Thursday, January 13, 2011

Revise Civil Commitment Laws II

Revise Civil Commitment Laws II



A few days ago I presented the educated assumption that the man who shot and killed six people and wounded Congresswoman Giffords along with 12 others, was suffering from Paranoid Schizophrenia. I reviewed the deinstitutionalizing/community mental health initiative of the early 1960′s and also the change in our civil commitment laws that made it almost impossible to get psychiatric and psychological help to those who are in psychotic states and who refuse to seek or accept help for their condition.

Many facts are now available that were not then. Professionals interviewed on the media have tentatively diagnosed his condition as paranoid psychosis. Neighbors had seen symptoms of psychosis in this young man for a long time, high school classmates and friends reported his increasing symptoms of psychosis, college classmates and a math professor reported their fear of this man in their class. The students feared he would bring a gun to class and the professor was afraid to turn his back to do math problems on the blackboard for fear that the actively psychotic person might shoot him in the back. These fears were present despite the fact that no one reported ever seeing him bring a gun to class. Also, the man’s disturbed and and forboding ramblings were publicly posted on the internet.

This tragedy could have been, and should have been, avoided.

Once again, America has hog-tied itself with our laws and we see the inhumane outcomes of our attempts to be humane. It is a sad truth that mental patients were once locked away and many were never released. It is a happy truth that, with the discovery of antipsychotic medications, many were able to benefit and lead more normal lives. It is a sad truth that a large proportion of hundreds of thousands of mental patients who were once released from hospitals did not get medications, or refused to take them, or were ones for whom the medications did not work very well. A great many of these former mental patients joined the legions of our mentally ill homeless and those in our prisons.

So I ask, what is humane about this outcome for nonviolent psychotic? And what is humane about America allowing an obviously dangerous paranoid psychotic to wander freely amongst our citizens who were fearfully trying to get help for this individual, while our mental health systems and our legal systems were unable to provide the help and protection needed? So now a man is a mass murderer who likely never would have hurt anyone. All of thishappened because of his untreated paranoid psychosis. So now a congresswoman has been brain damaged, twelve more have been wounded and nine other citizens have been killed.

In response, our government predictably swings into frenetic and futile action. It proposes that we limit the capacity of firearm magazines (use two guns, or poison, or several knives and a sword). It proposes that we limit the zone around a public official in which citizens may possess a gun to 1000 feet. What does it matter? How would such a law be enforced and how likely is the law to control the behavior of a dedicated sane assassin or someone in a murderous psychotic rage? Finally, the grand absurdity emerges among these lesser ones: it was Sara Palin, Fox News, Rush Limbaugh, etc., who need to be silenced!

No, dear friends, what really needs to happen is a revision of our civil commitment laws.

Although murderous attacks by paranoid psychotics can never be prevented 100% of the time, the probability of it happening again can be cut dramatically, if we will only behave rationally.

It is essential that our licensed doctoral level mental health care providers (psychiatrists and Ph.D. clinical psychologists) once again be given the authority to commit actively psychotic citizens, who refuse help, to mental health care facilities. This new commitment procedure can be much more humane than the previous ones. The new commitment procedure would be for evaluation and medication assistance (remember medication for psychosis was once unavailable). The first goals of this intervention would be to quell the ongoing psychotic episode, educate the patient as to their particular mental disease, and teach them how to effectively cope with it through medication and stress management. The final goal of this commitment would be discharge the patient as soon as possible with mandatory supportive follow-up.

It should be understood that such a treatment approach would need to be refined through outcome analyses and further revisions, to the point that it reflects our best efforts to protect the rights of all citizens concerned, including the patient under treatment.

V. Thomas Mawhinney, Ph.D. 1/13/11

P.S. You will note that I have omitted the paranoid psychotic murderer’s name. I did so because that person did not do the killing. Rather, it was a dangerous mental disease (paranoid schizophrenia) that America allowed to wander freely amongst its citizens that did the killing.

