Review of “My Brother Ron” by Clayton Cramer

February 28, 2013

Perhaps nothing better illustrates the modern notion of “freedom” better than an anecdote from the annals of deinstitutionalization:

Joyce Brown, aka Billy Boggs, a homeless person living on the streets of New York City in 1987, became something of a poster child for where this abstract theory of Constitutional rights led. Her behavior was clearly psychotic: “She urinated and defecated on the streets, . . . ran recklessly into heavily trafficked streets, and exposed herself when assistance was offered.” . . . Brown was sleeping on a steam grate in freezing weather, and the city authorities hospitalized her against her will. The New York Civil Liberties Union filed suit, arguing that her essential dignity [!!] as a human being was being denied by her involuntary hospitalization, and the she should not be forced to take psychiatric medications against her will. Rather than seeing her living conditions as a sign of mental illness, the NYCLU characterized it as “a fearless independent life style” and the courts agreed.

How free are you unless you can smear your own shit all over yourself in the middle of the city? What sort of human dignity is left if someone is prevented from doing this to herself?

Thankfully, Ms Boggs only hurt herself and caused minor inconvenience. Nevertheless, one can’t help but feel that a society which actively defends and seeks to perpetuate this sort of behavior is extremely ill.

In certain cases, the results are much worse:

Seung-Hui was allowed to “commit himself.” The next day, Seung-Hui left the hospital, and soon he was back on campus, living in a world of paranoid schizophrenia, culminating in the largest gun mass murder in U.S. history.

Clayton Cramer’s – an interesting guy in his own right – book is really split into two parts. Part of it is a history of the treatment of mental illness in the US. This part covers how patients are treated, what the medical profession thinks of mental illness, and how the courts have treated the mentally ill. This part is heavily footnoted and somewhat dry, but it’s a totally serviceable summary of some broad topics.

The other part of the book is about Cramer’s brother, Ron. Ron is a schizophrenic. Ron and his family have had to pay the price associated with changing views, policies, and legal restrictions associated with the mentally ill. This part of the book is really good. Some of Cramer’s anger slips out, but all in all, the personal story sucks the reader in.

A hundred years ago, mental illness was poorly classified and the mentally ill were institutionalized. Cramer shows that the stereotypes associated with institutionalization are not necessarily true. For example (to pick one of many), “A study of 15,000 patients admitted to Pennsylvania’s Warren State Hospital between 1916 and 1950 found that 42 percent of first admissions in the first period 1919-1925 were released within a year.”

This bias toward institutionalization changes to what amounts to a prohibition on institutionalization. This push for deinstitutionalization was led by social activists, civil libertarians, some doctors and the courts.

Here’s Cramer’s description of the views of the social activists who led the deinstitutionalization charge:

The CMHC (Community Mental Health Centers) movement believed that preventing mental illness meant preventing the environment that caused mental illness. This meant going after capitalism, poverty, and racism, which many of the CMHC advocates and activists had persuaded themselves caused the disproportionate mental illness of inner cities. . . . The mental health care system “must encompass some effort at changing the basic racist background.”

The charge was also led by groups like the ACLU, who used the courts to essentially make institutionalization prohibitively expensive. For example, Wyatt v. Stickney gave the mentally ill a “right to treatment” and specified how many employees different job classifications the state mental hospital had to have per patient (it’s right there in the Constitution, obviously).

The courts were happy to oblige even though it often led to terrible results:

In 1982, Rebecca Smith, who had been in a mental hospital, and refused to go back, lived in a cardboard box on the streets of New York. She refused all assistance. While New York City authorities were attempting to get a court order to bring her out of the cold, she froze to death.

The legal status of the mentally ill becomes quite confusing. “If a person accused of a crime was not sane enough to stand trial, could he be held indefinitely? Could he refuse treatment? What if, by refusing treatment, he would never be well enough to stand trial? If a mental patient had a right to treatment, but refused it, to avoid trial, did the state have the authority to continue holding him?” What if not guilty by reason of insanity? . . .

The result seems to be a situation in which only the mentally ill who are well enough to know that they’re not well actually get help.

The results of deinstitutionalization are not pretty. A 2000 study of rampage killers found that, “of the 100 rampage murderers, forty-seven ‘had a history of mental health problems.’” Another study found “an astonishingly strong negative correlation rate between the institutionalization rate, and the murder rate: -0.78.” Prisons suddenly became filled with mentally ill prisoners.

Less dramatically, there are lots of personal stories that are profoundly tragic. Including Cramer’s brother who leads a tragic and occasionally violent (including attacking his mother) life. He’s arrested multiple times, but never held. His brother manages to get help now and then, but policies change the few times that something seems to actually be working.

As time wears on, it becomes difficult to find doctors to treat patients on the outside. “As even a 1984 American Psychiatric Association report admitted, psychiatrists willing to work with the chronically mentally ill were in short supply.”

To cut to the chase, there seems to be a relatively readily identifiable group of people who need someone to take care of them. The choices are the state/community, family or nobody. We’ve chosen the nobody path (unless someone is lucky enough to have their family help, but in that case, the family’s efforts are often thwarted by the legal “rights” of the mentally ill).

The results are what they are, from mass killings, people starving themselves to death in subsidized apartments, or streets filled with people exercising their Constitutionally protected rights to piss in front of all of us. The future doesn’t look bright.


Learn to take (and give) shit

February 27, 2013

Someone recently asked me for some non-generic career advice. My advice was to learn take and give shit. Beyond the fundamentals, nothings served me better than some friendly shit-giving.

Frankly, this skill goes beyond work (it’s a life skill). I consider good friends to be people that I can make fun of and who can make fun of me without feelings getting hurt and offense being taken.

