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I'm top posting without snipping because what you quoted (the part below
your cites) is so exactly correct I don't want anyone to miss it. In fact, I'm going to use it as a handout in my healthcare law class. "Gunner" wrote in message ... On Mon, 11 Aug 2003 08:27:31 GMT, "Jeff McCann" wrote: refusing to take their meds, or go to outpatient clinics etc. Basicly..,the Libs created the homeless situation in California, and in doing so, are responsible for the deaths of hundreds of thousands of mentally ill folks whom died and are still dying on the streets, not to mention those that are killed, raped etc etc by the more vicious members of the homeless nutcases. Sounds like typical revisionist neo-con spin to me; blame everything on the "Libs." Cites? Jeff Simply cannot accept that the Libs would do that to people? How many did Stalin kill? Stalin's mass murders are connected to the mainstream beliefs of American progressive politics how, exactly? Such an obviously overblown smear is really beneath a man of your intelligence, Gunner. Few Libs have ever heard about the Law of Unintended Consequences, nor would they ever admit that their way is not the Perfect way..... Oh, like cutting taxes on the rich while paying $1+B per week for a highly dubious war and offering no rational plan to control bloating deficits and the resulting drain on the economy is wise, prudent, the product of careful foresight, and the perfect way to help the economy. It seems to me that plenty of neo-cons are actually stupid enough to believe their own rhetoric. The current situation in Iraq is the perfect illustration of the Law of Unintended Consequences, or the effect of neo-con wishful thinking and the triumph of ideology over reason. Now, let's look at what you've offered as cites supporting your assertion that the "Libs" caused the problem in California: http://www.psychlaws.org/GeneralResources/article45.htm "In 1967, Gov. Ronald Reagan signed the Lanterman-Petris-Short Act (LPS), which went into effect in 1969 and quickly became a national model. Among other things, it prohibited forced medication or extended hospital stays without a judicial hearing. . . . As a practical matter, involuntary commitment was no longer a plausible option. . . . In 1999, the Legislature finally funded pilot projects in Stanislaus, Los Angeles and Sacramento counties that offered comprehensive treatment for the mentally ill. And they appeared to work. Within the first four months, the $10 million pilot program helped move 1,000 people off the streets and into support systems of care. Last year, Assemblyman Darrell Steinberg, D-Sacramento, sponsored legislation to allocate $54.9 million to expand these pilot programs to 24 counties and two cities during the next three years. . . . " It seems a Democrat (gasp!) was trying to address the problem here. Nothing attributes the problem to "Libs,", so the cited work doesn't appear to support your original claim http://www.psychlaws.org/StateActivi...a/LPSoped3.htm Nothing about "libs" causing the problem there, either. http://www.latimes.com/news/opinion/...1streets.story "This week the Assembly Judiciary Committee will consider legislation by Assembly- woman Helen Thomson (D-Davis) that would solve a key part of the problem. AB 1421 would amend the Lanterman-Petris-Short Act, a well-intentioned but ultimately misguided law passed in the 1960s that bars doctors, judges and counselors from compelling seriously mentally ill people to be treated unless it can be proven they are at imminent risk of harming themselves or others." Another Democrat trying to address the problem. http://sftimes.editthispage.com/stories/storyReader$82 That's a story about (Democrat) SF Mayor Willie Brown's efforts to address the problems in San Francisco, caused by the Legislation Gov. Reagan signed back in '67 http://www.namisonomacounty.org/reflect.htm " 'The passage of California's Lanterman-Petris-Short (LPS) Act in 1967...made rational treatment for the mentally ill increasingly difficult.' (Out of the Shadows, Confronting America's Mental Illness Crisis, E. Fuller Torrey, M.D. , John Wiley & Sons, Inc., N.Y. 1997. pg 10, pg 143)" Nothing about the "libs" here either, I'm afraid. Yet it seems clear that the Lanterman-Petris-Short Act was the source of the problem, or rather was the source when combined with the lack of funding for community-based care, according to your own cites. Gov. Reagan, a Republican, signed the Act. Frank Lanterman, a Republican, chaired the committee responsible for the legislation, so he controlled what went into the Act. Nicholas C. Petris and Alan Short were Democrats. All of them later expressed disappointment that the funding for follow-on community based care was not provided. That was not their intent. In 1967, the California Legislature was divided almost equally between Democrats and Republicans, with a 1 member Democrat edge in the Senate and a 2 member edge in the Assembly. Any legislation would therefore require bipartisan support and could not be passed over a governmental veto. Furthermore, Gov. Reagan enjoyed the power of a "line item veto" over expenditures in the State budget. This was the year that Reagan actually increased the state income tax rates on the wealthy (he did so again in 1971 IIRC); he was in a budget crisis and was more than happy to unburden the state budget from