Very Orwellian. I shudder to think how this would be used in the hands of J. Fuller Torrey and his ilk or just psychiatry in general. Man, the creative ways they are coming up with to make us all "compliant." This is not the way to help health care costs at all in my view. We need to get people off meds altogether to solve that problem. But almost no one sees it that way. It's sad.

Posted by: Sara at August 10, 2009 09:17 AM

If you support forced drugging for anyone, philosophically you have to favor this sort of monitoring. I don't support forced drugging for anyone, those of you who do might want to meditate on your reactions to this piece.

I do think we're headed in this direction though. Over the weekend the New York Times had an article about the Mitt Romney Massachusetts mandatory health insurance plan and how it's what the dems are pushing, yes I know Romney is a Republican, but this is what we're about to get. Mandatory health insurance. If you have to have health insurance by law then you have to do everything your health insurance carrier tells you to do to stay insured and that means if your doctor tells you to lose weight, you lose it. If your doctor tells you that because you've got a history of psych labels, you have to be monitored so you won't get pregnant, so be it. Dangerous times.

Posted by: Sally at August 10, 2009 09:40 AM

This is really bad news for psychiatric patients. It'll be just another tool in psychiatry's arsenal to curtail patients' civil rights. I'm wondering if a possible loophole exists because this pill isn't technically medicine. Forced treatment laws don't really cover it.

Posted by: Francesca Allan at August 10, 2009 10:07 AM

This is also bad news for those of us who are aging. The elderly are a real target for Big Pharma. One pill leads to another and another...and another. We do not metabolize medications when we're older but no one bothers to do much (if any) research on this or monitor the docs about it. It's very easy to tip over an elderly person's applecart. Then you've got 'em.

I live in NH. I have a ring-side seat to the Mass. "experiment." I do NOT consider being forced to subsidize the private, blood-sucking insurance industry any sort of solution to our health care problems. I'd rather have nothing at all, thank you. That's why I refuse to sign up for Medicare Part D. Well, that and the fact that when it started I was on no medications at all so there was simply no where to begin. Step One was always "Enter your medications." Excuse me?

Now that I'm on a whopping ten bucks a month of thyroid hormone I hardly think shelling out a minimum of $25-30 to an insurance company in order to pay a co-pay--and be refused the ability to fill my six-month prescription in one visit (thus saving money per pill)--a good deal at all.

Big Brother really is alive and well. I hate electronic records, also. I resent being forced to give up my privacy.

Posted by: Sherry at August 10, 2009 12:25 PM

Voluntary or coerced? Can it be voluntary if THE MAN has all the cards? As in take the chemicals or you don’t get a place to live, or you won't get a monthly check to pay for food etc.

A second story on machines and mental illness is at the BBC, with voluntary patients.

Monitoring mental health by text
By Jane Elliott
Health reporter, BBC News

Every morning at precisely 10 am Joe (not his real name) gets a text message from his clinician, asking how he is feeling.
LINK

Posted by: mark p.s.2 at August 10, 2009 02:25 PM

"If you have to have health insurance by law then you have to do everything your health insurance carrier tells you to do to stay insured and that means if your doctor tells you to lose weight, you lose it."

How does that follow? If you have insurance by law and you don't lose weight even though your doctor told you to how can you lose your coverage if that coverage is guaranteed, mandated under the law? I've never had health insurance in my entire adult life so I have no idea how it works now never mind how it might work if it were legislated.

"If your doctor tells you that because you've got a history of psych labels, you have to be monitored so you won't get pregnant, so be it"

My mother has had mental illness all her life and she was a prolific breeder despite that and despite the additional burden of being financially poor most of her adult life.

Regardless of the different fathers and there were several every child she bore and raised ended up with mental illness without exception. Most of those kids are still messed up today. One kid is a burden on the justice system because he has some kind of disorder that forces him to commit crimes. Another sister is in and out of mental health services that the State pays for because she was never able to get her act together as an adult.

I spent a few years in the juvenile mental health system and I was warehoused with many kids the majority of whom had drug and alcohol addicted parents who of course had underlying mental illness. They may have been abandoned by parents with mental illness. They all had numerous behavioral and emotional problems associated with being routinely psychologically and physically abused and neglected by their mentally ill parents.

Then we have the news reports of mentally ill parents snuffing out their children because God, the Devil, demons or some other voice told them to. Then we have the mentally ill parents who snuff their kids out because of the meds they are on made them do it like some kind of cheap horror film.

Enough is enough already. If people can't take it upon themselves a moral and civic duty to society and to have some empathy and compassion for the lives they have not yet created and ruined then it falls to the government to intervene.

Oh and you know what happened to some of those labeled kids I lived with in the group homes? I know for a fact that one male resident became a career junkie because I met him years later and he was homeless and on the run for drug dealing, petty theft and defaulting from court summons, violating probation requirements, the works.

One labeled female student went on to become pregnant within a year of leaving the group home she was in at 17. She had a lot of problems when she was a resident and she was entering motherhood with those problems unresolved.

Mentally ill parents having mentally ill children is almost criminal. The high rate of failure at life of offspring of mentally ill people and the burden they put on the system is unconscionable.

The social worker interventions. The special needs classes. Juvenile detention. Years of counseling. Polypharmacy as treatment. Runaways that end up in gangs. Teen pregnancy. Teen alcoholics and addicts. A childhood and teen life punctuated by office visits, psych appointments, court hearings.

All the local cops know who your family is because of the sheer number of times they were called to the home for domestic violence or because your kids were picked up for truancy, vandalism, running away, violating curfew, dealing your psych meds at school. Carrying weapons and getting into fights. The usual mentally ill family dynamics and drama.

