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View Diary: Stop blaming mental illness (58 comments)

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  •  It is not mental illness so much (17+ / 0-)

    as lack of treatment.  As I have said many times before, mental health care in this country is the so-called red-headed stepchild of health care services.  Reimbursement rates are low, but instead of seeing six patients an hour like your family doctor, psychologists  and psychiatrists are expected to see the patient for 50 minutes in order to bill a treatment hour.  At a lower payment rate than your family doc charges.  Visits are limited to anywhere from six to twelve per year, maximum.  How in hell can you monitor someone who is potentially dangerous to self or others with those limitations?  

    Another thing, most mental health professionals are not all that good at predicting violent behavior. There was an article in the Journal of the American Psychiatric Association several years back showing that board certified psychiatrists were no better than architecture students at predicting which patients would act out violently.  Better training is needed.  Violence and violent people have been my professional specialty for the past forty years. I have seen more dead bodies than I can count.  I have been instrumental in sending many perpetrators to prison, but when I get cases, it is usually too late to save the victim.  It is not the illness itself, but the detection of which mentally ill people pose a danger to society.  

    The general who wins the battle makes many calculations in his temple before the battle is fought. The general who loses makes but few calculations beforehand. - Sun Tzu

    by Otteray Scribe on Tue Dec 18, 2012 at 08:39:28 PM PST

    •  Exactly. (7+ / 0-)

      And in some cases, insurance won't even cover mental illness, so the patient has to pay out of pocket. My psychologist charges $130 per 1 hour session, and he wants me to come every week. I can't do that because that would take most of my income. At the same time, state legislatures (mainly Republican) across the country are cutting crucial mental health services, so if you have a severe mental illness, what do you do?

      I sincerely hope the ACA addresses this. I believe it does in some way, but I may be wrong.

      •  I've always been able to get help (3+ / 0-)

        at the county or city level, with sliding scale payments and free or discounted medications. One time I saw a therapist through a local church (though I wasn't a member). I know it's harder in rural areas, and the quality of doctors varies (I had one county doctor who was fantastic).

        It's not just a zip code, it's an attitude.

        by sboucher on Tue Dec 18, 2012 at 09:52:32 PM PST

        [ Parent ]

    •  True, but if there were no gun: Then no shooting./ (5+ / 0-)
      •  New York Sen. Chuck Schumer (D) said (2+ / 0-)
        Recommended by:
        CherryTheTart, leu2500

        on Sunday that when entering the gun control debate, the left must "admit there is a Second Amendment."

        "No guns" is a fantasy of one polarized side in the gun rights vs. gun control conflict, because the actual policy debate is what constitutes reasonable regulation.

        The one permanent emotion of the inferior man is fear - fear of the unknown, the complex, the inexplicable. What he wants above everything else is safety. H.L. Mencken

        by ancblu on Tue Dec 18, 2012 at 11:13:59 PM PST

        [ Parent ]

    •  Maybe the reason why psychiatrists do no better (7+ / 0-)

      than architects at predicting who will be violent is that psychiatry is not actually capable of predicting who will be violent.

    •  It's so difficult to predict which patients will (2+ / 0-)
      Recommended by:
      smartdemmg, amsterdam

      be violent but it's easy to predict that guns will kill people. It is easy to predict that when there is a proliferation of semi-automatic guns there will be massacres. We have the numbers.

      So let's first regulate the guns and make them very hard to obtain.

      ❧To thine ownself be true

      by Agathena on Tue Dec 18, 2012 at 09:54:09 PM PST

      [ Parent ]

    •  I disagree with the premise of this Diary ... (1+ / 0-)
      Recommended by:

      Gun violence is a national public health issue and as the President said: it is complex, but that cannot be an excuse to do nothing.

      This Diary and many commenters seem to deny the complexity of many factors that do correlate with violence generally and gun violence specifically.

      Major mental health disorders do show a somewhat higher correlation to violence than in non-affected population groups -- this is not disputed in the academic literature.  The correlation increases when presented in combination with other independent variables that also correlate to violent propensity, including gender (male), age (young), income (low), education level (low) and substance abuse (alcohol and drugs).

      To deny these data is just silly and the argument "Stop Blaming Mental Illness" really does nothing to address this public health problem in the comprehensive manner it requires.  In fact, it puts out more smoke than light -- a similar fault of demagogues who would deny the existence of gun violence as a national problem in order to avoid dealing with the problem of easy access to firearms for those who may pose a greater risk of using them violently or criminally against members of the public.

