. (I don't actually know whether the AG or the Trib reporter used this characterization. I'm a lawyer not a reporter, so I'll blame my own kind.) This is just amazingly, criminally, stupid.

Dammit! Violent felons are NOT "patients" to be "hospitalized" in the room next to my mother or father, no matter who has attached this horrifically unfortunate metaphor to their medical records, this "mental illness" excuse! The effective "safely breaches" are in our thinking, not in the procedures at Summerset Place.

We all wanted, some decades back, to be more humane. We decided that well, maybe some of these guys who do terrible things could be fixed instead of just punished. We theorized that maybe their violent or self-destructive behavior was not chosen by them, but was really caused by a brain disease.

After all, syphillis used to make people crazy, right? But then it was discovered to be a treatable, curable disease. With rapidly advancing medical science, other diseases that make people crazy should certainly be discovered and cured. That, we decided, must be the right strategy for dealing with all kinds of human behavior, and even with human conflict and suffering in general....

It was a very expensive error. It led us directly into the utter morass of mental health law, wherein people may now be denied their most intimate liberties and the privacy of their very bodies and minds because someone says, often with no proof or commonsense justification, that they might behave disagreeably or think disagreeable thoughts.

Yet we are not protected against violence. Our parents and our grandparents live at Summerset Place, a safe house for rapists.

We need to wake up, recognize that "mental illness" is a myth and a metaphor, and reject this strategy of medical "treatment" for bad behavior. Violent felons do NOT become "patients" who should be in hospitals and nursing homes the moment some state psych slaps a DSM "diagnosis" on them.

We need to eliminate the insanity defense and ban involuntary commitment. We need to refuse psychiatry. It's a far simpler and cheaper solution than all of Ms. Madigan's background checks, raids, and processes and reforms.

Liberty or Mental Health, part 2

It seems over-obvious to me, that when any private doctor or private hospital forces products or services on an unwilling patient and then charges the patient or the patient's insurance, the situation is well outside the realm of normal business transactions and relationships. The first question becomes, how exactly do doctors or hospitals, as entirely private actors, pull that off and get away with it?

The answer is quite simply, they are not entirely private actors, they are doing the state's business. They are effectively deputized.

A psychiatrist or other doctor who "certifies" a person for emergency commitment becomes the state's designated decision-maker. He authorizes the use of the state's coercive power to hold someone against their will in a locked room, often with security guards outside to prevent escape. The hospital which pays the guards and maintains the locked room becomes the state's designated custodian. No other private person may authorize the arrest and effect the involuntary custody of an individual. 

Doctors and hospitals do this, however, for at least some limited time, longer than what it takes for law enforcement to arrive on the scene and take over per their independent observation and judgement, as in a citizen's arrest. In fact, doctors and hospitals take their cues for involuntary emergency commitments directly from law enforcement after the fact, if a person is brought in by the police. The police go away and the hospital takes over for them, even if the "patient" continues to insist that he or she wishes to leave.

Private individuals, no matter who they are, may not unilaterally deprive a person of his or her liberty for mental illness without medical and institutional (hospital) authority. Such authority is not inured in the general citizenry. It is bestowed by the state. In fact, in modern times it is formally bestowed with great and complex ritual, in written state mental health codes.

If a person is confronted by police in a private home, strapped to a gurney and removed over his protests to an emergency room, guarded there and prevented from leaving or making phone calls to family or attorneys, assaulted and battered, unsubtly threatened with continued imprisonment unless and until he signs legal papers absolving everyone involved, and if he is then billed thousands of dollars for "hospitalization and treatment" ... and if everyone maintains after the fact that it was all perfectly legal ... I say we have combined action under color of law by public and deputized private actors.

If the involuntary "patient" was indeed dangerous to self or others, perhaps the state action was justified. But if the individual was never dangerous to anyone, everyone who did it to him should have to pay for the insult, big-time.

The state deputizes doctors and hospitals to remove those who seem dangerous, or those who are particularly obnoxious.  But people prefer not to look very closely at the application of violence against individuals. They are squeemish, and they're happy to believe that involuntary psychiatric commitment is really medical "help" rather than imprisonment. Before most of us ever notice that the therapeutic state is all about tyranny rather than therapy, it may be too late.

That's why those of us who are forced to notice should at least be allowed to sue!

Give me Liberty, or give me Mental Health!

Thomas Szasz once wrote, "When health is equated with freedom, liberty as a political concept vanishes." He also wrote, "The main impetus for converting private health into public health came and continues to come from psychiatrists."