I have seen the results. I lived with the results. It's not fair. If all that could be largely avoided by, as you say, monitoring labeled women to make sure they don't get pregnant how could that be wrong?

I know, I know. There is supposedly only a chance that the offspring of mentally ill people will have mental illness. I know that's how some people think. I've seen that line of reasoning over at Psych Central bipolar forums. A Twenty-something women newly Dxd with bipolar concerned about having children and one of the forum moderators steps in and tell this woman not to worry, go get pregnant. If the kid comes down with bipolar she can be medicated just like Ma. There so many wonderful treatment options these days.

More customers for big pharma am I right? Why not give bipolar, diabetes, TD and obesity to the whole family. No reason Ma should have to suffer it alone. Jaw droppingly appalling and self centered, short sighted rationale for having kids. In reality it's exceedingly common for parents with mental illness to have kids that develop some kind of illness too.

Are you going to keep some spare lithium in the med chest for that special day when you have to sit down and give your daughter that long talk about family bipolar after her first suicide attempt?

I didn't mean to hijack the thread comments with this rant. I see eye to eye with many of you when it comes to opposing TAC and AOT and all that stuff but on the subject of mentally ill parents having kids I am not very flexible.

I didn't have kids out of fear that there was a shred of truth in the hereditary argument. I didn't want to make more people like me. I didn't want to have to turn my kid over to the state like my mother did to me because she couldn't handle the mentally ill child she created.

I can't help but wondering if parents with mental illness were prevented from having children by law or if they had to pass parenting exams and stress checkups to get permission by the government if there would continue to be a need for all those horrible placements, lockdowns, group homes, abusive foster homes, transition programs, residential schools.

An entire system exists right now that your mentally ill child may end up a part of when the social worker comes for your kids after you tried killing them because of the meds you were on or because of all the neighbors calling CPS because of the nightly screaming and sounds of physical punishments coming from your home.

Life in those places, living with entire co-ed populations of mentally ill teens was not pleasant folks.

Reading the comments here by FS regular readers I know some of you, perhaps most of you are smart, educated, lucid and perhaps some of you who have labels are or would be good parents. I don't dispute that it's possible to be a good mom even with mental illness.

The bulk of Americans with mental illness are not spending their spare time reading FS articles. They don't know the stuff that Philip reports on and these are the parents that stuff their kids with ten different meds or they abuse their kids in other ways. Look at the Schofields as another example of mentally ill parents having mentally ill children and what can happen. An entire family on meds and wedded to psych services from the get go. What an awful story.

Maybe a massive truly massive amount of State and Federal money could be saved from that kind of monitoring. Wouldn't all that saved money help our economy not to mention society as a whole? Perhaps an entire population of unborn children can be saved from a lifetime of pharma drugs and stigma and suffering if there was some kind of monitoring and prevention going on. Perhaps this fiasco could be avoided with monitoring and prevention.

http://www.furiousseasons.com/archives/2009/08/thousands_of_mentally_ill_youth_warehoused_in_juvenile_justice_system.html

Posted by: Jane at August 11, 2009 09:19 AM

Jane,

If you are mandated to have health insurance and your doctor tells you that to comply with his orders you must lose weight and you don't then you are non compliant and your insurance rates go up because to the insurer you are voluntarily increasing your risk. They are correct, still when we have our lives micromanaged like this, then well we have to wonder what is being human all about. Eventually the cost of health insurance will be prohibitive...

As for your argument that people with psych labels shouldn't be allowed to have children. That one got played out in Nazi Germany. It's simply immoral. A lot of the "mental illness" you discuss is simply economic and social depravity. Sure our society should do a better job of distributing resources in an equitable way.

A bigger problem than people with psych labels reproducing, is stupid people reproducing. People with higher IQs don't have as many children generally and don't have children they can't afford to feed. Does the mean IQ tests should be administered to determine who can have kids? Hopefully that idea strikes you as wrong. Go out and get a copy of the Rise and Fall of the Third Reich and see where your ideas lead.

Posted by: Sally at August 11, 2009 09:43 AM

Jane,
I was raised by a sadistic sociopath. DSM notwithstanding, I do not consider this a mental illness, but rather a choice to engage in criminal behaviour.

When I got my first social work job I was amazed that what I grew up with was:
1) common and
2) still going on.
(It took me a few more years to see the part I and my sw colleagues played in ensuring the cycle continues.)

It didn't take me long watching children be abused in their birth and foster homes to start fantasizing about compulsory sterilization or maybe putting something in the drinking water. Really. I was struck by the fact it takes more effort and coherent intelligence to get a driver's license than to have a kid.

The standard response to this line of thought, of course, is "Who will decide who gets to have kids," to which I say "A four year old pulling names out of a hat will probably do better than what we have going now."

I do not believe in the "brain imbalance" theory, certainly not as an across-the-board explanation for individual or social pathologies, but I do know children learn their responses and behaviours in their homes. A I do know that stuff is hard and time consuming to unlearn as an adult. There was no way I was going pass on what I grew up with so I too made the choice to be childless at an early age. Unfortunately, I was extremely fertile in my younger days so thank goodness abortion is safe and legal in the US because I'd either be dead or be visiting two adult children in institutions by now. Personally, I consider safe, legal abortion a gift.

One thing that would help a lot would be to stop assuming everyone should have children. The social pressure is immense and unwarranted.

Posted by: Sherry at August 11, 2009 10:45 AM

Jane,

I can appreciate your rant. Clearly, you have lived a difficult life as a result of being born to a mother who was labeled, and no doubt drugged into oblivion. But what you're suggesting is nothing more than eugenics.