To those who ask: What about individual freedom? I will ask: What about the individual freedoms of those students and the professor terrified in the classroom? What about the freedoms of the professionals who were called to help, but who were restricted from providing help? What about the individual freedoms of those killed and injured by a paranoid schizophrenic’s murderous attack? What about the individual freedoms of all of the victims?

The list of victims includes the paranoid schizophrenic who did the shooting, those who were killed and injured, and all of their friends and relatives and the rest of us who have been traumatized by this and similar tragedies.

Some say that this suffering is “the cost of freedom”. I say it is the cost of our own cultural design mistake, and a loss of freedom which must now be repaired.

Sunday, January 9, 2011

Revise Civil Committment Laws!

Revise Civil Committment Laws!


It is true, as I taught for 36 years as a professor of psychology, that people with mental illnesses are generally no more dangerous than people without them. However, there are some exceptions. Those who are depressed are prone to suicide. Those who suffer from Bi-Polar disorder can be prone to suicide while depressed, or other dangerous behaviors when in high manic phases.

But, in instances of bizarre and senseless violence, such as the recent case of Congresswoman Gabrielle Giffords and the others who were gunned down with her, a severe mental illness (probably Paranoid Schizophrenia) was the cause. A particularly dangerous form of mental illness was allowed to wander free among us, and it was this (or another psychotic mental illness) that repeatedly pulled the trigger on our innocent and precious citizens.

Paranoid Schizophrenia is a specific and sometimes dangerous form of mental illness, especially when delusions of persecution are prominent. This should make sense to anyone. Delusions of persecution are false beliefs, often bizarre in nature, that others are “out to get me”, ”spying on me”, “taking my property”, or “trying to harm or kill me”. Of course, many normally functioning people would become very angry and tempted to “defend” themselves by attacking the “perpetrators” if they really believed that someone, or some people (perhaps the government, the next door neighbor, etc.), were trying to harm them or destroy their lives. People with this psychotic mind-set can be very dangerous and no amount of security will protect the innocent from their unpredictable psychotic behavior.

The deinstitutionalization movement culminated in 1963 when the Federal Government ordered that mental patients be freed from mental hospitals and be treated in their communities. Congress passed the Community Mental Health Act which provided funding for the construction of community-based facilities to treat mental patients on an outpatient basis. All of this happened shortly after the discovery of antipsychotic medications. In 1955 there were around 600,000 mental patients in state institutions. By the year 2001, there were only about 60,000 in state institutions. Where did the rest of the 500,400 mental patients go? These individuals with severe mental problems went back to living among us.

Following 1963, if hospitalization was necessary, patients were to be admitted on a short-term basis, medicated, stabilized and then released. This led to a “revolving door policy”, in which patients frequently were admitted, medicated, stabilized, and released, but, many then stopped taking their medication, again became actively psychotic and were rehospitalized.

Also, in the name of civil rights and humane treatment, the criteria for “civil committment” (committment to mental hospitals against one’s will) were narrowed to the point that only those who were a clear danger to themselves or the public, could be committed without their permission. This meant that even those who were actively hallucinating, ranting and raving, homeless, filthy, or in some cases starving could not be hospitalized against their will. In my view, these criteria are far too restrictive and great suffering among the mentally ill, as well as the rest of us, continues as a result.

Once again an over-reaction in the name of personal freedom and humane treatment has gone too far, predictably resulting in social chaos and tragedy, with a net loss of personal freedoms for all. Once again, I judge the true governmental motivation for a provision of more “personal freedom” ( in this case for mental patients) was largely revenue savings.

It is true that those patients who seek help at Community Mental Health Centers tend to benefit. But on a yearly basis, 40 to 60 percent of all people suffering from schizophrenia “and other severe mental disorders receive no treatment at all”. While poor coordination or shortage of services are frequently named as the cause for this shortfall, no one is willing to face the other obvious fact. Giving an active psychotic the right to refuse treatment is an absurdly self-destructive big part of our problem!

While institutions may become more effective in their treatment, there is no happy feel-good remedy for psychotics who are unable to make rational decisions in their own best interests, who do not seek treatment, or who refuse treatment when it is offered.

