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 Post Posted: Mon Dec 17, 2012 11:27 pm 
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OK, so how about we talk about mental illness? Most of these mass shootings were committed by mentally ill individuals who clearly were not getting the help they needed. Being paranoid, they didn't even want it.

In most parts of the United States, there is very little that can be done to compel an adult to receive mental health treatment, or be hospitalized against their will, due to civil liberties concerns. And that's assuming that they're even able to pay for it, or that treatment programs are available. No wonder so many severely mentally ill people end up in jail.

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 Post Posted: Tue Dec 18, 2012 12:50 am 
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That's something I've always believed. Why do people focus so much on [Banned Topic] when the reality is that so many people who commit these crimes have gone off their rocker for reasons that are at best unrelated to the laws people are pushing for? Some people are just born disturbed, and would eventually go on to commit these sorts of crimes even if they COULDN'T get access to what they'd need to do it on a grander scale thanks to [Banned Topic].

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 Post Posted: Tue Dec 18, 2012 6:35 am 
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Well, people have been talking about the guy in China who went berzerk and attacked a school full of kids with a knife. People go berzerk all over the world. The word "amok" comes from a cultural phenomenon in Southeast Asia, where a man goes all quiet and brooding, usually in response to some perceived insult, then explodes violently and goes on a killing spree, after which he conveniently loses all memory of what he has done. (The DSM-IV catalogues this as a "culture bound syndrome"). But it does make a difference to the death toll when those who run amok have highly efficient means of mass murder at their disposal.

Should we just accept people going berzerk once in a while as a fact of life, or treat it like something that can be prevented? If it's the latter, then how?

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 Post Posted: Tue Dec 18, 2012 8:45 am 
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It would certainly help if we could get rid of the stigma attached to seeking psychiatric help. Many people who have psychological issues won't seek help either out of paranoia or embarrassment. Most of the time those who do seek help only have minor issues that could be solved by just talking to someone instead of bottling it up inside and so they get charged hundreds or they choose a psychiatrist instead of a psychologist and end up over medicated which could incidentally exacerbate the problem.

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 Post Posted: Tue Dec 18, 2012 10:30 am 
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There's also a growing movement of people with mental conditions who assert that the condition is part of who they are and that receiving therapy or medication to treat it is taking away their true personality and replacing it with a more "socially acceptable" one. To some extent I can understand and sympathize with this; I have ADD and there are some aspects of it that I actually value. But I find that argument difficult to justify when a person becomes a burden--or more especially, a danger--to society.

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 Post Posted: Tue Dec 18, 2012 11:37 am 
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Not all therapy has the goal to "repair" the clients and make them normal. It can also be finding strategies to mitigate negative aspects.

And you definitly can't treat everything that somehow falls under mental condition the same way. So there is no general answer to therapy methods and medication being good or bad.

Treatment against the will of the client is always a difficult matter. On the one hand, there are people, who clearly are unable to manage their lifes on their own, and who don't understand the consequences of making or not making a therapy. On the other hand there is always the temptation to declare people, who are not really a problem in any way, but kinda make the place look untidy, as having a mental condition and force a treatment on them*.

And there is some grey area in between and you have to arbitrarily set a line there.

* While it has no references to diagosing mental illnesses, the basic attitude is well presented in the villagers of Hot Fuzz

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 Post Posted: Tue Dec 18, 2012 12:42 pm 
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Mental illness is a hard nut to crack.

I think in the US, it's pretty abominable that our mental health system is so jacked up - state run facilities are constantly facing budget cuts and have been underfunded for decades, which led to the mass exodus of "harmless" mentally ill people from hospitals to the streets back in the 70s. This lack of actual budget for people who cannot afford private care means that hospitals can't hold people who come to them for long unless they're obviously a danger to themselves or others. I believe most states have a 72 hour observation period for people who are committed against their will, and in the states where I'm more familiar with the rules, the ill person must cause harm or threaten harm for a family member to get them treatment.

In the US, we also adore individuality as our supreme right. People must make their own way in all things, and that includes mental fitness. There are some circles that recoil at the idea of a person being forced into treatment because of the what ifs -what if he's not really sick? - mostly a result of the disgusting misuse of hospitalization and treatment in the past (i.e., throwing undesirable family members in the hospital to avoid embarrassment, extreme and untested treatments, the prevelance of quacks in the profession. The worst case was the butcher who gave ice-pick lobotamies *shudder*). I completely understand that fear, and unfortunately treating mental illness is still undergoing many changes of thought and understanding. Hell, the "repressed memory" scandal only came to light in the late 90s, and some practitioners still claim that it's a legit practice.

However. We need to get past both issues to address people who are definitely mentally ill but refuse to seek treatment. The red flags of mental illness begin way before harm is caused or threatened. A severe change in mood, the person no longer caring about hygiene, paranoid or clingy or erratic behavior, sudden movement toward the criminal with no past record, all of these can be signs that a person has undergone a major mental shift. And unfortunately, because of the lack of funding and the worship of autonomy, a person who is not of their right mind have the responsibility of treatment thrust upon them. There are a number of illnesses that leave a person self-aware enough to seek help, but what of the illnesses where a person is so damn sure that they're the sane ones in a world of people who can't see the truth? Why are they forced to be the ones to seek their own treatment?