Why not skip the monitoring and go for a full hysterectomy of any and all women labeled as mentally ill. Or maybe there are certain labeled women who should have children and others who should not. Who gets to decide? Who gets to decide what the standards are?

What's next? If you have the breast cancer gene, then perhaps you shouldn't be able to have children because of the likelihood of passing that gene on and costing insurance companies, and by default other people in that insurance plan, more money than someone who doesn't have the gene. The list could go on and on. Pick and choose.

Maybe we should just take a look at all of the genetic abnormalities-and I am in no way suggesting mental illness is a genetic abnormality-and screen out those who shouldn't have children because they and their offspring will be burdens on the system.

Again, I can appreciate your rant, but eugenics is eugenics is eugenics. Any way you slice it.

Posted by: WomanofHope at August 11, 2009 11:16 AM

Jane,

Do you also advocate monitoring mentally ill men who seek to reproduce?

Posted by: WomanofHope at August 11, 2009 11:43 AM

Jane asked: "If all that could be largely avoided by, as you say, monitoring labeled women to make sure they don't get pregnant how could that be wrong?"

And my answer would be it is not ethical for the government to arbitrarily decide who can or cannot have children. No eugenics, thanks.

Posted by: Francesca Allan at August 11, 2009 12:54 PM

Just for the record: I do not favour eugenics, having seen the results of it up close and personal in NH where no one left our state school for the retarded--which was used as a dumping ground for poor children of normal intelligence from the northern area of our state--without being sterilized. The Indians of VT were sterilized also.

But I'm entitled to my rich personal fantasy life. And I really do think almost anything or anybody could come up with a better set of standards than what we have going now.

I guess what I really wish is for a world where making the decision to not have children is much, much easier and more socially acceptable.

I've read enough of Jane's postings here to say "I respect your beliefs." And I do think I understand where you're coming from.

Posted by: Sherry at August 11, 2009 04:04 PM

WomanofHope: I did not say that I advocate for monitoring mentally ill women. I asked why that might be a bad thing. I think if you had witnessed all the messed up teens born of the messed up parents first hand and actually lived with a population like that you too might think really hard about it sometimes.

I would not protest if mentally ill men were monitored in either. I had the crap beat out of me for years by a guy that should never have had access to children. This guy went to church and mowed the lawns of all these old ladies and people thought he was a nice guy.

Where it is written that we are all entitled to people the world with mentally ill humans? The problem is not that it's written it's that it's not written and like all the other farmers using the commons we want to pass the buck of missing out on parenting to other people because by God I have a uterus or sperm and I am entitled to use them because that's what humans do and I'll be damned if I care if I sentence my child to a life of disabilities because I want to hear the pitter patter of little feet and so be it.

My mother was not labeled and drugged. She was a sociopath. She innately distrusted psychologists and psychiatrists. She was totally anti drugs, anti meds. An aspirin for a headache was the only thing on the approved list.

If you were in the same room with her for ten minutes you would think there is nothing out of the ordinary about her. It's behind closed doors way out on a dirt road far from sight of neighbors that she would transform into a vindictive, manipulating shrieking abuser. She's never asked for or received any treatment ever as far as I know. Not even office counseling.

At the end of my rant I asked a question, why would that be a bad thing? I don't need an education on Nazism, Sally. I am fairly well read on the subject.

I appreciate the responses WomanofHope and Sally. It was a dead given that someone was going to bring up Nazis and eugenics.

If I understand you Sally, and maybe I don't, but if I understand what you are saying you think that for some people mental illness occurs because you were in raised in the projects or the boondocks instead of in middle class suburbia. That they are really suffering from Lower Class People Disorder and the pain of wanting and not having what other people take for granted.

The cure for being depressed because you are one of the have-nots instead of the haves is to promote communism. Let's make everyone economically equal and no one will have anything to be depressed and agitated about. You wanted a playstation and a flatscreen and a bigger food budget than here you go you can just have these things because everyone should have them. Or will it be no one can have a flatscreen because since we can't make them for all and some people will covet the TVs of those who have them we can't allow that.

The question in eugenics is always going to be 'Who decides what's defective and what isn't?'

The question of communism is who gets to be a prole and who gets to be a party member? Party members get flatscreens and organic produce and the proles don't? It's already been proven that we can't give everyone everything that everyone else has. Nor is that the answer to class disparity caused by a free economy.I think we can agree that life under Stalin, Pol Pot and Mao was less than ideal from the accounts we've read about those times.

"It didn't take me long watching children be abused in their birth and foster homes to start fantasizing about compulsory sterilization or maybe putting something in the drinking water. Really. I was struck by the fact it takes more effort and coherent intelligence to get a driver's license than to have a kid.

The standard response to this line of thought, of course, is "Who will decide who gets to have kids," to which I say "A four year old pulling names out of a hat will probably do better than what we have going now."

I do not believe in the "brain imbalance" theory, certainly not as an across-the-board explanation for individual or social pathologies, but I do know children learn their responses and behaviours in their homes. A I do know that stuff is hard and time consuming to unlearn as an adult. There was no way I was going pass on what I grew up with so I too made the choice to be childless at an early age...........One thing that would help a lot would be to stop assuming everyone should have children. The social pressure is immense and unwarranted. "

Sherry seems to have understood my rant. Obviously I don't want people carted off to ovens because they have depression or adhd but where is it written that we are entitled to people the world with offspring that have disabilities? The 'go forth a multiply' bit from the bible we inherited from a time when infant mortality was huge and there was a great amount of space to spread out in.