the cost of mental health care by passing the buck to county and local governments that had no hope of meeting the needs of the newly de-institionalized mentally ill. Your assertion that "[b]asicly..,(sic) the Libs created the homeless situation in California, and in doing so, are responsible for the deaths of hundreds of thousands of mentally ill folks whom died and are still dying on the streets, not to mention those that are killed, raped etc etc by the more vicious members of the homeless nutcases[,]" doesn't seem to be borne out by the facts, does it? Oh, I'm sure the liberals of that era played their part, but it's neither fair nor accurate to blame them for the resulting mess. Jeff Lanterman, Petris, Short Act The state mental hospitals of the fifties and sixties were overcrowded. A tug of war existed between the federal government and the local governments as to which was responsible for the funding of care for those afflicted with mental illness. California had pioneered a more progressive program for the care of the committed patients. But a movement began to stem entry into state hospitals and encourage community systems to accept more patients. In the climate of the sixties there were even those who claimed that mental illness was not a real biological reality but instead a socio-political attitude. There were some who argued that mental illness was a myth perpetuated by totalitarian governments. A pivotal bill called the Lanterman, Petris, Short Act (LPS act) was signed into law in 1967 by Ronald Reagan which abolished 1700 hospital staff positions and closed many state operated care facilities. The intention of the LPS act was for the most part well meaning. It's intent was to eliminate inappropriate commitment of individuals to hospitals. It was intended to affirm the civil rights and the right to fair treatment to those with mental illness. However what should have happened and did not was having the monies which use to be allocated to state hospitals be reallocated to areas of community support for patients entering the community. Instead what happened is a continuing tragedy today. Patients were turned out in huge number with little support system in place. Many individuals in this category soon found themselves in trouble with the law and society. Today we have a tremendous number of those suffering from mental illness in jails or homeless. "...deinstitutionalization has helped create the mental illness crisis by discharging people from public psychiatric hospitals without ensuring that they received the medication and rehabilitation services necessary for them to live successfully in the community. Deinstitutionalization further exacerbated the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill, and this situation continues up to the present. Consequently, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment." (Out of the Shadows, Confronting America's Mental Illness Crisis, E. Fuller Torrey, M.D. , John Wiley & Sons, Inc., N.Y. 1997. pg 10) "...the total number of homeless people in the United States appears to have increased between 1980 and 1988 by approximately 300 percent, whereas the total U.S. population increased by only 7.6 percent. (402,000 homeless in 1988)" "If the definition of 'mentally ill' includes alcohol and drug addictions, then studies indicate that 75 percent or more of the homeless are mentally ill. If, however only severe mental illness is the criterion, as defined in 1993 by the National Advisory Mental Health Council...then approximately 35 percent of the homeless persons qualify." (Out of the Shadows, Confronting America's Mental Illness Crisis, E. Fuller Torrey, M.D. , John Wiley & Sons, Inc., N.Y. 1997. pg 10, pg 17) "Over the last 30 years, the number of patients who once might have been in State hospitals, but are now on the streets, or in our jails and prisons, has risen significantly. In 1968, the year before LPS was implemented, the year-end population in State hospitals was 35,739. Today, state hospitals are primarily forensic and house fewer than 4,000 mentally ill patients. Between 20,000 and 30,000 people with mental illness are in our jails and prisons. At least an equal number are homeless on the street."(L.P.S., A New Vision for Mental Health Treatment Laws, A Report by The LPS Reform Task Force, editors: Carla Jacobs, Elizabeth M.D. , Beth Howard, published by The LPS Reform Task Force, Long Beach, Calif, March 1999, pg 32-33) So today we are in the situation in which we have replaced one inadequate and in some cases inhumane system of care with another inadequate and often inhumane system or lack of system of care. The economic cost of this dysfunctional system, or lack of system is more than a humane and proper system would be. It is not efficient and inexpensive to deal with individuals with mental illness through the justice system. It is not efficient and inexpensive to house these individuals in jails. It is not humane for these individuals to be living on the streets or in a whirlwind cycle from the streets to the jails to the hospitals and so on. The result of this lack of system is too many suicides, too much unnecessary suffering and too much unnecessary expense and waste. NAMI and other organizations acting as advocates are proposing a major overall of the LPS legislation. One of the realities of severe mental illness is frequently an acute lack of insight about the