The Post 1/8 World Will Be Whole New Version of Crazy

Questions are coming up about the last couple years for Jared Loughner. His fellow students sat near exits "just in case he brought a sub-machine gun." The college dismissed him and informed his parents that he could only return after a psychological assessment. Police knew about him. The warning signs were plain as day. Still: he could buy a gun and ammo. He was completely unwatched until it was too late.
Police are now serving as frontline social workers and de facto psychologists. And, why not? Psychology is as much about social mores as it is about mental health. And crimes are relative the society they apply to. Crime, social norms and behavior are all relative. When you take things to their cold abstractions, many psychological disorders get applauded when the time is right:
  • When someone is praying and demonstrating their faith, are they asking for wish fulfillment from an imaginary super being?
  • When Loughner leapt out, mowed down a politician, a little girl, a judge and many others, we was seen as the pinnacle of crazy. If he had jumped into a throng of Taliban leaders and villagers and mowed them down, it would be just another day.
  • Going to work so that people that give you slips of green paper that you can give to others who also think the paper is special (aka cash)-- does that seem sane? Would you work for paperbacks or issues of magazines? No: working to get a stack of Elle back issues would be crazy.
When someone commits a crime, they are largely committing a social transgression. When they do that, it's either because they are detached from the social norms and don't appreciate the impact of their act. In some cases, they are gaming the system: they don't appreciate why a stereo in a car is necessarily someone else's. If they were in-line with the general societal norms, they wouldn't steal, do drugs or harm others. Their sense of decency would kick in and they would not commit crimes.
If crime has mental illness at its core and police are out there to fight crime, police are countering the manifestations of mental illness.
It has become much less abstract though: the image of the mentally ill person has shifted. Two generations ago, they were institutionalized in deplorable conditions, drugged and given shock treatment-- generally boxed up. Political correctness made us see that the mentally ill are people too. Counter-culture movements made us accept people outside of the straight-and-narrow. Showing up at the office in blue jeans went from pariah to tolerance to applause as hipster culture and nerd chic cemented in our mindset. Big Pharma saw they could cash in by medicating the mentally ill. Mental illness is such a big business that there are more people on anti-depressants in America than there are people living in the whole of Canada: talk about a Prozac nation. If the world around you sucks, you don't need to acknowledge that: just take some drugs and get back to work.
Housing the mentally ill is expensive, resource intensive and now politically incorrect. Nursing schools only turn out so many graduates. As our population ages, there are more beds for aging Boomers than there are the mentally ill. A mentally ill person who may rarely demonstrate dangerous behaviour still needs 24x7 care in an institution. On the street, you can play Russian Roulette: an occasion of danger may rarely sync up with an opportunity for massive harm.
With all of these advents and the Reaganomics of the early 1980s, the mentally ill left the institutions and entered our society. Children with developmental issues and/or mental issues mainstreamed into our schools. Schizophrenics were drugged into a stupor and put into our workplaces. Just try to get a random handful of people into a room wherein no one is on anti-depressants. Mental illness is common.
The problem is that this doesn't entirely work. The drugs may not work well for some people. Maybe they hate the side effects. Maybe the side effects convince them that they don't need the drugs. After 30 years of career musical chairs, people either don't have health insurance in the US; or, they are working somewhere new-- somewhere where they arrived with a pre-existing psychological condition that may not be covered by their health care. Without drugs, some people go off the rails really quickly. When they skid off the rails, they land on the street.
Life on the streets combined with our overly legislated society means that the honestly mentally ill very quickly butte up against law enforcement. Police are put into the role of social worker. Police are not often hired for their IQ but for their neck size. They are not well equipped for that role of street psychologist. In sleepy Victoria, this has resulted in a number of deaths of mentally ill people at the hands of police. Last week, a brain damaged driver was kicked in face by the RCMP because he was slow to comply with their demands. Put into this position, the police are killing off the handicapped and mentally ill people they encounter.
If we normalize their role and turn police back from health care workers and back into law enforcement, the next line of defense for the Jared Loughners of the world will be psychologists and social workers. Unlike police, psychologists have a code of conduct and they need to adhere to confidentiality. If someone says to their psychologist that they want to kill people, they are obliged to act. But if the warning signs are vague, the reaction is also vague. All the way along, psychologists are hard pressed to not violate doctor-patient confidentiality. What's a mental health care worker to do? They can learn from other industries.
When you are turned down for a bank loan, you are just told that the credit report came back bad: the loan officer is not supposed to show you the itemized details of your financial wake. I usually cajole my loan officer into a peek. It is my information and it shapes my fate, so I feel entitled to see it.
Lots of people cannot fly because their name appears on a secretly derived list. When children were ending up on No-Fly lists at airports, people started asking "How did they end up on this list?" The answer is that the qualification for getting on the list is masked. You cannot get to the chain of information that leads to the No-Fly list. You are simply on the list or not. The layers of confidentiality are retained.
Psychologists can take the same approach and they will want to do it. Hiding behind their code of conduct and confidentiality is cold comfort to the victims of their patients. The demarcation line between psychologist and astrologer would start to evaporate if psychologists had to guess about people's inner thoughts in lieu of candor. Yet they cannot survive as an industry if they keep getting advance word of murderous rampages without so much as saying, "Duck!" A professionally issued but unspecified warning is the compromise that keeps their industry alive and well. Using their bona fides as health care professionals, they could declare people as being a risk to others, do so without justification, and quietly filed away where the information can be found-- like an appendix to a criminal record check. If they start to justify their claims, a psychologist will violate doctor-patient confidentiality. If there is nothing wrong with you but you get branded as dangerous, listing no problems is the same as not sharing any problems. The psychologist or social worker who declares you as such can't say a peep about their decision. Psychologists can hide behind the rule of confidentiality and take the medical equivalent of the Fifth. In the case of Jared Lee Loughner, they could fill out a form, stamp it and suddenly put the likes of Loughner under a spotlight prohibited from buying guns and ammo; or being put into a position where they could endanger others. The downside: this abbreviated process could hit anyone who was considered worthy of such a ban. Have the same name as someone labeled crazy: you get labeled crazy-- sort of the equivalent of one of those toddlers who ended up on a terrorist watch list. If you got such a mark on your record, you would have to run afoul of the list and its impact before you'd know you were tangled up in the system. That would be crazy.


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