May 22, 2007Conservatives Gone WildI generally steer clear of politics on this blog, but not today. That's because the attack dogs of conservativism in psychiatry are at it again. This time out it's Sally Satel, a psych doc in the DC-area who is also affiliated with the American Enterprise Institute (a con think tank), writing a piece in The Weekly Standard in which she takes a preemptive swing at the emerging debate in Virginia over that state's commitment laws. It's a time-honored tactic for agitators on any side of ann issue to paint their opposition as delusional and against public safety and apple pie well in advance of a legislature taking up an issue such as civil commitment. It's called planting the seed. Satel paints the two sides of the debate as: "On one side are civil liberties lawyers and disgruntled patients who insist that lowering the "imminent" danger threshold would threaten individual rights. On the other side are psychiatrists caring for people with schizophrenia and bipolar illness and their relatives who have lived through the nightmare of not being able to get timely treatment for desperately ill loved ones." Well it would endanger individual rights, Sally, and I'm not sure a psychiatrist is always the best person to make the call as to who is too sick to function in society. But call me a disgruntled civil libertarian if you want to. She also uses her article as an occasion to attack SAMHSA and the state-level Protection & Advocacy systems, federally-mandated groups whose job it is to look out for the rights of the disabled in state institutions: "Unless SAMHSA miraculously reforms itself quickly (and Congress could help things along by prohibiting P&A's from lobbying state legislatures on mental health laws), a much less overbearing federal role might be the best thing to hope for from this process. It is disgraceful that, to date, the lead federal agency on mental health care has not been able to grasp the complexity of severe mental illness and has failed to keep its watchdog component from harming the vulnerable souls it is entrusted to protect." Based up on my own experience with P&As in the Northwest, I'd say that Satel overstates her case for how much power these groups have by, say, 100 percent. Nonetheless, my good friends at TAC jumped on Satel's column as an opportunity to call for reform of the groups, as they have linked them several times in the past to every malady in the mental health system. Such as deinstitutionalization. If anyone at TAC or Satel can prove to me just how spectacular the days of mass institutionalization were, I'd be happy to look at their evidence. The implicit gripe of folks like Satel and TAC is that commitment standards are too low, unmedicated schizophrenics are committing mayhem in our streets and homes and it is impossible for families to force them into treatment. They generally base their arguments on distorted readings of research on links between schizophrenia and violence, on an assumption that docs and moms and dads know what's best for emancipated adults who are breaking no laws, that treatment is an absolute buffer against violence and that long-term institutionalization is the only effective way to handle such folks. There are a small number of cases where that is no doubt true, but their arguments are about as solid as cheese cloth. TAC, for example, refuses to discuss with me how it accounts for patients who were on medications yet committed violent acts in its "preventable tragedies" database. What's more, TAC and Satel know damn well that the link between violence and schizophrenia is much looser than they claim. But then they've got an agenda to market to politicians in Virginia and elsewhere. Posted by Philip Dawdy at May 22, 2007 12:03 AMComments
I think you meant to say "neo con" think tank. The AEI was front and center (Wolfowitz and Cheney) in the push to have the US government involve itself more intensively in the lives of the Iraqis, with mixed if not regrettable results. Posted by: lurks at May 22, 2007 04:25 AMGreat post. Posted by: Mark(p.s.2) at May 22, 2007 04:44 AMTAC's blog has a rave review of this same article by Satel. I find it quite telling that TAC does not allow comments on their blog. Let's stifle all dissent and not let there be dialogue. Posted by: Gianna at May 22, 2007 07:54 AMI've got something to say here. I am a parent who needed help with a sick adult age child. At one point, just like these type of people claim happens; it did happen. She was deemed by one nurse as "the most psychotic patient ever seen in this ER"--and the attending psychiatrist send me home with her. She got a inpatient bed eventually; and I am not at all happy with the 4 months care she received as a result. WHY? because it was medication based only. If one didn't appear to work, they trialed another, and another, or higher dosages. There are no therapists on board. Lowering the imiment danger threshold is a dangerous rope to walk on; this can reduce civil liberties down to someone who tosses a punch at another--or scratches arms of someone--that can be deemed "danger to self or others"--so can stopping traffic---so can not taking medications---NOW. I say now, because these are all of the ways the social workers and mental health professionals were able to detain my adult kid. Self inflicted scratches, and stopping traffic.