illness. Consequently advocates for those suffering the effects of mental illness are, for the most part, seeing a need for the provision of involuntary hospitalization in some cases. It is argued effectively that it is inhumane to not have these individuals hospitalized. Frequently the result of no hospitalization is untimely death or unnecessary and severe suffering. These advocates in no way want inhumane conditions in a hospital setting. They advocate for no unnecessary restriction and respect for patients human rights within and without the hospital setting. (passim, L.P.S., A New Vision for Mental Health Treatment Laws, A Report by The LPS Reform Task Force, editors: Carla Jacobs, Elizabeth M.D. , Beth Howard, published by The LPS Reform Task Force, Long Beach, Calif, March 1999, pg 22-44, pg 66-83) "The passage of California's Lanterman-Petris-Short (LPS) Act in 1967...made rational treatment for the mentally ill increasingly difficult." (Out of the Shadows, Confronting America's Mental Illness Crisis, E. Fuller Torrey, M.D. , John Wiley & Sons, Inc., N.Y. 1997. pg 10, pg 143) Summary The stigmatizing of the individual afflicted with mental illness has always been a significant and major problem. Sadly it sometimes presents more of a problem for the individual involved than the illness itself presents. Also historically there has been societal stigmatization of the family of the individual afflicted with particular focus on blaming stigmatization of the mother of the individual afflicted. Some progress has been made in alleviating this problem through education resulting in a somewhat more enlightened public. However, regrettably, stigmatization continues to be a major problem. The effect of stigmatization has had many ramifications. There has been a tendency to blame bad parenting, laziness or reckless behavior on the condition of mental illness. Legal consequences include the lack of parity in insurance and a resulting inadequacy of hospital care, the relegating of many afflicted individuals to a homeless existence and the improper incarceration of many afflicted individuals in our jails and prisons. A lack of understanding of the symptoms of mental illness can result in punitive treatment on the part of society, even on the part of close family and even on the part of those we call caregivers. It takes insight on the part of healthy normal individuals to realize that the afflicted individuals resistance to treatment or dependency abuse of illicit drugs, the seemingly lack of commitment to showing up for appointments, the lack of cognitive thinking and the lack of insight into their own illness is all symptomatic of the illness itself. These type of dysfunctional behaviors are extremely frustrating for all involved but there is a serious need to not resort to punitive treatment. When punitive treatment escalates in our prisons and even in our hospitals to the unethical use of physical restraint resulting in actual deaths, the behavior on the part of caregivers and justice personnel is actually criminal. There are many legislative issues that need to be advocated and addressed for those afflicted with mental illness. The closing of mental hospitals in the 1980's has been a disaster which has aggravated conditions and resulted in unacceptable conditions for the vast majority of those afflicted. The body of this paper contains a short discussion of the major concerns: -Compulsory hospitalization/lack of insight/humane conditions -freedom from restraint -housing -gainful activity -juvenile justice -LPS act What to do for individuals can be complex especially because the individual often suffers from a lack of insight into their own illness. The objective however should be clear. Advocates want fairness for those afflicted. Fairness should include compassionate understanding from communities and equitable treatment by insurance and medical infrastructure. We want to see fair and humane treatment within hospital settings, within the justice system and in our communities. With regards to treatment there is basis for some optimism. Medical science continues to make significant advances towards the understanding of mental illness from the biological perspective. New medications are available and more are being developed which can provide significant improved help for many. The emphasis in treatment weighs heavily towards only the biologic and mechanistic approach. This is promoted in large part by the influence of the pharmaceutical industry and the economic pressure of managed care. In my view this approach needs to be balanced with more emphasis on the whole person and the whole context in which we find the individual. This should be done avoiding the pitfalls of blaming and stigmatization. The emphasis of course should be in how to improve the quality of life for the individual and the family and ultimately even the whole community. Advocates such as E. Fuller Torrey have contributed tremendously to our understanding and our compassion for those afflicted. At the same time there is room for the holistic approach as well and even alternative methods which are being explored as a supplement to medications, not as a replacement for the much needed medications. These are being explored on the growing edge of psychiatry and will lead to better ways of treatment. Gunner "What do you call someone in possesion of all the facts? Paranoid.-William Burroughs |