There is a finite amount of space on earth. We can go online and look at satellite images and see for ourselves how much empty space we have left on this planet. We are not primitives anymore suffering from the plague, famines and a lack of knowledge about science and demographics . We form immense communities now which thrive. Old folks live longer and babies don't die in developed counties like they do in undeveloped ones. Our population expands and expands and we consume and consume.

In many ways I am relieved I never had kids. I never had to fight school teachers and admins to keep my children in school and undrugged. I've never had to have social workers investigate my home. I've never had to wage a war of wills with my doctor over my kid's health and all the drugs he wants them on. I will never be accused of negligence on public TV because I refuse to drug my kids. I will never have to get a phone call because a mentally ill kid raised by mentally ill parents just shot and killed my kid in school as a result of his treatment making him insane.

The world we have now and the world we are going to have is not one in which I ever felt compelled to risk adding a mentally ill person to. I was very lucky in a way that I was able to overcome a lot of those disadvantages and mental conditions. Dealing with my own mental illness was enough of a challenge in my life then trying to be a parent too.

I asked myself seriously what right do I have to add human beings to the world? The only parenting style I know is hitting and screaming and mind games. I've never been rich or middle class so I would never be able to provide richly for my kid's needs. My kids would have to suffer class disparity the minute they set foot in public school and they get to learn a life lesson about the haves and have nots while I have to explain why mummy can't afford to buy them ipods, designer clothes and get to them to a dentist or an optician.

I am not sure if you middle class, college educated types with mental illness truly appreciate the kind of suckitude you experience when you have mental illness and you are poor. You can't afford bipolar shopping sprees. You know what bipolar shopping is like when you make 20k a year? There isn't any. You have to decide to pay rent or get your brakes on your car repaired but you can't afford both the same week. A bipolar shopping spree when you are poor means you bought a 4$ starbucks coffee on Monday when you knew you only had $8 budgeted for coffee for the rest of the week.

Maybe you say well, that economic setback is why the poor folks can't get access to good treatment options. You mean the treatments you get now that would be available to all under socialist medicine? Are you so sure we are missing out?

It must be nice to be able to shop around the market for 'knowledgeable' Pdocs that can give 'accurate' diagnoses. To able to fire your Pdoc and hire another. It must be nice to be able to get into your SUV to drive 80 miles to the awesome therapist you read about and be able to pay those fees and the gas and time off from work because you are salaried and not hourly.

Poor people don't get expert psychiatrists and the latest greatest meds. If they get anything it's generic Prozac because it's cheap as hell. That's part of the class disparity in treatment.

Middle class and the insurance coverage you can afford grant the ability to buy expensive drugs which give you kidney damage, obesity and diabetes. But fortunately you have coverage and you can afford to pay for dialysis, specialists, orthomolecular consultants, expensive supplements, insulin injections, quality CBT facilitators or other drugs which improve your mood, reduce anxiety etc.

Poor people don't have any of that stuff. All wealth does is make living with mental illness a little more bearable because of all the neat things you can afford to try to distract yourself with. It means when you are having a really bad day you at least have your nice safe suburban home and your nice big TV and nice healthy food and your internet and your online social groups.

When you are poor you live in crappy neighborhoods where everyone has a pit bull and over whose homes police helicopters drone day or night. People whose lawns are unkempt and their car sits on blocks. You keep a baseball bat by the door and put one hand on it when you look through the peephole because you had an unexpected knock on the door. The cops just busted the neighbors for having a meth lab and you wondered why there was always lights on in that house. Turns out they never slept.

Right now there is no quick fix for mental illness and there is no quick fix for poverty. But our mortality rate decreases. Rich folks don't reproduce as much and those low income hoods keep spreading and sprawling and the juvi system is overflowing with mentally ill kids and our water supply has psych meds in it. Why should this continue?

Let's be honest. If you click on links to people's blogs who post here you find most of the people who comment here are college educated. You folks enjoy a level of financial and educational privilege that most don't. If you have never been confined in a population of mentally ill people you have no idea what it's like. By and large you folks are fairly rational. Your posts are articulate and well considered.

Your blogs talk about your moody days and your struggles to find the right medication. Your world of mental illness is not the same as the one I lived in. The world I lived in included violence. The people with mental illness that I was exposed to were liars, thieves, bullies, charismatic manipulators, sexual abusers, addicts. People who didn't care one iota about themselves or about you.

They don't have a college education. They never took humanities courses and learned that it was mean to beat their children and pets. They exposed their genitals and made inappropriate sexual remarks.

They get in your face, too close and too often over a perceived bad look or something they imagined out of thin air that you said under your breath. They posture and threaten. They rant about demons and the End Days. They are not nice people and most of you seem to be. If you gauged the impact of life with mental illness based off the majority of the commenters here it doesn't seem so bad.

It's frightening to be around people with mental illness. To watch a mother beat a child. I don't have a single close personal friend with a mental health label in my life today that I interact with. To me psych labels go hand in hand with violence and abuse and obscene, irrational phone calls in the night threatening to call the cops and accusing you of things you didn't do. It's lies that were told behind your back. It's watching someone hit walls and scream nonstop about how the world is to blame for everything It's stalking someone despite the restraining order they had from previous stalking.

The world of mental illness I was a part of is ugly and brutal. It's one I could have done without and one I do not particularly wish to see grow and fester by adding more people with it. It's a world I never wanted to bring an innocent into.

Because we are so afraid of becoming Nazis if we discourage people with low incomes and mental illness from reproducing we will allow the problem to grow and grow and grow. We are going to wash our hands of any notion of trying to do something about the status quo and the foreseeable future because we won't stand for communism in our country either.

The attitude I am sensing from Sally is, sure let's let everyone with mental illness reproduce and simply make psych meds available to all and leave it at that.