I say this as a person with family members who clearly need treatment, and a friend of someone who has worked the last 3 years trying to get her ill father to regularly go to the doctor: this is messed up. My family members have yet to harm themselves or others, but their lives are not, shall we say, optimal. And because they are supposedly not dangerous, there's nothing anyone can do about it besides begging them to see someone, anyone, please, before you do something awful to yourself or others. My friend's father DID cause harm to himself, so to hospital he went. But once the doctors determined he was safe "for now", he was out, much to the desperation of my poor friend, who has watched her father spiral out of control. She's had him under observation a few times, but they always release him - and he never does get to the doctors outside the walls of the hospital.

This system leaves family members at a loss, and if there isn't any family in the picture, threatens the mentally ill with a myriad of worst case scenarios. I'm not saying we need to start committing people left and right, but we need to fix this system.

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 Post Posted: Wed Dec 19, 2012 6:28 am 
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This is definitely a sister issue to that of universal health care. We've seen the rabid opposition to anything even remotely resembling that by those who are ideologically opposed to paying for something that they can't see immediately benefiting them personally. Widespread mental health treatment will always have the trailing question of "who will pay for it?". Unfortunately, I can't help but think until we see a single payer system, not a lot will change on the mental health front.

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 Post Posted: Wed Dec 19, 2012 9:27 am 
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One major change that needs to happen if we want this sort of thing to stop (or, at least, happen less often) is for the media to report school shootings less, and to report them better. School shootings, like suicides, tend to happen in clusters, and following Columbine - which got an extensive level of wall-to-wall media coverage, the rate of school shootings sky-rocketed. For approximately one year after September 11th, when the media had other obsessions, there were, literally, no school shootings in the US at all.

People inclined to behave in these ways are inspired by media coverage. We can see this from studies done on suicide, which show that detailed reporting on suicides is regularly followed by an increase in the rate of similar suicides. The detailed, voyeuristic media obsession with this shooting is sickening and irresponsible.

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 Post Posted: Wed Dec 19, 2012 12:01 pm 
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It's worth having a look at this clip from Screenwipe if you haven't already. It's a pretty good demonstration of how hopelessly irresponsible media coverage of this kind of tragedy is.

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 Post Posted: Thu Dec 20, 2012 6:22 am 
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weatherwax wrote:
However. We need to get past both issues to address people who are definitely mentally ill but refuse to seek treatment. The red flags of mental illness begin way before harm is caused or threatened. A severe change in mood, the person no longer caring about hygiene, paranoid or clingy or erratic behavior, sudden movement toward the criminal with no past record, all of these can be signs that a person has undergone a major mental shift. And unfortunately, because of the lack of funding and the worship of autonomy, a person who is not of their right mind have the responsibility of treatment thrust upon them. There are a number of illnesses that leave a person self-aware enough to seek help, but what of the illnesses where a person is so damn sure that they're the sane ones in a world of people who can't see the truth? Why are they forced to be the ones to seek their own treatment?

So what do you guys think? Should the family of a grown adult be able to have them involuntarily committed to residential care? How high should you set the bar to prevent abuse of the system, so that people can't lock away merely inconvenient or burdensome family members? And if family members can have their relatives committed, then don't mental health professionals have to break privacy rules, by telling said family members about their relative's mental condition? I could easily see a scenario in which, say, a college student from an abusive family doesn't want her parents to know that she's on antidepressants, or that she had thoughts of suicide.

Grillick - do you know anything about what it takes to have a relative declared unfit to care for themselves and to establish legal guardianship over them?

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 Post Posted: Fri Dec 21, 2012 2:41 am 
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I hate to sound callous, but I think reactions to these kinds of things get a little overblown, because they are relatively rare and shocking.

For a little bit of perspective, a quick search says there were 32,367 motor vehicle deaths in the US in 2011. That means about 89 people, every single day of the year. Are these deaths any less tragic? And yet because they are so common, they fade into the background noise of modern civilization.

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 Post Posted: Fri Dec 21, 2012 9:32 am 
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At the same time, the US murder rate is way higher than that of practically every other developed country on Earth. Although it has been falling over the last couple of decades, you guys clearly have a problem with violence.

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 Post Posted: Fri Dec 21, 2012 11:42 am 
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Kea wrote:
Grillick - do you know anything about what it takes to have a relative declared unfit to care for themselves and to establish legal guardianship over them?

I know that it varies from state to state, and that some form of evidentiary hearing is required by the Constitution. What the specific procedures are and what the standard of proof is will vary drastically across the country.

But in general, the person seeking to be appointed guardian would have to demonstrate either that the relative is a danger to himself or others, or that the relative is incapable of making decisions because of mental illness.

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 Post Posted: Fri Dec 21, 2012 11:55 am 
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Gor wrote:
I hate to sound callous, but I think reactions to these kinds of things get a little overblown, because they are relatively rare and shocking.

It's not callous at all; it's actually more sensitive to the fact that there are people behind statistics.

The CDC says that smoking is the root cause of 443,000 deaths a year; more than HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. To put that in perspective, suppose that every day we had 46 mass shootings of the same magnitude as the Sandy Hook Elementary incident. That still wouldn't match the body count from smoking.

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