When I think of this skill, I immediately think of a scene from Gran Torino here

At one point after I had been working for my current employer for a while, my boss’s boss came by to ask me to go to something with him. We’d had a little bit of a back and forth before then. On the way, he told me I was too young to be going to this particular meeting. I said something like I’m getting older faster than you’re getting thinner. He told me I was an asshole and then he brought me everywhere he went.

Obviously, given modern taboos, this sort of relationship is only possible between people of the same sex, race, sexual orientation, etc. No one ever seems to discuss the fact that the threat of lawsuits means you can’t really ever get too close with some of your co-workers.


Review of “Wool (1-5)” by Hugh Howey

February 26, 2013

What can I say about a book that has a five star rating on Amazon with almost 4,000 reviews? Especially since the movie rights have already been sold.

The books are all self-published (spoilers in the wikipedia page). I think this is a hugely important development. Certain art forms – particularly books and plays – have a disproportionate impact on culture. The more self-publishing the better, as far as I’m concerned.

It’s basically impossible to even begin discussing the book without giving away parts of the story. I’ll just say that it’s fun and entertaining sci-fi. I don’t think it’s particularly fascinating, but it’s good stuff. It sets up an interesting question of whether the truth is better than a well-intentioned lie, but it’s too soon to say whether it’ll answer this question in an interesting way.


What to do

February 26, 2013

There’s a lot of hand-wringing in these parts of the interwebz about what reactionaries should do.

I have no idea. I certainly have no grand plans to change the world. I like knowing what’s going on around me and I like open discussions – i.e. ones that are not choked to death by political correctness.

However, if I were to suggest a plan, I’d say tell the truth.

Start a wiki in which people can track changes on The Constitution so that the text actually describes how the document is currently interpreted.

Explain in simple terms how the Federal Reserve works. Shouldn’t the last two rounds of QE have actually reduced interest rates instead of just getting crappy assets off banks’ books?

Create an honest list of protected groups.

Create a list of people who are white and who are various shades of not white.

The possibilities are endless, and the results are often pretty entertaining.


The mandarins

February 26, 2013

Arnold Kling rounds up the latest articles criticizing the ruling class.

There are two ideas about the elite/lower-class divide that seem to be held by people who think about these issues.

The first idea, expressed in these posts, is that the elites need to spend more time with the lower classes so that they can (I’m not precisely sure about this) speak the language and understand the problems of the lower class. Speaking such language more broadly would be a terrible development and the problems of the lower class are not particularly difficult to understand. Anyway . . .

The second idea, best expressed by Charles Murray (though I doubt he’d put it the way I would), is that lower classes are basically falling apart. Murray seems to believe that the lower classes would benefit from exposure to the upper class, because the upper class still lives in a productive way.

On one hand, elites need to understand the poor so they can better help the poor, on the other hand, the poor need to see the example of the elite staying married, working and participating in civil life.

I see a few big problems with these ideas.

Obviously, they’re wildly unrealistic. Why would elites volunteer to spend time with an increasingly dysfunctional lower class? Even if you could convince a few, I’m highly skeptical that more cross-class exposure would actually do anything.

If you really read Murray’s work, I think you can’t help but draw the conclusion that the differences between the upper and lower are becoming more well-entrenched. Worse, as the lower class gets worse, the problems get harder to fix (though not even remotely difficult to understand). How do you fix the problems of an unmarried, unskilled, uneducated woman with a bunch of kids, especially if she’s never known any other way of living?

Finally, it’s not clear to me what’s supposed to happen to elites as they gain exposure to the lower class. Does exposure to increasing dysfunction make for better government or policy ideas? My own minimal exposure to the lower classes has made think that their problems are largely (and increasingly) insoluble. It certainly hasn’t left me with lots of good policy ideas (other than the obvious and unmentionable ones).


Randoms

February 26, 2013

– A good long article about the suicide of a census worker that the lefties tried to gin up into a right-wing violence story.

The price of progress is truth

– Bryan Caplan discusses how minorities vote. Hilarity ensues: “Indians vote Democratic because they correctly sense that Democrats respect them more.”

A apostate on libertarianism.

IQ variance.

– “The agenda of Outside in is to cajole the new reaction into philosophical exertion.”

– The student loan crisis is way overblown.

– A glimpse of the future (thanks to a reader).

– Do humans yearn to be free:

You begin to see that when life becomes unsettled, when there are dangers, especially that people cannot understand. It’s then that human beings tend to look at solutions to these problems that typically involve restricting freedoms. In other words: when life gets rough, the need for freedom, or the impulse for freedom, which is real —it’s part of the human constitution you might say— tends very commonly to be eclipsed by other needs. These can simply be for security, or they can be darker needs to bolster up an identity to attack, marginalize, or even exterminate others. These are all classic human responses. The idea that humans are by nature free is one of the most harmful fictions that’s ever been promoted anywhere.

– New Kipling poems.

– It’s probably gauche to link to someone linking to me, but whatever.


Randoms

February 25, 2013

– Say what you will about Berlusconi, but he understands democracy almost as well as he understands women. I think these things are probably related.

– Round-up of thoughts on WWI.

– If your policy idea makes Lee Kuan Yew “chuckle[] for several seconds at the idea,” you might want to pause for thought. More from Mr Lee here (subscription?)

– On paperwork:

But feeling powerless and actually being powerless are not at all the same; blurring the difference between the two may be the most far-reaching ideological function of frustration with bureaucracy.

– Lots of economists seem to support a higher minimum wage and that policy seems to be contradictory to simple economic theory. What should one therefore conclude about economists?

The Barbarous Years.

– The first one that I would have named is Earth Abides.

– Review of Flashman

Beards