I am not very good at math and I didn't take statistics in college so bear with me and correct me if I am wrong.

If there are X many people being born and the rate of birth exceeds the rate of death then without doubt our population is growing. If X number of babies out of X number of babies is born from mentally ill low income parents and X number of those babies come down with mental illness then the rate of poor people with mental illness inhabiting our planet is increasing fairly constantly.

That means the number of people on psych meds increases. The number of crimes committed by mentally ill people increases. The number of 911 calls to report mentally ill people going off on other people increases. The number of kids taken away from parents and forced into adoption, foster care or group homes is increasing. The number of kids with mental illness and criminality who become adults who end up in jail increases.

What if we do discourage people with mental illness from breeding and it works? No need for forced sterilizations and camps. Just poster slogans, public service announcements, specials on TV here and there which promote being childless as a good way reduce the number of consumers on the planet. Less people equals more for you and me. Class room education that teaches kids that the whole planet is a Commons and that never ending population growth decreases sustainability and limits how much people can consume.

Gradually we teach people to have a racial awareness of all of humanity as a presence that effects the planet. We encourage successful people to pass on their genes and make more successful people. We teach kids to think about their personal consumption footprint and how much more consumption happens when you create more people to share a shrinking amount of resources or who believe they are entitled to a higher rate of consumption simply because others have it and so should they. We teach kids about mental illness itself. We teach them that it's not fun to be the child of a low income mentally ill parents so why would you make children to experience that if you have a choice?

We teach kids to think about this sense of entitlement.

No government can tell me what do to with my genitals.

Really? Why not? You don't live all by yourself on a nearly empty planet. The rest of us have to deal with the results of what your genitals make. Laws exist so we can live together. We agree to them in order to live in society. Why can't we agree that not everyone who is capable of reproducing should? How many of you would dare to look so insensitive or politically incorrect to suggest such a thing? I think about it all the time when I read the news and watch CCTV footage of parents caught abusing their kids on youtube.

What if my mother had been unable to get a mental health certificate which would give her permission to make children? She might have just pursued her talents and become a successful artist who never hurt anyone but herself rather than the mother of an entire brood of kids who were unable to care for themselves. Would that have been such a tragedy?
That's all I was thinking of when I 'advocated' that mentally ill women be monitored.

The topic of this post, the tattletale implants and the import of that is something we have to factor in when we are talking about national health care policy and what that might mean. If we are serious about saving money as a national economy cutting back on the numbers of people being born every day who will end up with mental disorders and be unable to afford to care for themselves or their brand new mentally ill kids seems to me to worth looking into and seems also to be more sustainable to the earth itself.

Frankly if I was going to advocate for anything that Orwellian I would advocate licenses for reproduction either for everyone or for just people with mental illness. A giant MMPI-like test which includes your financial situation that must be assessed before you get a birth license. Can you even afford the extra medical costs of a child with disabilities or will you create another burden on the system the rest of us have to pay for?

Part of the test measures a parents raw education. Does the parent understand very basic medicine? Does the parent understand the process of normal child development? Does the parent have any common sense at all? Does the parent think it's cool to let the Uncle sleep with their kids when he comes over?

If you child becomes sick do you:

A. Pray hard. It's all in God's hands.
B. Ignore it, kids get sick all the time.
C. Take the kids temp, if it's not 108F they are going to live.
D. Scrutinize your Nursing Manual for Moms and if you can't figure it out take your kid to the doctor in case they have an ear infection that threatens their hearing.

If you answered, E: We just let it heal naturally because a doctors visit would bankrupt us then you are not financially ready to have kids. Sorry honey that you lost your hearing but we just couldn't afford the doctor's visit and the antibiotics that would have saved your hearing had we even known you were losing it.

It's 104 degrees outside and you are going shopping do you:

A. Leave your kids in the car with the windows up.
B. Leave your kids in the car with the windows cracked.
C. Put your children in the trunk so no one sees you left you kids in the car in the heat while shopping.
D: Never leave your kids in the car unattended in the heat. It can be fatal.

If you answered E: Leave them at home with the drunk boyfriend who just got out of prison last week then you are not ready to have kids. I don't see why a simple common sense exam, some financial stability requirements, an intelligence test ( or education level assessment ) to screen out those who are mentally ill and financially poor who would otherwise have kids they can't take care of is too fascist or controlling. Look at the problems we have now because we don't do that. Juvi halls everywhere overcrowded housing behaviorally or emotionally challenged kids in a traumatic institutional gulag until they are adults.

If you are wondering the locked in the car in summer heat while Ma is shopping actually happened to me and my siblings because we were such monsters we couldn't be taken inside with her and she couldn't afford a babysitter. Also I lost my hearing in my left ear because my mom was too uneducated to realize I was truly sick. She had a HS diploma and a head full of wives tales, superstitions and a lack of a real education. She was a provincial and a simpleton.

She was pretty much angry at me for daring to get sick and tried to make me feel guilty about it and how much it inconvenienced her. My family was too poor to afford medical help even if they had tried to get it for me. She forced me to go back to school when I could barely stand on my own two feet.

Years later it was my paternal grandparents and their middle class existence which allowed me to go to the hearing specialists who found out what happened. I never saw a dentist until I was 13 and it was my paternal family who paid for it. My teeth grew in messed up and I've never had the financial cushion needed to get them straightened.

Yes I think if we scrutinized who we allow to have kids and set some limits that situation that festered in the house I grew up and that occurs in other families homes might have been avoided.