New Laws with more nuanced civil commitment capabilities, intensive medication and psychological treatment strategies, and mandatory close follow-up with recommittment capabilities are essential.

Wake-up America! Advocate for a Revision of our Civil Committment Rules!



V. Thomas Mawhinney, Ph.D. 1/9/11


P.S. (I) The history and statistics of the Community Mental Health Movement and its failings is based upon the college textbook Abnormal psychology, by Ronald J. Comer.

P.S. (II) Schizophrenia is a life-long mental disease with strong heritability. There is not cure for schizophrenia, though medication can imperfectly help to control its most bizarre symptoms. Since deinstitutionalization, the reproductive rates of people with schizophrenia have naturally risen and is thought to now approximate that of the normal population. The implications for the growth of the genetic basis or schizophrenic spectrum problems in our population should be clear. But, this is a topic for another time.

Thursday, January 6, 2011

For All Of Our Years

For All Of Our Years


It is six days past the start of the New Year. But, some dear friends sent me an inspirational and heart-warming video wish for the New Year and I must share it with you.

You will be happy that you took the time to view it.

http://www.worshiphousemedia.com/mini-movies/16526/New-Years-Inspiration



God Bless,

Dr. Tom

Sunday, December 26, 2010

A Belated Merry Christmas!

A Belated Merry Christmas!

"The best Christmas light display". Sent to me by my life-long buddy Vic Palenske— it is really neat!



http://www.flixxy.com/best-christmas-lights-display.htm



Nat King Cole and his daughter Natalie! What a great idea, made possible through modern technology.



http://www.youtube.com/watch?v=LGflQbQudGY&feature=related



Dr. Tom

Let's Stop Making Our Own Misery

Let's Stop Making Our Own Misery

Albert Ellis has written about how we make ourselves anxious and depressed by embracing certain irrational ideas or beliefs. He is correct! You and I both know from experience that it is not so much what happened to a person that makes them miserable..it is how they choose to think about what happened to them.

I once sat with a friend who was dying of cancer. I dreaded visiting him simply because I feel more skilled at talking about coping with life and less so about coping with death. My dear wife who is a nurse is so much better at that than I am. It was comforting that she was with me that day.

To our surprise, our bed-side visit with our friend was another valuable lesson in life. Our friend welcomed us with a great smile and, after our initial greetings, said: "Let me put this in perspective"!

He then cheerfully summarized the many wonderful things that he had the good fortune to enjoy in his life: His marriage, his children (now grown), his grandchildren, his good friends, pleasant hobbies, his pleasures and good fortunes in work, and his faith in God.

All of this from a man who we knew had suffered some significant defeats, hardships, losses and embarrassments in his life. In short, he had many of the problems in his life that a lot of people would describe as failures and great disappointments.

But not my friend. He chose to focus on the good things. The good things were as real and they were much more enduring than the bad things. By focusing upon the good things he became an inspiration to everyone who knew him. He beamed a glorious comfort for all of us to aspire to imitate.

He was thinking rationally about his own death. It was not a horrible or terrible thing! He could choose to be miserable in his last days or he could strive to find some happiness and do some good for others. His thinking was positive in nature and he focused upon his own intended goals. It was as follows:

Everyone dies. I am going earlier than I wished, but 68 years is a long time. There is much that I have accomplished. I will celebrate the good things. I will not dwell upon the bad things that I cannot change. My last gift to everyone I love (including myself) will be my love of them and my cheerful encouragement of them to carry on, make good contributions, be happy and enjoy their lives!

If my dying friend could do this through the power of rational thinking, it is certain that we can do better with our common problems in life that we must manage and overcome.

God Bless,

Dr. Tom

Thursday, December 2, 2010

Last Vestiges of Self-Restraint: Sunday Carry-Out Alcohol Restrictions.

Last Vestiges of Self-Restraint: Sunday Carry-Out Alcohol Restrictions.



It is interesting to watch government control over more and more of our behavior progress in leaps and bounds. Yet, our sexual and drug consumption activities are increasingly deregulated under the guise of personal freedom.

