Incompetence or bad intent? (Tim C, RN on N Unit at EMHC)

"Never ascribe to bad motives those things which can just as easily be caused by incompetence." This is one maxim of investigation into bad results occuring in bureaucratic contexts.

On February 24, 2025, an N Unit staff named Tim C spoke with a doctor from an outside medical facility who called to consult with an EMHC doctor, regarding why an EMHC "patient" had not received prescribed medication. The doctor calling in mentioned that the "patient's" blood pressure was very high and the medication had been prescribed to deal with that specific problem. Why was EMHC incapable or unwilling to treat a clearly serious medical problem with the medication the doctor had prescribed? 

Tim is a nurse, and he blithely suggested that this particular patient was probably just clenching his fist to fake the high blood pressure reading. The doctor calling in was taken aback. Did this nurse think he was incapable of getting an accurate reading from a blood pressure cuff?! What kind of "hospital" or prison medical unit was this?!

It turns out Tim previously worked in security at EMHC, so maybe he was more into playing cop than playing medical professional. The security department at EMHC was reportedly very happy to get rid of Tim and his sarcastic, "know-best" attitude, when Tim was finally transferred to his current clinical job on N Unit. The outside doctor who called in on February 24 reacted to exactly the same, obnoxious attitude.

Just because Tim C might plead incompetence as opposed to intentional denial or attempted denial of necessary medical treatment (i.e., abuse!) for an EMHC "patient" (i.e., slave), it doesn't mean he's not in lots of trouble if that "patient" suffers some serious consequence due to the lack of treatment. When Tim glibly suggested to the doctor who called in to EMHC that the patient's blood pressure really wasn't high, he was questioning the doctor's competence as well as willfully or carelessly obstructing or discouraging proper medical treatment.

At the present moment there's no legal claim to which this evidence might be attached.

But we'll see.

Laura Delano and Unshrunk are a big deal!

This Psychology Today article is the latest of several extremely high-profile book reviews of Unshrunk: A Story of Psychiatric Treatment Resistance by Laura Delano (New York: Viking/Penguin Random House, 2025). Others are from New York Times, and Washington Post. It has been a grand total of two days since Laura's book was published, and already I can't even keep up with all the media attention it's getting.

I met Laura Delano many years ago at a conference in Portland, OR. I've corresponded occasionally with her ever since, and I had pre-ordered Unshrunk, so it was delivered to me the same day it was published. The first couple chapters, along with the media reaction, have already convinced me that this is an extraordinarily important book. Not only that, it's a delightful read despite the serious and socially problematic (perhaps dark) subject it presents.

I could actually predict (and hope) that Unshrunk will have major, lasting cultural impact such as I recall from The Population Bomb by Paul Ehrlich (circa 1968). That book seemed to more or less inspire the whole modern environmental movement, which had previously just been about Sierra Club-type interests in "conservation". Greenpeace and other radicals since the 1960's had very little in common with the earlier Teddy Roosevelt generation and the national parks crowd, who were a far cry from the SDS or the Black Panther Party.

I'll keep reading and see what I think, but Laura's book may turn out to be the biggest anti-psychiatry event since Jack Nicholson played Randle McMurphy in the 1975 film version of One Flew Over the Cuckoo's Nest. Anyone who doubts the impact of that film only needs to know that almost 1000 results will come up from a search for the title... on the American Psychiatric Association's website (which is not otherwise much about movies).

Judith Warner's Washington Post review asks, with obvious anxiety which she evidently expects her readers to share: "But what if she (Laura Delano) starts giving out life-and-death medical advice? What if that person, who also happens to be supersmart, attractive and compelling, is handed a bullhorn just when her message aligns perfectly with our post-covid, 'D.I.Y health' zeitgeist? What if she publishes a book at the very moment when her anti-expert, anti-science — in this case, anti-psychiatry — perspective aligns with U.S. government policy?"

Laura herself repeatedly claims that she wants little or nothing to do with radicalism. She explicitly denies being anti-psychiatry, or even anti-psychiatric drugs. Are the reviewers who clearly worry about her book afraid? If so, why?

Maybe they should be afraid. Laura Delano is a natural charismatic leader, just a bit like Randle McMurphy (or as I've said before, Mario Savio). She may change people's minds in a big way with her book.

And I say, psychiatria delenda est!

REALLY up fpr grabs! (addendum)

 

Mental Health and AI

"Artificial Intelligence" is first of all an obvious oxymoron. Machines simply are not intelligent in the sense of any living ability to create new stuff from nothing. Artificial means related to an artifice, or a clever, perhaps deceptive device, an expedient, or even a cunning trick. Intelligence necessarily indicates the ability or action of understanding, comprehending.

A machine does not understand or comprehend: it can only create a persuasive artifice of understanding and comprehension. Artificial intelligence, no matter how useful or dangerous it may become, cannot simultaneously be a machine, and alive.

An article in today's Chicago Tribune highlights a legislative effort in Illinois to regulate, among other things, the use of AI in medicine and mental health. State Rep. Bob Morgan of Deerfield is quoted: 

“(I)f somebody is going to hold themselves out as a health care professional they actually have to be a health care professional. But in this situation, AI is stepping in and not disclosing that they’re not a person. And they’re advising people on their health care, their behavioral health. And we’re going to put a stop to that.” 

I might ask why behavioral health advice should have to come from a licensed health care professional? What if a friend tells me I should be generally more polite so as not to upset my friends, or I should get a haircut or shower more often, or I should relax about politics and not watch the news so incessantly, but just do the sudoku and ken-ken puzzles in the paper? Isn't that behavioral health advice? Would my friend be violating the law which Rep. Morgan proposes if he/she is not a social worker or a psychiatrist/psychologist?

