Annabelle Algiers
Mrs. Baer
AP Lang
12/2/16
The Problem with Mental Health Treatment in America
Section I: Introduction and Context
Over one million people are affected by mental health conditions every year. Friends, family, and loved ones of those effected tend to face many hardships. When a mentally ill person has a breakdown, he or she must voluntarily admit themselves into the hospital to receive the treatment they want. Due to human rights activists and the deinstitutionalization of America, loved ones of the mentally ill cannot force treatment upon them. Unless extreme situations occur- such as the patient explicitly saying they intend to hurt someone or themselves- hospitals and treatment facilities cannot force medication or any other service upon anyone who refuses it. However, people who are against involuntary treatment are justified. In the 1950’s, the United States made the effort to lock up every mentally ill person in asylums or mental hospitals. There, sadistic doctors and nurses would use electro therapy to shock their patients into submission and preform lobotomy after lobotomy to calm patients with hallucinations. Then psychotherapy (talk therapy) became wildly popular. American media turned the American people against doctors and other medical personnel who worked in the institutions. This began the deinstitutionalization of America. Without mental hospitals or asylums, many of the mentally ill became homeless and poor. This caused a huge increase in the mentally ill’s population in jails. Since then, there has been a constant struggle with balancing the mentally ill’s right to refuse treatment and when their loved ones should step in. Involuntary treatment has created conflict for the mentally handicapped and their loved ones in pursuit of treatment, while voluntary treatment has increased the rate of incarceration of mentally handicapped people.
Section II: The Author’s Background
Pete Earley, a storyteller who has penned 17 books including four New York Times best sellers, is a life-long member of the National Alliance on Mental Illness (NAMI) (“Bestselling Author and Mental Health Advocate”). Earley is long standing member of the National Alliance on Mental Illness ( NAMI ) (“Bestselling Author and Mental Health Advocate”). Earley has spoken at a few of NAMI’s national conventions and at a significant number of its individual state traditions. He has been a highlighted speaker at conventions held by Mental Health America, the American Psychiatric Association, The National Council for Behavioral Health, The American Correctional Association, and CIT International (“Bestselling Author and Mental Health Advocate”). (“Bestselling Author and Mental Health Advocate”). In Crazy: A Father’s Search Through America’s Mental Health Madness, Earley portrays the struggles loved ones of mentally ill people face. Using his own experience from his mentally ill son, Michael, and research conducted at the Miami-Dade County jail, Earley explains how jails and prisons have become asylums due to laws against involuntary treatment and why programs such as CIT, Mental Health Courts, Jail Diversion and Re-Entry programs can save lives (Earley, Pete).
Pete Earley’s son Mike first began acting strangely during his senior year in college (Earley, Pete). Earley convinced Mike to see a psychiatrist, who said ominously,
“Let’s hope it’s drugs….It’s better than the alternative. Your son might be mentally ill” (p. 10).
He was diagnosed with bipolar disorder (Earley, Pete). Mike was prescribed medication to lessen the severity of his episodes, but the medication had harsh side effects on him (Earley, Pete). Mike, in his delusional condition, said that prescriptions were toxic and that everything was fine (Earley, Pete). By law, he had the privilege to decline treatment unless he was an impending risk to himself or others.(Friedenbach, Jennifer). Feeling helpless one evening, Earley expressed his frustrations to his wife (Earley, Pete). She suggested that he, as a journalist, should write about it (Earley, Pete). Thus, he began visiting prisons and hospitals around the country, interviewing judges, lawyers, community volunteer members, learning the ins and outs of the mental health systems in America.
Section III: The Book’s Argument
Earley focuses his research on the justice system in Miami, Florida. Since laws are in place that make it easy for the mentally ill to refuse treatment, many end up homeless or incarcerated.
The rates of institutionalization have made a severe increase from the late seventies to the early 2000’s (Locked Up. But Where?). Many more adults with mental health disabilities are being put in jail rather than being placed in mental hospitals (Locked Up. But Where?). Pete Earley archives how the city’s biggest jail has just a single objective for their mentally ill detainees: that they don’t kill themselves. The book closes with a snapshot of idealism for Mike. He stays away from crime allegations, and, after a long string of high points and low points, manages to find full time work (Earley, Pete).
The rates of institutionalization have made a severe increase from the late seventies to the early 2000’s (Locked Up. But Where?). Many more adults with mental health disabilities are being put in jail rather than being placed in mental hospitals (Locked Up. But Where?). Per 100,000 adults, more than 800 with mental disabilities are locked in jail (Locked Up. But Where?). The drop in admittance to mental hospitals is due to the term “deinstitutionalization”.