Health and freedom obviously are related for just about everyone, empirically. Maybe the archetypical experience of "free" for me was running through fields of alfalfa on a summer day, when I was about nine years old. And the opposite, "not free" was lying very sick in bed for the third day with a high fever at that same age.

But we're talking politics. There's a 1989 federal appellate court decision which, it seems to me, needs to be overturned for purposes of protecting liberty in the face of state coercion under the guise of health. In Spencer v. Lee (for anyone who wants to look it up, the legal citation is: 864 F.2d 1376, 1989 U.S. App. LEXIS 289, 7th Cir. 1989), Judge Richard Posner's opinion says private physicians and hospitals more or less never act under color of law when they imprison and forcibly treat a “patient” involuntarily. This makes it substantially  harder to sue them for violating constitutional rights.

OK. I usually tell my forensic clients that whenever they have a problem with actions or interpretations of state mental health workers, they should always begin with, "Well, here's what's right about what he/she said/did..." and only afterwards go into the disagreement or the complaint. It just makes it a bit harder for the system to discount the mentally ill (after all) person's side of every petty institutional conflict and every little tension. They can and do pathologize anything a patient thinks or says.

So ... I'll start with what's right about Spencer v. Lee. A person cannot really be free, if he/she is mentally ill and dangerous to self or others. Mental illness and danger to self or others are substantially medical issues. We desperately need and want medical experts to be dealing effectively with medical issues, so we should make it harder to sue them. It seems especially prudent to limit the likelihood that the untutored and unreliable feelings of crazy people, about what they imagine to be constitutional rights, will be a constant basis for frivolous litigation that interferes with well-founded mental health and public health practices. In particular, federal courts do not need to interfere in such issues, because states are at least as competent and at least as trustworthy to deal with them.

But, on the other hand... (I guess I'll do a pregnant,Tevye-the-Milkman pause here, and make my own argument in a separate post.)

Violence and fraud

Four and a half years ago on July 12, 2005, Illinois Attorney General Lisa Madigan's office announced with great fanfare that a new law would solve the problems of mentally ill felons in nursing homes. Only a month earlier, Emerald Park Health Care Center had been closed for gross mismanagement, but the new Vulnerable Adults Protection Act was sure to make Grandma and Grampa safer in the nursing home from evil parolees and sex offenders.

Today's Chicago Tribune reports that Somerset Place nursing home, which has 66 felons (we're shocked - shocked!) among its 400 residents, will be shut down due to violence and abuse. So much for the Vulnerable Adults Protection Act.

On the other hand, think about how well this law served Daniel J. Cuneo, Ph.D. for the last four and a half years. Without it, Dr. Cuneo would never have been awarded hundreds of thousands of dollars in state consulting contracts!

But wait... Cuneo's "clinical expertise" in identifying dangerous people was exactly what was supposed to protect Grandma and Grandpa, and it sure didn't work if they were living at Somerset Place. Guess what folks? Dan Cuneo's a fraud, and the state is wasting our tax dollars by paying him anything.

We want to believe bad people are just sick, and they can be "diagnosed" and "treated" rather than punished. Guess what folks? Forensic psychiatry is a fraud, and we are wasting too many people's lives by believing in it.

The mentally ill simply are not "patients" who belong in nursing homes or hosiptals, and they are not "sick" in the same sense as people with medical diseases. If we don't stop kidding ourselves, we're going to have to see Grandma get raped and Grandpa beat up.

And we're going to have to keep getting ripped off big-time by Dan Cuneo and his ilk.

Hunt them down!

Sorry, I mean "Bring them to justice!"

Johnson & Johnson is being prosecuted in Boston for a kickback scheme to drug our parents and grandparents in nursing homes with the so-called "anti-psychotic" Risperdal, which causes strokes and diabetes, not to mention: abdominal pain, vomiting, constipation, diarrhea, dry mouth, sore throat, abnormal walk, agitation, aggression, anxiety, chest pain, coughing, involuntary movements, nasal inflammation, decreased activity, decreased sexual desires, lack of coordination, impotence, dizziness, dry skin, difficulty urinating, heavy menstruation, tremor, weight gain, lethargic feelings, joint pain, difficulty ejaculating, and respiratory infection.

(Oops - I just can't help imitating a TV commercial once in a while. My wife is a carreer advertizing professional, aka "madwoman".)

I understand the utility of prosecuting a corporation: money - huge fines. Excellent. I absolutely wish the U. S. Attorney in Boston the best. But I really want to find individual criminals, too.