Posted by: Jane at August 11, 2009 05:25 PM

Jane,

If I get you right, you're not saying that people labeled as mentally ill shouldn't have children, but that bad people shouldn't have children. You write:

"My mother was not labeled and drugged. She was a sociopath. She innately distrusted psychologists and psychiatrists. She was totally anti drugs, anti meds. An aspirin for a headache was the only thing on the approved list.

If you were in the same room with her for ten minutes you would think there is nothing out of the ordinary about her. It's behind closed doors way out on a dirt road far from sight of neighbors that she would transform into a vindictive, manipulating shrieking abuser. She's never asked for or received any treatment ever as far as I know. Not even office counseling."

This is the thing, sterilizing or monitoring every person labeled as mentally ill would never pick up bad people like your mother.

I don't believe mental illness is a medical disease and I certainly don't believe that preventing folks gullible enough to go in for psych counseling from having children will prevent bad or irresponsible people from having kids.

Being a sociopath isn't a disease it's a moral choice.

Posted by: Sally at August 11, 2009 06:53 PM

"It must be nice to be able to shop around the market for 'knowledgeable' Pdocs that can give 'accurate' diagnoses. To able to fire your Pdoc and hire another."

I've been trying to say this for quite a while now in one conversation or another. Thanks, Jane.

I grew up intermittently in that world of poverty and violent middle illness you describe and am shielded from it today by three things (none of them are my masters degrees--which I got because I was losing my ability to work and was lucky enough to get a big, fat scholarship):
1) a nice, middle class husband
2) the ability to "pass" as middle class (lace curtain Irish may live in poverty but they teach their children how to have tea with the Queen...just in case)
3) the gradual shedding of my mentally ill family members and friends, one by dysfunctional one, over the years as I got better. I refuse to put up with a lot of drama now and have developed much better radar to avoid entanglement with people who will only complicate my life.

Like many women, I am one man away from homelessness. I never kid myself about this. I've watched more than one woman plummet from a nice, upper middle class life--big house, nice car, pampering of various kinds--when their marriage disintegrated. One of them has been homeless five times so far. Without my sweetie I would have to live on my meagre SSDIB. I would be very lucky to find a Section 8 room several years down the road. And if I ended up in subsidized housing (that's the best case scenario) I would probably have some pretty scary neighbours.

Actually, part of why my agoraphobia is so godawful is because I do live in a pretty low income rural area one of my neighbours once described as "a trailer park with wooden trailers." For the past 22 years I've lived next to a really scary guy who stared at me a LOT 24/7. I mean I'd wake up at 2 or 3 am and he'd be there, silhouetted in the dark, smoking on his porch, staring at my window. He was volatile and so scary I didn't realize the effect he'd had on my until he moved away. You better believe I appreciate the nice young couple who live there now. The single mother on the other side of him is also pretty agoraphobic. I, at least, had the protection of being "owned" by a man in his mind; she does not.

What you're saying is important, Jane. I do agree with Sally that money really does help mitigate a lot of the effects of poverty--our abuse was always much, much worse when my mother was under financial stress. But it's not a total cure all. My mother's sociopathic family ended up pretty middle class. But my cousin Eddie still had his brains fried because his parents didn't bother to give him an aspirin for his fever when he got the measles. We're all paying, by the way. He's in an institution.

I really do not feel I have the right to reproduce. I do not believe my mother should ever have reproduced. I wish abortion had been legal in her days, really. I don't believe I have the right to own a gun, either, with my mental health history. It really doesn't matter to me what the US Constitution may say about the matter, the fact is I have an obligation to others to avoid splattering my crap all over their lives. One thing I learned well in my social work career: my rights end where others' begin. I don't have the right to risk burning down an apartment building in which other people live when I become too demented to use my gas stove safely. I don't have the right to warp the lives of others (not to mention their backs) taking care of me because I "don't want to" go to a nursing home. I will, however, defend to the death my right to burn my own damned house down if I live in splendid isolation with wood heat and no electricity. My first job was in an impoverished rural area so I had to resolve these kinds of issues in my early twenties. It's stood me in good stead.

Now, if I can just remember all this stuff after I lose my marbles...

Posted by: Sherry at August 11, 2009 07:11 PM

Jane, you've obviously had some brutal experiences and I'm sorry for the pain in your life. However, I still think any kind of "got a mental wellness certificate, okay then, go ahead and breed" program would be a disaster. The genetics of mental illness, if it exists, is poorly understood. Why should somebody with an arbitrary, subjective label be subject to a special set of laws?

Posted by: Francesca Allan at August 11, 2009 07:16 PM

Interesting thread diversion.

But I had to go back and see why Jane thought "If I understand you Sally, and maybe I don't, but if I understand what you are saying you think that for some people mental illness occurs because you were in raised in the projects or the boondocks instead of in middle class suburbia. That they are really suffering from Lower Class People Disorder and the pain of wanting and not having what other people take for granted."

or why Sherry wrote:

"I do agree with Sally that money really does help mitigate a lot of the effects of poverty--our abuse was always much, much worse when my mother was under financial stress."

I assume it's because I wrote:

"A lot of the "mental illness" you discuss is simply economic and social depravity. Sure our society should do a better job of distributing resources in an equitable way."

If not, and if the thread is still alive, please correct me. When I wrote that I didn't mean throwing money at problems. These days we label normal human responses to poverty as "mental illness." Homeless people are dirty because they have no where to bathe and if delusional, delusional because they are living in horrible circumstances because our society is screwed up. Or society is not screwed up because we don't force all of these people to be injected with risperdal. Behavior that looks like what Fuller Torrey would call schizophrenia is a sympton, not a cause.