      The progressive agenda does need to look at underlying causal factors and avoid the error of myopic focus on simple banning, which in any case would have to overcome the inevitable constitutional challenges.

      The one permanent emotion of the inferior man is fear - fear of the unknown, the complex, the inexplicable. What he wants above everything else is safety. H.L. Mencken

      by ancblu on Tue Dec 18, 2012 at 11:01:45 PM PST

      [ Parent ]

      •  I'm not sure we should (3+ / 0-)
        Recommended by:
        ancblu, smartdemmg, Otteray Scribe

        lump all mental illness together in this. Are some forms of mental illness more correlated with violence than others? I would think that some may correlate more with self-harm but less with violence against others.

        "Okay, until next time. Keep sending me your questions, and I will make fun of you... I mean, answer them." - Strong Bad

        by AaronInSanDiego on Tue Dec 18, 2012 at 11:27:46 PM PST

        [ Parent ]

        •  You are absolutely correct ... (2+ / 0-)
          Recommended by:
          CherryTheTart, Otteray Scribe

          mental health covers of very wide range of clinical diagnoses.  As a society we are still working through the public stigma of this type of health diagnosis and we should careful when considering the role it might play in propensity to gun or other forms of violence as a public health issue.

          The literature does place the emphasis on "major" disorders as categorized by the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.  These would include certain anxiety or mood disorders, as well as schizophrenia and paranoia, etc.  DSM-IV

          Importantly, the statistical prevalence of violence is most strongly indicated when multiple independent correlating variables present in some combination.  

          The one permanent emotion of the inferior man is fear - fear of the unknown, the complex, the inexplicable. What he wants above everything else is safety. H.L. Mencken

          by ancblu on Tue Dec 18, 2012 at 11:52:35 PM PST

          [ Parent ]

    •  Better treatment for mental illness (0+ / 0-)

      is important, but I think the. discussion is not very relevant to finding a solution to these mass murders.

      I do find it fascinating how the right wing is trying to use it as a talking point.
      There not doing a very good job. It goes something like this.

      "We need to do something about these massacres. Let's do something about mental illness. But not Obamacare, because that is bad. We need to be able to identify these crazy people before they do something. But banning assault weapons won't work because it is to difficult to identify an assault weapon".

      What are they suggesting? Screen every American for mental illness, or just people who want buy a weapon?
      Are they suggesting it is easier to identify the potential crazy person who will be the next mass murderer, than to come up with a definition for an assault weapon?

      I think people should be very alert when the right wing start talking about mental illness being the problem. I seriously doubt that would lead to better treatment programs, and probably may be an excuse to gut  4th amendment in order to preserve the 2nd, eventhough that would not address the real problem.

      •  There is no guarantee that (0+ / 0-)

        any given gun owner won't develop a mental illness at some point in their lives. So there is always going to be a danger that someone who is mentally ill has access to a gun.

        Because gun ownership is a Constitutional right, it's clear that public access to weapons isn't going to be nullified in my lifetime (or yours, probably). And not all - or even very many - mental health abnormalities cause sufferers to become murderously violent. Mental health care is difficult enough to access as it is, and automatic abrogation of Constitutional rights if one does get help surely isn't conducive to people seeking out that help.

        Probably the most effective thing we could do is impose much greater restrictions on semi-automatic weaponry, especially the number of bullets that can be fired before reloading. Special classes (of people) do need guns with greater capacity, but the general public does not. 5 or 6 bullets in a magazine should be enough for any purpose a regular person has - like those who aren't such good shots who need to kill a rabid animal instead of simply wound it.

        That is me speaking as a person who has chosen to live far out in the country where police are 45 minutes away on a good day, neighbors cannot be seen or heard, and three-quarters of the property is bordered by state game lands and about a million acres of National Forest bear sanctuary. Worse, I've got livestock, pets and grandkids who are here a lot. We have had to kill rabid animals, starving abandoned dogs (always pisses me off that they were abandoned, but I'm not going to let them eat my ducks or tear into my dogs or grandkids). And way too many well-armed hunters don't pay any attention to posted private property signs on their way to killing some deer/bear/turkeys. They universally have more respect when they know we aren't helpless here.

        Cities and crowded megaburbs are a whole different deal, I don't know what ultimately is the best gun control there.

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