Kyle Hillman, a lobbyist for social workers, also pipes up to say:

“I’m sure this (AI-based advice on mental health) is something that individuals that just aren’t ready to make that call might look to. But it’s just not something that’s safe. We would never consider this as an option for physical health. Like, ‘hey, I have a laceration on my leg. I’m going to call an AI chat doctor on how to put stitches in my leg.’ … It’s not something we would do.” 

I think AI is a much better and much safer way to go, for behavioral health advice, than calling any random social worker, Ph.D. psychologist, or M.D. paychiatrist! It's far less expensive (which is probably why most people consider it). But even more importantly, behavioral health cannot pretend to be objective science. If medications are part of it, you certainly want somebody on hand (a pharmacist?) who is familiar with drug actions and reactions and interactions, etc. But that information is all available on line, too, it just lacks the perspective relevant to a particular individual in a particular situation.

Anyone who has a doctor (or a priest or coach...) who knows them and has given them good advice in the past, is certainly being reasonable to choose that health care professional over an un-person AI program. I just don't believe the decision should be enforced by law. Maybe that's only because I almost never go to doctors myself. And even though I don't admit to any scary symptoms at this moment, maybe I'll die tomorrow of something that could have been prevented. But I am 73, and for the last 50 years, I've virtually never bothered with or worried about tedious and unpleasant medical errands like proctology or cardiology or cholesterol tests. I never check my own blood pressure. Maybe it's a fair exchange.

Modern medicine does not represent the best prospect for personal salvation or social progress. The field even brags, I think, about being a system, or an objective, mechanical process for evaluation and decision making that can make everyone happier. That's a machine, or it aspires to (ideally) be a mere machine. What we need is creativity.

Our problem with so-called "artificial intelligence" is merely that we are unwilling to be alive, creative, and responsible.

And it's far worse in so-called "mental health."

Bob Morgan and Kyle Hillman are wrong.

REALLY up for grabs!

I've been hearing complaints recently from the IDHS plantations that toilet paper is rationed and nobody can do their laundry because there's no soap. I also had a "patient" (slave) call me to complain that psychotherapy cannot be provided any longer. Treatment is now being refused because there are no funds to pay for overtime. Clinical staff are not showing up for work, units are undermanned and it's not safe.

Downstate, there have been several recent cases when defense attorneys asked criminal courts not to place their clients at Choate MHC because it's so understaffed that it's dangerous and treatment is simply not possible. In at least one hearing recently, defense counsel called three separate Choate overseers (aka, "clinical staff") as witnesses to testify about how bad it is there for the slaves.

I got a call from a client just yesterday who was very frightened because she was assigned a new roommate who is unstable. My client is several months pregnant, and she's afraid there is a plan to traumatize her and cause her to loose her baby. The overseers probably would be greatly relieved if she had a miscarraige, because it's clear they are at fault for her pregnancy in the first place. They haven't been able to coerce her into an abortion, and they are quite impatient/unhappy about having to provide proper prenatal care for anyone, much preferring to follow the regular routines of just just drugging everyone into compliance and zombified sub-humanity, and punishing them when they cause extra trouble. This one will be a real shit show for the Packard plantation, however: when that baby is born, he or she should get a free ride to Harvard on the State of Illinois, and that's a whole lot of extra trouble!

The question of where a bunch of money went, that was supposed to buy toilet paper and laundry soap or pay for overtime psychological counseling, is unsettled at EMHC. Maybe it was stolen by the librarian who was recently allowed to retire with a pension based on his final, near-six-figure salary, after sexually harassing and abusing patients for many years; or maybe the thief was Nick Callapocalypse, who was supposedly the administrator responsible for ordering toilet paper, laundry soap and other supplies. I don't know Nick Callapocalypse, or even if my version of his name is close. I am told however, that whatever his name is, his "mismanagement of funds" caused him to be removed from his position, even though he was a loyal sycophant of Hospital Administrator Michelle Evans.

The "shortage" of psychological counseling doesn't seem to me like it should have anything to do with overtime. "Patients" are only held involuntarily on these plantations to be helped with "treatment" which includes not just psychiatric drugs or shock, but also counseling that might actually improve their mental and emotional/behavioral conditions. If the masters cannot provide counseling, the slaves are being held under unconstitutional conditions, in violation of their Fourteenth Amendment rights to substantive due process of law. The people running IDHS presumably know this as well as I do, so they have to schedule counseling where it is prescribed, overtime or no overtime.

An official publication entitled Patients and Support Persons Information Booklet, updated in 2023, tells the public that every clinical unit housing psychiatric slaves will have a staff psychologist to provide counseling. Well, guess what, that's just not true now. It might not have been true when it was written.

Housing male and female slaves on the same hallway and taking no responsibility to prevent or deal with entirely predictable unplanned pregnancies, rationing toilet paper and failing to enable laundry for a whole population of severely mentally ill people, allowing or failing to prevent staff financial misconduct and sexual abuse of patients for years, understaffing supposed "hospitals" to a point where they resemble medieval prisons.... These are signs of an enterprise which the public will sooner or later frown upon with a vengeance.

And incidentally, dealing with such crimes against humanity will not even require any Illinois version of Elon Musk and (the federal) DOGE. I note the Chicago Tribune headline just this morning announcing an eight-figure settlement agreement in a Federal lawsuit over the failure of DuPage County to effectively care for a 50-year-old mentally ill mother in their custody, who ultimately died as a result. Very likely, the DuPage Sheriff tried to defend by saying the state nuthouses just didn't have room, so he couldn't get the woman transferred to a proper mental "hospital".

But the state nuthouses are at least as hopelessly incompetent and downright dangerous as county jails ever were. The whole, laughingly-called, "forensic mental health system" is up for grabs.

No toilet paper for godsakes!