Sunday, January 16, 2011

Dangerous to Self/Dangerous to Others

Fr. Dale Matson
“Let his mind be changed from that of a man and let a beast's mind be given to him, and let seven periods of time pass over him.” (Dan. 4:16, NASB).

Jared Loughner murdered six people and injured fourteen others in Tucson Arizona this past week. This is another testament to our failed mental health system and is yet one more call for mental health reform. When the tipping point for treatment is dangerous to self or others, then it is no longer a mental health issue. It is then a legal issue and the police become involved. When Psychotropic drugs were introduced they were touted as the panacea that would save the day. The drugs are not a cure and the individuals who need them frequently stop taking them. There are untold thousands of folks living with their families and on the streets. Their families have pleaded for help and hear the same mantra. They must be dangerous to self or others.

I can remember the parents of a schizophrenic son pleading with us to help their son who had just stripped all the paneling and drywall off their interior cabin walls as some kind of defense against the aliens who were sending him messages. When we advised his parents to notify the police they said, he is not a criminal in need of incarceration, he needs hospitalization and treatment. This is an all too common and tragic scenario for the families of the mentally ill.

I was involved at the county level and was working in our inpatient unit the day it was permanently closed. It was a sad day for the families of the mentally ill. The rationale was that it would be cheaper to treat them in Community Based Residential Facilities (CBRF’s). So the mentally ill were passed from the state facilities (deinstitutionalization), to the county facilities to the CBRF’s. The CBRF’s were not equipped to deal with non-compliant residents and after wearing out their welcome in a number of CBRF’s, they were given a bus ticket. We used to call it “Greyhound Therapy”. Many of the folks that once had medical care; counseling and county services eventually had no access to any of these things. With the advent of the new system of crisis intervention and CBRF’s, a new group of folks was gradually introduced into the streets along with those already there.

I worked for years with individuals, both adults and adolescents with mental illness. I believe there is also a new generation of mentally ill individuals who would have been marginally productive and capable of living independently except they compounded their difficulties with drugs. The drugs took them over the reality precipice and created individuals with chronic difficulties. I pray that we will reform our mental health system. Using the streets to house the mentally ill is worse than the intentional use of the expressways as ponding basins for excess rainfall.

There needs to be a reexamination of what constitutes adequate care for the mentally ill and how to fund it once again. As a blogging associate from Texas who also has a mental health background stated, “To what degree should we as a community let them slide into degraded lives on the streets? Underneath that question is a discussion about choice and personal freedom vs. the ravages of mental illness.”

“For I was hungry, and you gave Me something to eat; I was thirsty, and you gave Me something to drink; I was a stranger, and you invited Me in; naked, and you clothed Me; I was sick, and you visited Me; I was in prison, and you came to Me.” (Matt. 25: 35-36, NASB).


St. Nikao said...

Unfortunately, sexual politics and tabula rasa have compromised and defiled and removed the mental health profession from truth and reality to embrace the 'gay' lifestyle as a normative alternate healthy choice. In a sense, the whole profession is intentionally delusional, operating with one eye closed...well, maybe both.

At least Robert Spitzer finally 'came out'... of denial.

Dale Matson said...

St. Nikao,
As someone who used the DSMs professionally, I believe they are a mixture of medical, political and legal judgments. For example in the DSM IV in the "Cautionary Statement" on page xxvii it states in part, "It is understood that inclusion here, for clinical and research purposes of a diagnostic category such as Pathological Gambling or Pedophilia does not imply that the condition meets legal or other nonmedical criteria for what constitutes mental disease, mental disorder, or mental disability." As a Psychologist The categories of "Impulse Control, Substance Related and Personality Disorders" seem to diminish personal responsibility. As an assessment tool DSM IV does not stand what is called the "inter-rater reliability test. One only needs to look at the huge files of the chronically mentally ill to see that they have accumulated multiple diagnoses over the course of treatment.

Dale Matson said...

There was also serious discussion by the American Psychiatric Association about whether Pedophilia should be "normalized" and removed in DSM V.