Somewhere there are a couple guys who got together and said to each other, "Hey, we can make a lot more money if we can get nursing homes to prescribe Risperdal for their residents on a routine basis. A little bit of payola might go a long way toward overcoming those silly objections that these people aren't psychotic, don't hurt anyone and really don't need to be neurologically disabled. And nobody really cares about old people anyway, that's why they're in nursing homes. We can get away with it."

Maybe a conversation like this actually happened, at some modern, little Wannsee Conference.

In 1945 Nazi Germany was destroyed utterly, but the world has never stopped going after individual perpetrators of the Holocaust. The monsters are almost all dead now, but we can't help knowing in the depths of our collective soul that they must still be hunted, each and every one, even into future lifetimes.

In 1865 the Confederate States of America were destroyed utterly, but for a century and a half the world has continued to fight racism. Even now we must enact and enforce hate crime laws against the likes of Edmund Ruffin, Josiah C. Nott and Thornton Stringfellow in our own day.

War against Big Pharma is fine, but I want to identify and prosecute the new monsters, too. What about Joseph Biederman for example? He is singularly responsible for putting thousands of young children on psychotropic drugs, ruining a significant portion of a generation, all in the name of "bi-polar" or "ADHD", but really for money or just the pure thrill of destroying life.

Biederman's not the only one, but there are only a few who are truly evil. We need to find them and bring them in. For practical purposes, there is no higher calling.

Respect mental health workers

"Full citizen" is a philosophical abstraction romanticized in one of my favorite movies, Starship Troopers. But for practical purposes it's a vague legal status. (The right to vote in elections is diminished by the common choice not to bother. The obligation to pay taxes is clouded by the numbing complexity of the code. Many voters have to be driven to the polls, and many taxpayers have to be threatened by the IRS.) In reality specific exchanges between any individual and his or her surrounding society are what count, and these show an endless gradient of "citizenship" and variations in its salient meaning for different people.

In the nuthouse people know the ultimate implications and consequences of marginal and unacceptable behavior as no one in normal society can. It’s what institutional people deal in, every hour of every day. And it happens to be what defines city/civilization or absence of city/civilization, too. Without clear behavioral margins and consequences there is jungle, not society.

A civilized society needs security, which generally comes from soldiers or police. Artisans, merchants, intellectuals, etc., do not, in their professional capacities, protect anyone from violent crime and predation. They can even begin to feel that there isn’t really any violent crime or predation, if their soldiers and police are very successful. After such great success has continued for a while, the nuthouse gets established to support a theory that there may soon be no need for soldiers and police. But very quickly, people not in the nuthouse forget this rather sophisticated purpose.

The imperative to “treat mental illness” is so obvious to those who don’t actually do it themselves. But try to sell a policy to “disable all bad people neurologically” and there will be considerable outcry about atrocity and constitutional rights.

In the nuthouse there is constant and unrelenting propaganda about mental illness because the all-too-apparent truth has to be drowned out. Psychiatric “cures” are atrocities, especially when they are forced on unwilling “patients”. But everyone in a state institution has a strong vested interest in maintaining and supporting the myth – and they really do know it’s a myth – that murderers, sex offenders and other violent criminals were not culpable for their behavior because their brains were diseased in some way that prevented them from choosing to behave better.

Every culture stands on its essential mythology. People who participate in the environment and operations of locked, maximum-security state institutions for psychotic killers and perverts have unassailable claims to full citizenship, precisely because they work hardest to create our essential mythology.

Dead men tell no tales

Dan Mojziszek died yesterday in a hail of police bullets, a perfect example of the amazing results regularly obtained by modern psychiatry as practiced in Illinois institutions.

I know the forensic clinical unit at Elgin Mental Health Center where Dan was treated (P__ Unit). I know the psychiatrist whose "patient" he was (Dr. H__). His social worker may have been Jennifer M__, and one of the security therapy aides he dealt with on a daily basis may have been Barb S__. These people are true-blue, unionized bureaucrats and true believers in the state psychiatric religion.

When they failed to help this particular patient, now a dead man, they were just doing their jobs.

Here's the way it works. Dr. H__ is a young and potentially charismatic psychiatrist. He immediately changes or arranges the psychiatric diagnosis of any new patient to justify his own preferred treatment, which is psychotropic drugs for bipolar disorder.