Somebody with an untreated emotional sickness is 16 times more prone to be killed by police than different regular citizens drew nearer or halted by law authorization (Lopez, German). Every year, 2 million individuals with genuine mental sicknesses are admitted to US correctional facilites ( Lopez, German). Mental health care is genuinely underfunded in America, and the justice system’s framework is the main foundation that picks up the slack.
15 percent of men and 30 percent of women booked for prison have a genuine mental health condition, the greater part of whom do not get required care while they are in prison, as indicated by NAMI (Lopez, German). A significant part of the criminal justice system’s outsize part came after the across the board shutdown of state-run mental institution (Lopez, German). The 2014 national review by the Treatment Advocacy Center found that the quantity of individuals with genuine emotional sickness in detainment facilities and prisons dwarf those in state doctor’s facilities 10 to 1 (Lopez, German). As indicated by NAMI, no less than 83 percent of prison detainees with a dysfunctional behavior don’t have entry to essential treatment (Laopez, German). Just around 3 to 5 percent of brutal acts in the US are completed by individuals with genuine emotional sicknesses, while around 4.2 percent of citizens in the US encounter a genuine dysfunctional behavior in a given year that significantly meddles with or limits their real life exercises ( Lopez, German).
Section III: Opposing Points of View
Although involuntary treatment may seem like it is the better option, it takes away certain human rights of the mentally ill. It allows a friend or loved one take a mentally ill person to the hospital and force meditation and treatment on them. Mental Health America (MHA) believes that voluntary care is the most effective in the protection of those with mental health disabilities (“Position Statement 22: Involuntary Mental Health Treatment”). It is essential that the rights of persons with mental health conditions to make decisions concerning their treatment be respected. MHA urges states to adopt laws that reflect the paramount value of maximizing the dignity, autonomy and self-determination of persons affected by mental health conditions. Voluntary admissions to treatment and services should be made more truly voluntary, and the use of advance directives should be implemented.
MHA believes involuntary treatment should be utilized only as a last resort in emergency circumstances and should only be limited to those who are explicitly planning on harming themselves or others (“Position Statement 22: Involuntary Mental Health Treatment”).
People with mental health conditions merit an indistinguishable level of individual self-rule from different citizens with handicaps with regards to accepting medical services (“Position Statement 22: Involuntary Mental Health Treatment”). This has not generally been the situation (“Position Statement 22: Involuntary Mental Health Treatment”). For quite a long time, people with psychological wellness conditions have been fighting the hundreds of years old generalization that they are not sufficiently skillful to settle on their own choices or to be responsible for their own particular emotional well-being consideration (“Position Statement 22: Involuntary Mental Health Treatment”). Today, we know generally, that people with emotional well-being conditions are not just equipped for settling on their own choices in regards to their care, yet that psychological wellness treatment and administrations must be successful when the consumer grasps it, not when it is coercive and involuntary. Involuntary mental health treatment is a genuine reduction of freedom (“Position Statement 22: Involuntary Mental Health Treatment”).
Involuntary mental health treatment happens in an assortment of settings (“Position Statement 22: Involuntary Mental Health Treatment”). The most widely recognized sort of involuntary mental health treatment is court-requested commitment to an inpatient psychological health office (“Position Statement 22: Involuntary Mental Health Treatment”). Be that as it may, involuntary treatment additionally incorporates involuntary medication or different types of medications including electro-convulsive treatment, whether court-requested or forced by mental health experts, treatment forced upon people with mental health conditions in penitentiaries and correctional facilities or as a state of probation, supervision or parole, outpatient duty, and the utilization of guardianship or conservatorship laws. While MHA perceives that automatic treatment may now and then be vital, they do not bolster the utilization of outpatient duty with the exception of in the tightest conditions. The MHA recognizes that when involuntary treatment is applied, it should be based on certain principles and understandings that are designed to protect human rights (“Position Statement 22: Involuntary Mental Health Treatment”). People admitted into the hospital are presumed to be capable to making their own decisions about their medical care (“Position Statement 22: Involuntary Mental Health Treatment”). In order to be declared incompetent, each state has a very precise court procedure to determine one’s competency (“Position Statement 22: Involuntary Mental Health Treatment”). Informed consent is required for all medical treatment of a competent person (“Position Statement 22: Involuntary Mental Health Treatment”). Unless and until a person has been declared to be incompetent, informed consent is required when mental health services are provided (“Position Statement 22: Involuntary Mental Health Treatment”).