But it's not really about money. Jane you mention your mother and how she looked sane and you are the one that got labeled. The fact that you ended up in a group home means you, not she, was living in an inferior, restrictive setting. Why, not so much because she has some mental illness that could have been detected but because the whole upper middle class house wife thing makes upper middle class housewife miserable before it hurts anyone else. Have you never read Bella Abzug's "The Feminine Mystique?"

And Sherry, yes money is not the end all and be all of solutions and poverty is not the cause of all problems but I would argue that poverty makes behavior that feels like abuse unavoidable sometimes. For example, if you have a child and can only find work that allows you to provide food and shelter but not child care, then you don't have much choice but to leave your child alone which for some children is detrimental. I might ask, "well why would someone so poor have sex." I might answer, because people in the end are human beings.

Jane, imagine the expense of having a universal screening for mental illness. If all we did was administer the MMPI (at worthless instrument but you seem to like it) to every citizen to determine who gets to have children, this testing and administration would cost a whole lot more than providing free child care to every child. Oh, and how are we going to decide who's sane enough to interpret the MMPI. You do know that if you are trained on how to administer it, it can't be a reliable testing instrument on you (or at least that's what one pshrink told me once when I told him I'd need to see his MMPI results to make sure he was sane enough to administer it to me;).

Posted by: Sally at August 12, 2009 05:10 AM

Jane,
I've been thinking of your very eloquent description of how it really is to live in poverty, with violence at the door. I only wish it could receive a larger audience, it's that good and that important.

But Sally is correct "This is the thing, sterilizing or monitoring every person labeled as mentally ill would never pick up bad people like your mother." Or mine.

The problem is something different than mental illness, really. (Personally, I think it's the moral and criminal choice to abuse.)

And we've never been very good at defining or--more important--accurately documenting it. And we never will be as long as we refuse to listen to the people on the bottom of the pile--many of us who wear the label "mentally ill."

This is a very interesting discussion and I'm glad we're having it.

Posted by: Sherry at August 12, 2009 05:22 AM

Drats, it was Betty Friedan, not Bella Abzug, who wrote the Feminine Mystique. Still, it's an important book.

And to beat a dead horse while preaching at least to some extent to the choir, it's our entire system, not just poverty, that breeds profound unhappiness and anti social acting out and secret bad detrimental behaviors like so often child abuse. To think we can fix this with pills and harsh laws is truly "insane."

To quote Friedan:

"The problem that has no name — which is simply the fact that American women are kept from growing to their full human capacities — is taking a far greater toll on the physical and mental health of our country than any known disease."

Posted by: Sally at August 12, 2009 06:12 AM

Jane,

Your story is a horrific one I wouldn't wish on my worst enemy. And you're right, being poor and labeled and being middle class or affluent and labeled are two completely different worlds. By the way, plenty of "normal" middle class and affluent people suck at parenting.

For the record, I grew up in a poor neighborhood and "witnessed messed up teens born of messed up parents first hand..." Still, I don't even begin to think about who should and should not have children. To me it's a personal choice, period. Some folks are highly irresponsible when making reproductive choices, but still it's a choice. Anything short of that does smack of eugenics.

You asked me why monitoring mentally ill people of childbearing age might be a bad thing. I believe you answered the question for me by writing, "The question in eugenics is always going to be "who decides what's defects and what isn't?" That's the scary part and the reason why I object to any sort of forced childbearing monitoring.

Posted by: WomanofHope at August 12, 2009 10:40 AM

Under such hypothetical use of a monitor to control med compliance in women of childbearing age, who had ever received a psych label, I would not now have my healthy 2.5 month old son. My bipolar diagnosis was a misdiagnosis. Plain and simple. However far fetched (and I don't think such a use is all that far fetched), it is ideas like this that were part of the reason I answered "Nope" when my OB office asked if I'd ever had any psychiatric problems, and why I carefully selected a hospital that did not have access to records from my psychiatric (mis)treatment.

Posted by: Tilting at Windmills at August 12, 2009 11:54 AM

"why I carefully selected a hospital that did not have access to records from my psychiatric (mis)treatment"

Let's all remember this vignette when Obamacare/universal care/socialized medicine/whatever comes to fruition...

Posted by: Paul at August 12, 2009 04:49 PM

Paul,
The problem isn't Obama or whatever it is you think of as socialized medicine. The problem we're talking about here is digitized medical records.

That is something that is in the works no matter who's in charge or what changes are made or not made to the health system. It's already here, actually, just is going to be expanded. For example, for the past ten years or so, I've been unable to go to any doctor or hospital within a fifty-mile range of my home with any degree of privacy because they're all owned by the same entity. My records are open to anyone within that system (well, except for me), all in the name of "efficiency." I no longer enjoy any privacy whatsoever, haven't had any for a long time and this has nothing to do with Obama.

I only say this in hopes we can have some sort of rational conversation in the US about health care issues. Are you aware there is alrady a bureau, much like a credit bureau, that holds our medical records? The insurance companies consult your records in that bureau, just like a credit check, as part of assessing you for coverage. This has been in existence for some time now, again nothing to do with Obama.

You may not like Obama, may not like whatever it is you think of as socialized medicine but it amazes me that people attribute things to the current administration that clearly predate it. The wholesale digitization of medical records has been on the docket for quite some time.

By the way, Medicare--a government insurance--is the best insurance I've ever had. It also has the lowest operating costs of any insurance in the US. It should be expanded to all US citizens. Actually, the stuff the Congress/Senators have is what should be expanded to us all, but I do try to keep my expectations somewhere on the planet.

Posted by: Sherry at August 13, 2009 07:45 AM

Sherry,

Good points.