Any patient at Elgin who does not want the particular drugs Dr. H__ prescribes, or who does not agree that they have the particular brain disease Dr. H__ says they have, is unanimously seen by Dr. H__’s treatment team as thereby displaying the exact symptoms of the disease Dr. H__ diagnosed. Those symptoms in turn confirm the diagnosis and require the drugs. Often there is absolutely nothing more than this circle, to the whole "clinical" process.

Consider one symptom of brain disease discussed in a treatment plan review I once attended at Elgin. The patient involved (not Dan Mojziszek) was said to have become “hypergraphic” after he had stopped taking his medication. This appeared in a hastily prepared report, and I asked Dr. H__, initially without any real cynicism, what exactly it meant. He responded, “Hypergraphic means the patient writes too much.”

Well, I was dense or cantankerous. I ventured further: “What is too much, Dr. H__? How can you tell if somebody writes too much, I mean, what if they’re Steven King or something? Has anyone on the treatment team read what this guy wrote to see if maybe it’s creative, or rational, or anything else? This is in a report as a symptom of a brain disease, so what exactly is writing too much?”

Dr. H__ made a condescending effort to placate me, answering with a straight face: “Writing too much means writing more than is necessary or appropriate.”

I was annoyed. The murderers and perverts at Elgin are locked in there under court order and must learn to be polite to their captors in highly creative ways. I on the other hand had no such motivation. Dr. H__ seemed illogical, arbitrary, or purposefully insulting to me. We had to have an argument.

“What is writing more than necessary or appropriate, Dr. H__? Are you talking about a quantity of words, or a number of pages? Is there some standard or baseline quantity of writing that somebody somewhere has established for all writers, or is there a formula of some kind that gets applied to an individual writer?” I got a little sarcastic. “Did you just make this up yourself? What does hypergraphic actually mean, if it’s supposed to be an objective medical symptom that’s being observed, and if it really has anything at all to do with any illness?”

He finally explained it. “We do compare it to a baseline. The baseline is the amount of writing the patient did before, when the symptoms of his mental illness were in remission because he was taking the medication I told him to take.”

Almost everybody pretends to go along with this in the nuthouse. It's the gulag story. They all know on some level it's a big lie, but they can't see any other choice.

Dan Mojziszek went along, because he wanted to get out. He told Dr. H__, "Yeah sure, Doc, I BELIEVE in bipolar disorder, I'll always take my meds, I promise." They let him go.

Of course, Dan didn't really believe. None of them do. Dr. H__, Jennifer M__, Barb S__ and/or whoever was on Dan's team on P__ Unit never taught him anything, because they were only supposed to drug him into sufficient disability that he wouldn't be able to drive without a license anymore. That's their job, given to them by us, the taxpayers. That's the plan: dehumanization.

So I have no idea whether to offer these people my condolences for their dead patient, or my congratulations.

But I know this plan is a bad one, guys.

NAMI re-write

I suggest a revision of part of the "fact" sheet on the website of the National Alliance for the Mentally Ill, Greater Chicago local chapter (NAMI-GC). After all, it was last revised in 1999, and there has been enormous forward progress in the empirical and scientific understanding of mental illness in the last eleven years ... right?

The last paragraph of the section about substance abuse in this publication reads as follows:

Many people who struggle with mental illnesses also struggle with alcohol or drug habits that may have begun in their mistaken belief that they could use the substance to "medicate" the painful feelings that accompany their mental illness. This belief is mistaken because substance abuse only adds to the suffering, bringing its own mental and physical anguish. Here, too. psychiatrists can offer a number of effective treatment programs that can reach the substance abuser and his or her family.

Based on broad empirical evidence and the most recent research, this paragraph should be updated as follows:

Most people struggling with behavioral, emotional or mental problems called "mental illnesses" attempt to use alcohol, street drugs, or over-the-counter and prescription medications to feel better or to assist desired behavior change. This popular strategy is mistaken in all but the most extreme, short-term emergency situations, because it invariably leads to increasingly complex side effects, disability and heartbreak. Here, too, psychiatrists insisting upon the medicalization of everyday life betray, abuse, and harm individuals, families and society.

NAMI-GC's original (circa 1999) paragraph and my more modern revision are each 79 words long. My 79 are much truer than theirs.

NAMI falsehoods

The "fact" sheet on the NAMI-GC website states: "Scientists are now certain that some disorders are caused by imbalances in neurotransmitters." By disorders, of course they mean mental illnesses such as the prototypical schizophrenia.

The "fact" sheet was last updated in 1999. One might expect that subsequent research and medical-scientific discovery would have substantiated the statement to some additional degree.