Persons with mental health conditions can and should be treated in the least restrictive environment and in a manner designed to preserve their dignity and autonomy and to maximize the opportunities for recovery (“Position Statement 22: Involuntary Mental Health Treatment”). Persons facing involuntary confinement have a right to substantial procedural protections (“Position Statement 22: Involuntary Mental Health Treatment”). MHA strongly agrees with the judgment of the United States Supreme Court that all persons, even persons lawfully convicted and serving a sentence of imprisonment, have a right to refuse medication and that medication may not be imposed involuntarily unless rigorous standards and procedures are met (“Position Statement 22: Involuntary Mental Health Treatment”). Olmstead principles require that non-coercive means be used before invoking the police power to compel treatment, and waiting lists show that there are inadequate treatment resources to meet the needs of people willing to participate voluntarily in their recovery from mental health conditions (“Position Statement 22: Involuntary Mental Health Treatment”). MHA urges states to admit persons to mental health facilities in the same manner as persons are admitted to medical treatment facilities for non-psychiatric illnesses (“Position Statement 22: Involuntary Mental Health Treatment”). MHA urges states to create and enforce laws which permit persons with mental illnesses to designate in writing, while competent, what treatment they should receive should their decisional capacity be impaired at a later date (“Position Statement 22: Involuntary Mental Health Treatment”).
According to San Francisco’s Health Commission, between 2007 and 2012 alone, the health department reduced behavioral health by $40 million in direct services, mostly coming out of civil service (Friedenbach, Jennifer). The majority of mental health providers and advocates oppose the law (Friedenbach, Jennifer). AB 1421 allows a family member, a roommate, or a police officer to petition the court, and through court order, drag someone before a judge where he or she is mandated into treatment under threat of being held in a locked facility for 72 hours (Friedenbach, Jennifer).
The media turned the public against involuntary treatment. One Flew Over the Cuckoo’s Nest, one of the biggest hits of the seventies, reinforced the widespread belief of everybody under 30 that the people who ran the world were the crazy ones, and the protesters, the rebels, the Merry Pranksters, and the nonconformists were the sane ones (Wente, Margaret). Doctors and nurses that worked in mental hospitals were portrayed as sadistic and evil. Today, mental illness has been acknowledged as a major cause of homelessness (Wente, Margaret). Prozac, although grossly overprescribed, hardly does much good at all; they’re barely better than placebos (Wente, Margaret).
Section IV: Conclusion
The high rates of incarceration of the mentally ill can decrease if states would allow loved ones of the handicapped to admit them into hospitals to receive treatment to avoid breakdowns. Keeping in mind the human rights of the mentally ill, there should be a balance of power between the mentally ill and their loved ones. If a mentally ill person is near mental collapse, a friend, roommate, or loved one should be able to put them in the hospital. However, if a mentally ill person passes certain tests to prove their competency, they should be able to refuse treatment. As funds for mental health treatment increase in large cities, more homeless people that are mentally ill can go to treatment facilities for help. Treatment facilities should help the mentally ill to get off their possible addictions, off the streets, and maybe even begin looking for work. If there were more programs to help the mentally ill find jobs, less would be on the streets. If there were less mentally ill people on the street, there would be less in jail. If hospitals and human rights activists could find a balance between voluntary treatment and involuntary treatment, mentally ill people could be able to stabilize and become productive members of society. Once the government begins to fund more treatment centers and job programs, mentally ill people can receive the treatment they really deserve.
Word Count: 2,384
Works Cited
“Bestselling Author and Mental Health Advocate.” Pete Earley. N.p., n.d. Web. 02 Jan. 2017. Website.
Earley, Pete. Crazy: A Father’s Search through America’s Mental Health Madness. New York: G.P. Putnam’s Sons, 2006. Print.
Friedenbach, Jennifer. “Involuntary Treatment for the Mentally Ill Is Dangerous and Harmful.” Mental Illness. Ed. Noah Berlatsky. Farmington Hills, MI: Greenhaven Press, 2016. Opposing Viewpoints. Rpt. from “‘Laura’s Law’ a Looming Disaster for Mentally Ill.” San Francisco Examiner 8 June 2014. Opposing Viewpoints in Context. Web. 28 Oct. 2016.
Locked Up. But Where? Digital image. Vox.com. N.p., 01 Mar. 2016. Web. 8 Nov. 2016.
Lopez, German. “How America’s Criminal Justice System Became the Country’s Mental Health System.” Vox. N.p., 01 Mar. 2016. Web. 08 Nov. 2016.
“Position Statement 22: Involuntary Mental Health Treatment.” Mental Health America. N.p., n.d. Web. 28 Nov. 2016.
Wente, Margaret. “The romance-of-madness myth.” Globe & Mail [Toronto, Canada] 28 June 2008: A25. Global Issues in Context. Web. 26 Oct. 2016.