I don't care about Obama, per se - just another politician as far as I am concerned. However, I am very concerned with centralized anything, especially medical records. Once the government gets involved there's no way to turn back the clock. I'd prefer for my records to say within my control and then allow care providers to view (but not copy or save) my records. I'd not be happy if HMOs and others shared my records with each other. I want insurance companies to be fighting to hide my records as if they were trade secrets. Alas...

Philip Dawdy responds: i am with paul on this. i simply do not trust the government to behave properly--ie, within constitutional bounds--in the context of centralized medical records.

Posted by: Paul at August 13, 2009 10:23 AM

Patient privacy is definitely an urgent issue, in some ways most of all for folks with psych labels on their records. You think a felony or bankruptcy is a big deal try a medical conviction for schizophrenia, bipolar disorder, borderline, or even adhd or depression, but it's mainly non mental health folks who are wisely and rightly active.

Here's a link to some of the back story that I believe to be fairly reliable:

http://www.patientprivacyrights.org/site/PageServer?pagename=Background

Posted by: Sally at August 13, 2009 11:48 AM

Paul (and Philip),
"I am very concerned with centralized anything, especially medical records. Once the government gets involved there's no way to turn back the clock. I'd prefer for my records to say within my control and then allow care providers to view (but not copy or save) my records."
Yessss... I totally agree. I'm outraged by the digitization of records.

The reason I said something is because I'm getting disturbed by the way people drag Obama into just about every discussion, at least on line. I swear I can read an article about rainbows and sooner or later someone in the comments will blame Obama for the fact they're happening more often or less often or whatever. This just clouds rational discussion and prevents us from really solving problems because we're not really focusing on the actual issues. Thank you for your response. I was afraid you might see it as an attack.

I'm very disturbed by the last of privacy I've experienced in the last ten years. I used to be able to consult with a specialist on my own and then decide whether or not--and how much--to share the results with my doctor. I have this silly belief that it's MY BODY. Go figure.

I also don't want my family doc sending me out for referrals to specialists as I'd much rather do my own research and selection, thank you. This loss of privacy makes that almost impossible.

And, of course, I'm stuck, stuck, stuck with those packs of lies that were written about me to cover up malpractice. That's become the gift that keeps on giving...

Posted by: Sherry at August 13, 2009 12:37 PM

Sherry is right. This all started way before Obama. The digitization of all records is generally a bad thing and yet inevitable. Hopefully such digitization with lead to the ultimate end of psychiatry as (well y'all know that song). Just as doctors can falsely report in charts, just about anyone can afford to buy a cheap digital recorder to record conversations with medical professionals without their knowledge, just in case and there's a good fight for if not privacy of medical records, criminal and civil sanctions for errors as well as financial compensation.

Posted by: Sally at August 13, 2009 04:19 PM

"Just as doctors can falsely report in charts, just about anyone can afford to buy a cheap digital recorder to record conversations with medical professionals without their knowledge, just in case and there's a good fight for if not privacy of medical records, criminal and civil sanctions for errors as well as financial compensation."

Oh Sally, what a good idea. Thank you. I'll have to check my state laws. I know it's illegal to record phone calls in my state without permission, but I do not know about personal interviews. Interesting thought.

Posted by: Sherry at August 13, 2009 06:38 PM

Ugh, sorry, I find Jane's comments repulsive. Yeah, let's have bureaucrats dictating who gets to have kids based on some arbitrary labels in the DSM annointed on disenfranchised people!

Sorry your parents were so nasty. Perhaps they were just bad parents, IN ADDITION to being mentally ill. There is a difference.

Posted by: kimbriel at August 13, 2009 10:31 PM

Sherry,

Usually though I don't know from state to state, it's legal to record any conversation to which you are a party but you can't record conversations you don't participate in, so you could record conversations between you and your doctor but couldn't leave the recorder in the room to catch his conversations with others without telling him. This has been helpful to me but again you are right laws vary from state to state and furthermore I hate to think of what a pshrink would do if he caught a patient recording, perhaps a label of schizophrenia and a lifetime of AOT and ECT but still it is important if you can to record sessions because I think much of the problem with many pshrinks and mhp's in general is that they misperceive and lack self awareness so tapes help challenge their subjective notes.

And of course as electronic records are upon us, it is crucial for everyone to realize that you should always remember that nothing you tell an mhp is really private. Never confide anything you don't want everyone looking at your medical records for the rest of your life and beyond to know or anything the pshrink can construe against you in the worst possible light.

Posted by: Sally at August 14, 2009 07:26 AM

Ah Sally, This is why I just love you:
"I hate to think of what a pshrink would do if he caught a patient recording, perhaps a label of schizophrenia and a lifetime of AOT and ECT"
and:
"And of course as electronic records are upon us, it is crucial for everyone to realize that you should always remember that nothing you tell an mhp is really private."

You *so* get it.

I had a client once whose mother was alluded to in passing by a psychiatrist in Vermont's crappy state hospital as being "schizophrenic." Mother was not his patient (she was not knuckling under to his "treatment" plan, however) and there was no basis in fact for his reference.

But I read the daughter's record 14 years later and the mother was described as schizophrenic in the introductory case notes written by each and every subsequent doctor, including the one in our state who vindicated her original explanation of her daughter's behaviour.

I keep my mouth shut around *any* medical professionals. I try to use specialist outside of my geographical area whenever possible. It's not them, I simply know better than to trust the system.

Posted by: Sherry at August 14, 2009 04:56 PM

Um, wow. Forcing yourself into someone else's body to sterilize them is certainly the way to create a sane, healthy and sustainable planet.

I can't believe such flagrant hate speech is kept up here.

Posted by: E.H. at August 16, 2009 08:49 PM

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