In 2008 (nine years after NAMI presented their "fact"), Stephen M Stahl published the third edition of his definitive and preeminent, Stahl's Essential Psychopharmacology: Neuroscientific Basis and Pratical Applications. On page 264 of this book, in Chapter 9 Psychosis and Schizophrenia, under the section "Neurotransmitters and circuits in schizophrenia: Dopamine" Stahl states simply, "The biological basis of schizophrenia remains unknown."

Also published in 2008, the third edition of Kaplan & Saddock's Concise Textbook of Clinical Psychiatry weighs in heavily against NAMI's "fact" of nine years earlier. Pages 159-160 contain fourteen separate section-paragraphs, each taking up a specific biochemical factor or possible neuropathology in schizophrenia. Not one of these fourteen sections omits some key admission of inconclusiveness and uncertainty. E.g., "...biochemical and pharmacological data bearing on this proposal are inconclusive", "The ...  dopamine hypothesis of schizophrenia...", "... whether an active pathological process is continuing to evolve in schizophrenia patients is uncertain."

Stahl's and Kaplan & Saddock's are authoritative, mainstream medical-psychiatric sources. They incorporate the understanding resulting from almost a decade of additional research since NAMI-GC's "fact" sheet was last updated. There are of course, many more authorities, and guess guess what? Not one of them validates the utter falsehood quoted above from NAMI-GC's web site. There is no known biological basis for any mental illness.

Why does NAMI persist in defrauding the public about mental health? 

Better yet, why does the State of Illinois persist in offering NAMI's deceptive propaganda as "education" to the public? (See my posts of December 18 and 21.)

NAMI incoherent

All the inspirational material I will ever need for this blog is on the website of a single local chapter (Greater Chicago) of the National Alliance for the Mentally Ill. I'll start today with a statement in the third paragraph of their "fact" sheet entitled "Mental Illness: an Overview". (By the way, this document was most recently  revised in 1999, so maybe that's a problem....)

They say: "The unrelenting hopelessness, helplessness, and suicidal thoughts of depression may be hard to comprehend, but these are real, painful emotions, not hallucinations or delusions."

What exactly does this mean, and why is it important?

I understand NAMI as a group promoting mental-illness-as-brain-disease, which I believe to be an extremely destructive (not to mention largely or totally fraudulent) idea. But I'll try to give these guys the benefit of the doubt and start with what could be right about what they say.

People do get majorly depressed to the point where they can't even move, eat, etc. It can become a critical situation which will even be fatal unless somebody else helps them. This kind of thing is of course real, and anyone who is part of such a situation (e.g., family and friends) should take personal responsibility accordingly. Sometimes medicine is part of necessary help, and doctors know more about medicine than most other people. This is all a matter of common empirical understanding.

OK, now for my problems with the quote.

"Real" emotions are subjectively created feelings, chemical reactions in the brain, or a combination. Take your choice, suggest your own formula (you reader, are actually as good for this definition as the best neuroscientist). Regardless, hallucinations and delusions have to be defined exactly the same way. The sentence in NAMI-GC's "fact sheet" attempts to point out a difference between real emotions and hallucinations or delusions which cannot apparently exist on their terms.

I suggest that the only difference between real emotions, painful or not, and hallucinations or delusions lies in the opinions other people have about someone's thoughts or feelings. If we say painful emotions are real, we agree they are somehow correct or justified. If we call them hallucinations or delusions, we imply a person should not think or feel the way they do. In the first case we may feel obligated to help, in the second we may not. It's essentially a moral judgment.

People used to sympathize with and romanticize heartbreak, and punish deviance. Now, NAMI advocates the same help (medicine, psychiatry) whether anyone's emotions are said to be "real" (as in depression, bipolar) or "hallucinations or delusions" (as in schizophrenia, etc.). That makes the "reality" of feelings or perceptions look pretty irrelevant. NAMI wants to eliminate morality, but it's ultimately necessary to their definition of reality.

Reality is a hot propaganda button. NAMI can tell family members their loved ones' feelings and their experiences are "real" the same way a door-to-door salesman tells a fat, disheveled housewife answering her rickety door in curlers she's "looking great today". All this brain stuff in mental health/illness is propaganda. It makes people feel better because people believe in medicine and science. So they have feelings that NAMI tells the truth, and they buy into useless nonsense. (Big pharma sells lots of drugs, too.)

Mental health is an existential, spiritual or ethical/moral issue, not a medical one. Ironically, NAMI proves this by attempting to argue the opposite.

