So. Last spring I heard a public health wallah on NPR talk about the fact that there is no intermediate step between involuntary institutionalization and voluntary therapy. That is, the government can’t mandate any sort of mental health care other than by essentially incarcerating the moderately unstable. This is bad.\n
The suggestion was that the courts (presumably the courts, since that’s who ultimately makes the decision for involuntary institutionalization) should have the ability to compel a person who has committed no crime<\/i> and who is not currently considered to be dangerous to check in weekly with a probation officer. Well, not technically a probation officer, but a therapist or perhaps social worker or someone who will keep that person under observation. Then, if that person goes, as the parlance has it, off his meds, either literally or figuratively, the officer would have the responsibility and authority to put him away.\n
The odd thing is that no matter how I slant the language, it still seems to me like a good idea. Oh, there are lots of problems with it, I am aware of that, both from a constitutional and a medical perspective. But look—you’ve got a Joe who is brought to the attention of the courts as being potentially in need of involuntary care. They investigate, however that’s done, and they essentially say to themselves Joe is not about to snap, so it would be wrong to lock him up.<\/i> So they don’t. There is a court record of this, but there’s no way to know whether, six months later, Joe has started drinking heavily, or Joe has been visiting gun shows out of state, or Joe hasn’t left his room for a week. Or, for that matter, whether the combination of therapy and drugs that Joe was responding to has now failed, because Joe has stopped taking the drugs (or can’t afford them) or stopped going to therapy (or his insurance made him change therapists) or for whatever reasons.\n
On the other hand, for every Joe that you are able to catch in such a system before he commits some violent act (perhaps against himself), there are thousands of Joes who you will be putting on probation (essentially), who have committed no crime. Futhermore, since all of those Joes have their liberty at the whim of their probation officer, the potential for abuse is substantial, particularly since these are very vulnerable Joes in the first place. Even well-meaning well-trained court observers would likely make it difficult for a Joe to change therapy or medication, even where the change should be well within Joe’s rights. And there will be observers (as with the state social workers) who are either ill-trained, corrupt, burnt-out, overworked or incompetent. So it’s pretty well certain that if this system were in place, there would be a fair number of cases where the government would be actively violating the rights of innocent citizens. Citizens with mild mental illnesses, to whatever extent that changes things.\n
Back on the first hand, that violation would need to be balanced by the violence that this sort of program would diminish. I don’t mean to say that any particular act would have been prevented or could have been prevented by such a program, just that there are (as I understand it) a fair number of assaults, murders and suicides that are committed by people who were at one point marked as unstable and who had in the weeks before committing violent crime been thought by acquaintances to have become increasingly unstable.\n
Back on the other hand, though, that’s presumably a small percentage of crime in this country and an expensive program to combat it; if we were going to spend a ton of money on either mental health or crime prevention, there are other underfunded programs.\n
It would be easier if someone were to explain to me how the entire idea is awful and wouldn’t work, and there’s no need to do the difficult ethical calculus. And no, there really isn’t any need to do that calculus anyway, because there is no real chance of such a program actually being put in place in the next couple of decades, anyway. But still.\n
Tolerabimus quod tolerare debemus<\/I>,
-Vardibidian.\n\n","protected":false},"excerpt":{"rendered":"
In Which Your Humble Blogger doesn’t even like beets.<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[204],"tags":[],"class_list":["post-10967","post","type-post","status-publish","format-standard","hentry","category-politics"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/posts\/10967","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/comments?post=10967"}],"version-history":[{"count":1,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/posts\/10967\/revisions"}],"predecessor-version":[{"id":18268,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/posts\/10967\/revisions\/18268"}],"wp:attachment":[{"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/media?parent=10967"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/categories?post=10967"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.kith.org\/vardibidian\/wp-json\/wp\/v2\/tags?post=10967"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}