[all of that on Haldol and Zyprexa]. The seed has been planted. The benefits reaped are the same old junk science, of medications are the only answer crap. Recently, when my daughter skipped 2 doses of medications? her psychiatrist told me to take her to the ER to admit her, and he said this: "Danger to self, per not taking meds". Imagine, after being locked down for a year in psych wards that showed such lack of a well-rounded recovery system--and getting out for 8 months---and the psych's knee-jerk reaction "lock her up until she takes her meds"--no thanks. She took her meds, she went to school, shes done quite a lot, and I am now supporting her to remain hospital free--but there is already that theme running in the real psych world. Even the case manager [who she told my adult kid "trust me"]threatened to admit her to a psych ward for skipping one dose of medications. I've told this to her psych and most professional people around her--that I will never take her to a psych ward again. Period. Until the system works, and is much improved, the "lock em all up and drug em all up" thing is just as bad as jail.It took her that long to get well, because they are parked in folding chairs and drugged up so a person can't think, speak or participate; then continued to be held over until they can think or speak. You know, Pete Earley faked a story to get his kid care. He justifies it. That's wrong. Sorry for the off tangent rant. I've witnessed a bad system, and one that is complacent in finding real solutions for real life people. This system in place already strips people of dignity, civil rights and humane treatment. I'm disgusted w/ the in house treatment I witnessed. Anyone thinking getting a person into a psych ward is the answer is wrong. I regret it. Believe it or not. I regret seeking that care. The trauma and care itself inpatient is now what my daughter is recovering from; not her illness. I would also like a real explanation from Torrey and TAC telling me WHY my adult kid was the most violent while FULLY MEDICATED. Posted by: Stephany at May 22, 2007 09:33 AMSpeaking as one of the 2 (out of 22) "disgruntled patients" on the taskforce in question in Satel's article, I found her willingness to attack psychiatric patients she does not know ethically disturbing. Her article was also inaccurate, not unusual for her, except one would think her good friend Mary Zdanowidcz would have given her better information, because there is only one person on the taskforce who could possibly be called a civil rights lawyer and that isn't even his full time job. And the people who are causing conflict on this taskforce are not the 2 csx, that's for sure. Pretty low for TAC to go to a friend to go after individual csx in a national journal. I have written about the taskforce in more than one post on my blog, http:hymes.wordpress.com Maybe I should change the title of my blog to "disgruntled patient"? Posted by: Alison at May 22, 2007 12:23 PMI'm one of the 2 (out of 22) "disgruntled patients" on the taskforce Satel wrote about. Believe me, it isn't the csx on this taskforce who are acting out and causing problems for everyone on it. I find it ethically questionable for Satel to target patients she has never met in a national paper on the word of her friend Mary Zdanowizc, director of the TAC who is on this taskforce also. I wonder if this falls under the "Goldwater rule" of the APA or not? We do not have civil rights attorneys on this taskforce, we have a director of a legal aid center who does some civil rights work when he has the time and that's it. The family members on this taskforce up until the last meeting when someone knew was added by the Commission chair, Richard Bonnie, are journalist Pete Earley, author of Crazy and Mary Zdanowizc, director of the TAC. The consumer/survivor members are not authors nor directors of anything, in fact, both of us are on disability. But that's a fair match up don't you think? Than we have a sheriff, a chief magistrate, a director of a state hospital, a law professor, etc. I don't think I knew what manipulation and fanaticism really were until I joined this taskforce, it has been quite the learning experience. I have more about it on Charlottesville Prejudice Watch. Posted by: Alison at May 22, 2007 01:03 PM Pete and Mary? NO WONDER. Anyone ever google Mary from TAC? it would be wise to do so--oh for the love of God. Posted by: Stephany at May 22, 2007 05:35 PMEditorial in response to: "Kendra's Law Fearmongers" by E. Fuller Torrey and Mary Zdanowicz, 2000. By E. Fuller Torrey, M.D., and Mary T. Zdanowicz, J.D. "While they have yet to fully embrace the promise Kendra’s Law brings to the state’s most vulnerable, we hope these well-intentioned yet misguided civil libertarians eventually recognize that defending an individual’s right to remain psychotic is mindless." "My name is Mary Zdanowicz and I am the Executive Director of the Treatment Advocacy Center in Arlington, Virginia. Our focus and expertise is civil commitment laws." Mary T. Zdanowicz, J.D.,Executive Director,Treatment Advocacy Center[TAC]. Posted by: Stephany at May 22, 2007 06:33 PM"Those who deny freedom to others, deserve it not for themselves; and, under a just God, can not long retain it." -- Abraham Lincoln, April 6, 1859. As true today as it was in 1859, and as applicable to Ms. Satel, Dr. Torrey and their ilk as it ever has been to anyone. this here is dated May 22nd, the link to the Sally Satel is dated May 28. a magic link into the future or a new writing of Satel? Posted by: Mark(p.s.2) at May 30, 2007 06:03 AM |
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