Monday, February 20, 2012

Jail and the mentally ill

Bridget O'Shea's article on yesterday's NY Times Health page featured Sheriff Tom Dart and others, complaining about Cook County Jail being the biggest mental health provider in Illinois. I never quite know what to say to people who seem to think this is so pathetic.

The presumption of course, is that individuals who are sick belong in hospitals, not jails. But there's a highly ironic and eery similarity between mental "hospitals" and jails. The people of Illinois should notice, just for example, that these hospitals have locked doors and guards to make sure the "patients" don't escape.

I would love to walk around the cell blocks at 26th and California with Tom Dart, and say, "OK Sheriff, point out one guy here who's mentally ill as opposed to just a bad guy, and explain to me how you yourself can tell." My guess is, he'd only be able to reliably distinguish between the regular criminals and the mentally ill in his own jail by looking at a file or a record, or asking somebody else who had looked in a file or record, which might include pronouncements by psychiatrists or other so-called mental health professionals.

These pronouncements are called diagnoses. But the people who make them are completely confused these days about whether and in what sense they are valid at all. There's is never any objective test, and DSM-5 intends to define mental illness of every kind on an unbroken continuum with normal behavior. In other words, nobody knows exactly where to draw a line between the guys who are sick and the guys who are bad at Cook County Jail.

For ten years, I've worked with "patients" in this system who were found not guilty of violent crimes by reason of insanity. I'm down at 26th & Cal almost every week. Some of my clients have been basket cases who didn't brush their teeth or bathe; others have been smart, totally symptom-free, unmedicated murderers. Sometimes their doctors have insisted that they had to take psychotropic drugs, or even threatened to get court orders to force them; other times the clinical team has carefully contrived to change a diagnosis so a non-drug treatment plan could be justified to a true-believing judge.

The one thing that's always obvious is, it's not medicine or science in any sense that the public could ever recognize. It's a tortured attempt at a giant social control machine which can run on automatic without any responsibility by any individual human being, so nobody ever has to be punished, or blamed, or wrong. People can just get their brains fine-tuned by the experts, and we can all live happily ever after.

This is the probably most destructive social delusion in history. Maybe it's easy for Sheriff Dart to pretend he's being humane and scientific and medical, when he moans about too few state nuthouses to relieve his crowded prison. The truth is he's just passing the buck like all the other helpless, wasted bureaucrats we pay.

And ultimately, the New York Times reporter has no excuse not to know that. Nor do any of the rest us.


  1. I love your blog. Do you have an organization, because I have been thinking of organizing, as Citizens Against Psychiatric Abuses (CAPA) or some other name. If I tell you I was inv. committed for sending an email that mentioned suicide, can I then say that I am not at all insane and be believed? Maybe by you, SRK.

    When this happened to me, I was a professional with an M.A., but I was totally ignorant of the process. I've spent eight months researching how I was "mugged" by the system and it get wierder every moment.

    I want to sue the bastards under Section 1983. I'd like to discuss it with you but I understand you probably want anonymity, too. Don't blame you.

  2. We've been doing some work on this issue also, and it occurs to me that possibly the agenda going on is to relieve the stigma of the U.S. locking up too many people in prison by transferring a good many of these people to psychiatric institutions and pretending they have made a difference.

    1. The problem is less "too many people locked up" than "too few people corrected."

      Psychiatric "treatment" may be equally as effective as prison, for the purpose of punishment or incapacitation. But it's certainly no more likely to make anyone better.

  3. I've had times in my life when my behavior was truly not under my control. Years ago I had this terribly intense feeling of pressure in my sinuses/head, and it caused me to begin screaming involuntarily. Then, for no reason and with no conscious awareness, I began beating my head against the wall, then my fists, then I was tazed and arrested. Whatever it was, still today unknown, it was definitely medical and not a matter of free will. My landlord filed charges and I was facing up to 2 years in prison, A plea bargain was offered with only 180 days in jail if I could pay the extremely (intentionally) inflated cost of around $2,600 for what was truly maybe 200 dollars worth of damage. I decided to take it to trial and plead insanity, but just after I did the prosecutor re-bargained for 1 year probation, no-contest plea, and a civil court would deal with damages and restitution.

    I guess my point is, to hell with psychiatry, but not the insanity defense. If a person having a diabetic fit or a seizure crashes their car and kills somebody, should they go to prison for vehicular manslaughter? Are you denying that phenomena occur in people in which their behavior goes out of control? Should anybody be punished for something that's not their fault, was not a conscious decision that they made?

    1. Couple things Jeffrey...

      For one, you were not found NGRI. If you had been, you'd have been committed involuntarily for a period not to exceed the maximum sentence for the crime had you been found guilty (apparently 2 years). Then, as you entered the gates of the state nuthouse, somebody would have told you essentially, "Either take the meds you are prescribed or you will never leave here." It would have been illegal for the person to say that, but they would have said it anyway.

      I've had plenty of clients say that if they had to do it over again, they'd prefer to serve an honest prison sentence than be found NGRI. You're willing to keep the insanity defense around, perhaps, because you've never been found NGRI.

      Secondly, if a person having a diabetic fit crashes their car and kills somebody, they don't plead "not guilty by reason of insanity". The law has many, ages-old, subtle ways of considering and accounting for responsibility, lack of mens rea, etc. We do not need psychiatry, which does nothing but degrade the law, and medicine, and humanity itself.

  4. OMG, I typed out a giant response and then somehow it disappeared. Anyway, I'll just sum up what I was saying.

    I agree that psychiatry is bogus but I don't think we as a society can continue going on the way we do with law and punishment. There are some people who break the law because they think it will benefit them and often it does, and they should surely be punished when caught. But many more, probably 90%, of people are simply just living their lives and everything else is incidental. Most "criminal activity" is either an "episode" of yet to be understood medical illness or the product of daily life in a certain environment. I'm positive that even the most thick headed of the flag waving, "law abiding" conservative rednecks out there would be gangbangin and smoking dope if that were the environment that they grew up in. We need ways of addressing these problems and preventing crime through that approach, as opposed to just chasing "bad guys" and locking them up. I was hoping psychiatry would be this something, but they are not. There is no such thing as good and evil. People are just people and as the species evolves this will become better known.

    Lastly, I only intended to plead not guilty by reason of insanity -- full well knowing I would be forcibly drugged, as I had been in the past -- because I felt totally violated that I was even being charged. I didn't do anything!, I had as much control over what happened as a lamp shade. I would had rather died, or spent years on neuroleptic drugs, than to plead guilty to that "crime".

    1. Criminal activity is NOT medical illness. It is behavior which a person's fellows will not tolerate, no more and no less. No excuse or reason will alter that fact.

      Good and evil are chosen, and as real as life itself.

      I believe you are quite honest, but partially mistaken, when you say, "I didn't do anything!"

      The people who locked you up as a bad guy were also partially mistaken. But they are somewhat better than "thick headed, flag waving rednecks" and you probably will die or spend years on neuroleptic drugs unless you can understand them better than that.

  5. The gun just went off man. I didn't do it! (joke)