Forgive them their transgression

Rich Lowry on mental health

Another alarmed professor went to her dean with worries about Cho.
She was told that nothing could be done, so he was simply placed off to
the side of the seminar, where he said nothing and his disturbing
writings weren’t read aloud. This is a microcosm of how we’ve handled
many of the mentally ill during the great deinstitutionalization of the
past 30 years, when they have been left to their own devices — and
often to the streets or prison — rather than treated.

There are
many reasons for this – the rise of psychotropic drugs, budget cuts,
expanded conceptions of civil rights -€” but one intellectual current
behind the trend was a moral disempowerment of sanity. One of the most
influential academics of the late 20th century, Michel Foucault, argued
that attempts to label and treat madness were inherently arbitrary and
repressive. Academia has been celebrating “€œtransgression”€ ever since.

I must thank Mr. Lowry for the rush of memories of all those hours spent in meetings while working as an MSW clinician treating the mentally ill, that myself and colleagues spent musing on the work of Foucault. Wait Foucault… the French philosopher? Jesus H Christ with an Axis II diagnosis, you have to be freaking kidding me.

I’m ready to spit teeth…teeth cut in a system so under funded and screwed up, that at the time I left, it was an abomination and now is near collapse. Diagnosis was easy, coming up with a viable treatmmet plan? Not so much so and I can guarantee you Foucault never once entered into the equation.

Just what does Lowry think the incredibly under paid mental health clinicians of America do? I can tell you what I spent way too much time doing. Calling insurance companies begging for more sessions. (Please please I’m sure 4 more sessions of that brief therapy you insist on me providing will take care of that personality disorder and associated features) Calling around to hospitals in search of an empty bed for near suicidal patients. (Well no he doesn’t have insurance…Hello? Hello…? shit) Justifying my worth to the not for profit agency–ready to close up at any minute–when my billable hours are out of whack with expected goals necessary to keep the dumping ground for the poor and uninsured open. (Supervisor: You’re over 50% in Medicaid hours here. Can’t you get more clients with insurance? Me to self: More marketing. Great) Seeking out long term care programs that did not exist and I assure you I wasn’t celebrating Focault when I heard–no such thing–I was more likely cursing Reagan. Funny Lowry doesn’t mention the influence of that name. No. Coming close to reality with a few of the “many reasons” he noted, Lowry just couldn’t help himself and instead took that hard right and offered up the strawman, Foucault.

If Lowry wants change in mental health care then put up or shut up. Admit the policy mistakes of the past. Institute policy and programs and most important–Fund Them.

11 thoughts on “Forgive them their transgression

  1. Lowry’s column reeks of privilege. The privilege of someone who has never acquainted himself with something as overwhelming as what you describe. There is no way he could have written that if he had a scintilla of a clue about “the real world.”
    Or, more to the point, if he understood fully that wholesomeness does not equal sanity, and insanity does not equal unwholesomeness. Insanity is an illness, not a transgression. Speaking of Reagan…
    And then this, in next paragraph after the one you quoted:
    After seeing the sick trail of misery left by such transgression, can we expend some of the same intellectual energy honoring wholesome normality?
    That of course, wouldn’t cost anything, in either dollars or intellect, so knock yourself out, Rich.

  2. thank you. this single post may be the most worthwhile and confirming thing i have read online in months, if not years.

  3. Foucault?Foucault?! I’m guessing this is because Foucault is French, and the reference makes Lowry sound like an intellectual.
    Thanks, Scout. I’m adding this to my observation about Americans being in love with ideas and abstractions, and screw real people.
    Gak. Even Hopkins doesn’t quite cajole me out of the bleak mood stupidity like this puts me in.

  4. Not to reveal too much about my self, but ol’ Spocko spend a year with some chronically mentally ill. They were Manic Depressives, people who had more than one psychotic break and people with auditory and visual schizophrenics. This was when Reagan was dumping people onto the streets so “the community could provide for them”. It was, what do the kids say today? A cluster frak. Yep. That’s the term.
    I KNOW what it was like, I worked with them. And people like Scout were the backbone of a struggling system. The OTs and MSW were great but overwhelmed. I had a ton of myths busted in that program. For example. Mentally ill people aren’t stupid. In our program 3 people had Master’s degrees, and one had a Ph.D. There were also not all poor, two came from upper class families that simple couldn’t handle them and “private care” wasn’t something they could afford anymore after 20 years.
    One guy who was manic depressive was more well adjusted than most of my college buddies. Then he went off his meds and wandered away from his board and care home when the one guy for 15 people wasn’t watching. He put his leg on a train track and waited for the train to take it off.
    Spend a few days with these people and you will say, “There but for the grace of biochemicals and a few triggering events, go I.”

  5. Excellent post, Scout. People just try to gloss over the emptying of mental institutions that occurred under Reagan. “Oops! Budget cuts!” Budget cuts meant that the mentally ill lived on the streets. We should not let Reagan teflon his way out of that shameful legacy.

  6. Late 80s I was riding a motorcycle in Los Angeles when a motorist intentionally tried to run me over. I turned into a Vons parking lot and so did the guy in the car. He followed me around yelling at me and trying to run me over.
    He was yelling about the planes and the aliens trying to attack him. And I guess I looked like an Alien in my helmut.
    I was eventually able to find a somewhat safe place to park and darted into the Vons.
    Folks in the store called LAPD, but the guy had driven off.
    The LAPD came by and as they were taking my statement, some other cops found the guy about a mile away and they arrested him.
    That night and the next day, everyone, I mean everyone, the LAPD, and the DA that contacted me, everyone agreed the guy was insane. They wanted to know if I wanted to press charges. They told me that a few years earlier they would have just had the guy put into a mental hospital, but they told me, that is the LAPD and the DA told me, that thanks to Reagan, that was no longer an option. They all agreed jail was not the place for this guy who was severely whacked out, but they also said the only way to get this guy any amount of the help he needed was to have him arrested and go to trial.
    Which is what happened.
    Foucault? Or Reagan?

  7. expanded conceptions of civil rights
    Those uppity weirdos think it’s some kind of right to not be castrated or electroshocked into vegetability.
    New nickname for Lowry:Nurse Ratched.

  8. We are reaping what was sown by lack of imagination. Personality disorders? Axis II diagnoses? Piffle! Shouldn’t *those people* just buck up and act right? Mental illness is institutionally denied. If we can’t imagine it, it must not really exist. If it isn’t acknowledged as real, then those who suffer must do so in shame. Today in his radio address, Bush said, “Our society continues to wrestle with the question of how to handle individuals whose mental health problems can make them a danger to themselves and to others.” Gee. How about, start early and stay on top of it. Make it okay to get help. Then, make it possible.
    Great post, Scout. Thanks, Ray, for the pointer to Hiromi.

  9. Taking Michel Foucault seriously is a major mistake. Anyone who knows anything about the man just laughs and laughs at the notion.

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