China's Rebuke of Mental Illness

See a wonderful article by Andy Germak on the website of the Mental Health Association of Morris County, NJ, which clearly and explicitly states a view exactly 180 degrees opposite to my own regarding the psychiatric role in criminal law. Believe it or not, it is actually entitled, "China's Rebuke of Mental Illness".

You have to read it, I'll say no more. I linked to it earlier, but the link was soon "broken". Maybe MHA doesn't really like my attitude.... Anyway, it's easily googled by the title.

(As one quick aside, while I am absolutely on China's side on the main issue raised by this article, I'm not any huge death penalty fan. I would call for a law mandating that capital juries be required to draw straws for who pulls the switch personally if they sentence someone to death. That would solve most arguments, and I'd leave it there.)

Psychiatry and national health security

The U. S. Department of Health and Human Service recently released a document presenting the first National Health Security Strategy (NHSS) pursuant to section 2802 of the Public Health Service Act. (http://www.hhs.gov/aspr/opsp/nhss/nhss0912.pdf.) The strategy is intended to help minimize health consequences of "significant health incidents", defined as including, but not limited to, infectious disease outbreaks, hurricanes, earthquakes, storms, tornadoes, tsunamis, hazardous materials spills, nuclear accidents, biological and other terrorist attacks, and fires.

This is a 48-page document well worth reading. Two things struck me: 1) The document envisions bad scenarios which would threaten security sufficiently to warrant virtual martial law; 2) It is replete with statements recognizing an overarching necessity to convince the people to trust and independently cooperate with organized efforts by authorities in the amelioration of any significant health incident.

As to number 1, the only thing I might say is that high governmental authorities always have such contingent functions and powers, implicit or explicit. Although the subject is scary, it's better to have more discussion of it, not less. The planning and thought HHS has put into this is evidence they're doing their job, and not necessarily indication of any evil conspiracy.

Number 2 is much more interesting. First of all, it reminds me of the essential point in General Rupert Smith's book about the new paradigm of war among the people. (This was mentioned in my post of December 28.) The only achievable strategic victory in modern conflicts involves winning the popular will, above all else. For corresponding reasons to those which Smith explores, in less formally military contexts emergency social controls can perhaps only be effected broadly with substantial uncoerced voluntarism.

That means that ultimately, HHS can only employ health security policies which first of all secure the basic faith, confidence and consent of individual Americans.

So what of psychiatry?

I read a New York Times book review not long ago which opined that our recent love affair with modern psychiatry is a sub-prime crisis waiting to happen. I believe that. The biggest health fraud in history is psychiatric "diagnosis" and "treatment".

The ultimate security threat is a catastrophic failure of confidence in authority. Battles and wars are lost pricisely and only when one side suddenly believes it has lost. I would urge the would-be architects of any national health security plan to distance the state from psychiatry as soon and as thoroughly as possible.

Otherwise, when the government most needs the confidence and cooperation of the people, and when we all most need social cohesion in the face of disaster, we may hear the sound of something like a guillotine instead.

Existence of mental illness

My friends and clients occasionally dispute "whether mental illness exists" as an intellectual, scientific or policy issue. I think the question is confusing.

Certainly "mental illness" exists as a topic of discussion or investigation, and as a desciptive phenomenon, a prevalent and apparently useful metaphor, etc., in every Western public forum I have ever encuontered. Just as certainly, "mental illness" does not exist as any specific, proven disease or objectively measurable bio-physiological brain pathology. Honest, educated disputes regarding the existence of mental illness are therefore really about appropriate language and effective remedies.

But it's quite amazing how the overwhelming majority of people who talk about mental illness are either critically ignorant or dishonest. This especially includes people who make their living as mental health professionals, lawyers, judges and public policy makers, and those who claim to be mentally ill.

Most modern adults in Western societies would say that witchcraft and magic don't exist as they were defined and fought against for hundreds of years by the Inquisition and other religious and social institutions. But of course, there are Wiccans and stage performers today who are expert in the subjects of witchcraft and magic, who practice them daily and even make their living doing so.

Certainly "witches" do not exist to be burned at the stake, and just as certainly they do exist, in covens currently enjoying legal protection under the First Amendment's free exercise clause.

There's a great deal of work to do in the world. It is destructive to waste time confusing each other. We should know what we are actually disputing, and take personal responsibility for the understanding we impart, or fail to impart to others, every time we speak or write.

My argument is simply that medical treatment for spiritual, emotional or mental problems (i.e., psychiatry) is an extremely bad proposition. It should not be public policy, and anyone who seeks to enforce it overtly or covertly on others should be fought with ferocity.