Talk:Mental health care

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This is a great start for a vital subject, but I am hanging up on Human Rights Watch's apples-to-oranges comparison. We might also conclude that on any particular weekday, there are more physically ill children in public schools than there are in the nation's hospitals.

Consider HRW's lead: One in six prisoners is "mentally ill." Many suffer from major illnesses.

How many of the one-in-six suffer a "major" illness? Did HRW have a statistic they omitted because it would have weakened the lead? Most importantly, is "major mental illness" synonymous with "treatable by hospitalization"? Probably not. What is HRW's standard for "major mental illness" and what, if any, effective treatments are available for socially marginalized people suffering "major" mental illnesses other than major psychosis?

How many of the one-in-six mentally ill prisoners suffer primarily from either "anti-social personality disorder" or "drug addiction"? And how many in prison receive "treatment" - i.e. primarily psychiatric medications - that are identical to nominal treatments one would be afforded by a public health system outside the prison.

Is hospitalization a preferred treatment for the "major mental illness" of bipolar disorder? How many people being medicated for "bipolar disorder" have been the subject of lawsuits alleging medications (usually selective serotonin reuptake inhibitors) have caused a serotonin syndrome that led to an act of violence (See the book "Power to Harm" re: Prozak and workplace shootings)? If we are to consider illnesses that put people in prison, we need also to consider allegations that treatments are also suspect.

And how many of the mental illesses found in prison are a result of the prison system itself, or of chronic exposure to an anti-social criminal culture? Therein lies the core problem of HRW's report. While authors might have more far reaching personal opinions about social causes of mental illness, the report assumes the "mental health-care system" should be capable of treating problems that might in reality result primarily from social conditions. In this regard, HRW is reflectng an uncritical view of an industry opinion that argues available medications can effectively treat "mental illnesses" that are presumed to be primarily organic and not a result of social or personal conflict.

In as much as many of the mental illnesses reported by HRW are likely primarily a substance abuse problem, we need to review the status of "drug treatment" in the criminal justice system. A close review will reveal a network of private contractors who are secular on the face but in whose group counseling sessions, religious doctrine or 12-step pseudo-religous groups provides a primary surrogate addiction.

In its totality, the HRW report points to far reaching reforms, but in individual passages, especially in the lead, the report resorts to propaganda to push a point of view. The problem I have with this sort of propaganda by my presumed allies is that it invites readers to set aside mentally rigorous examination in favor of groupthink acceptance of a freindly authority. In this case, HRW gets away with their device largely because "treatment" is often used as a motherhood term among liberal circles though in many cases, treatments are largely ineffectual, unproven or misapplied products of for-profit laboratories.

HRW has used a handy rhetorical devise to emphasis the magnitude of a problem, but in the process has glossed over problems and controversy surrounding the diagnoses and treatment of "mental illness." Slight misrepresentations used to emphasis a problem are more or less standard in the public press releases of progressive organizations. I learned to produce this sort of propaganda while working in the progressive media. We held a standard of truth, but we shined a bright light on one side of the truth while not emphasizing for our audience other elements of a conflict. -prpgtr