In my view the explanation for this seemingly incongruous set of events is significantly comprised of a complex mix of our government animal’s “food deprivation” (cash) and its primal motivation to propagate (physical growth, and increasing control of its populace).

With regard to our government’s weakening the moral values and traditions of America and providing greater access to addicting substances and activities, all of this validates the need for greater governmental growth and control of the resulting troubled population behavior. In a diabolical circle of destructive forces, the legalized and expanded access to alcohol (soon other drugs), pornography, prostitution (perhaps sooner than you think), gambling, and violence in media, etc., when taxed, becomes food for the further growth and maintenance of a voracious government-animal.

Furthermore, with the decline of religiously based restraints upon immoral or unethical behavior (“concepts of Sin”, Vice” and “Blue-Laws”), free market pressures in our capitalistic economy naturally join in confluence with the government-animal as they prey upon us all for cash.

When laws against carry-out alcohol sales in Indiana are repealed, it will probably not lead to very many more alcohol problems within our population. Alcoholics can easily plan ahead to feed their addictions and adolescents have always been able to raid liquor cabinets, even on Sundays.

The problem is much larger than the loss of one of the few little examples of morally based self-control practices left in America. The loss of carry-out alcohol restrictions on Sunday will represent a mere spit-in-an-ocean of trouble caused by a historical torrent of such losses.

Dr. Tom,  12/2/2010

Thursday, September 9, 2010

Rediscovering God in America”

The title to this blog is in quotes because it is the title to a New York Times BESTSELLER by Newt Gingrich. The subtitle is: “Reflections On The Role of Faith in Our Nation” (2006, by Integrity Publishers: Nashville, TN).

I strongly recommend that you read this small book that undeniably documents the role of Christianity and God in the construction and success of this great nation.

The bed-rock values involved in every fiber of this massive creation were religiously based. The removal of the affirmation of these values from all public places, except the hallowed halls and monuments in Washington D.C., has been a self-destructive and propagandistic act of epoch proportions. “Separation of State” was never meant to be taken to this radical extreme.

This act, among many others, is a significant part of our decline and impending downfall.

Joe Grunert sent me the following Email which comports with the documentation in the book I just referenced, so I am posting it for you to see. Unfortunately, the pictures visually documenting the described religious artifacts in Washington D.C. did not transfer to my post.
Perhaps you will read the book I referenced to see many of them, or better yet go to Washington D. C. (take your children for an education?) to see them for yourself.

Dr. Tom, 9/9/10

DID YOU KNOW?
As you walk up the steps to the building which houses the U..S Supreme Court you can see near the top of the building a row of the world’s law givers and each one is facing one in the middle who is facing forward with a full frontal view … It is Moses and he is holding the Ten Commandments!

DID YOU KNOW?
As you enter the Supreme Court courtroom, the two huge oak doors have the Ten Commandments engraved on each lower portion of each door.

DID YOU KNOW?
As you sit inside the courtroom, you can see the wall, right above where the Supreme Court Judges sit, a display of the Ten Commandments!

DID YOU KNOW?

There are Bible verses etched in stone all over the Federal Buildings and Monuments in Washington , D.C.

DID YOU KNOW?

James Madison, the fourth president, known as ‘The Father of Our Constitution’ made the
Following statement:

‘We have staked the whole of all our political Institutions upon the capacity of mankind for Self-government, upon the capacity of each and all of us to govern ourselves, to control ourselves, to sustain ourselves according to The Ten Commandments of God.’

DID YOU KNOW?
Every session of Congress begins with a prayer by a paid preacher, whose salary has been paid by the taxpayer since 1777.

DID YOU KNOW?

Fifty-two of the 55 founders of the Constitution were members of the established Orthodox churches in the colonies..

DID YOU KNOW?

Thomas Jefferson worried that the Courts would overstep their authority and instead of Interpreting the law would begin making law an oligarchy the rule of few over many.

How then, have we gotten to the point that everything we have done for 220 years in this Country is now suddenly wrong and Unconstitutional?

Lets put it around the world and let the world see and remember what this great country was Built on The Holy Bible and belief in GOD!