When Mental Hospitals Resemble Jails

prison

A friend recently forwarded me this article from The Atlantic, arguing how the Cook County Jail in Chicago could be considered the “largest mental-health facility” in America due to the high percentage of inmates who have received or are eligible to receive mental illness diagnoses, as well as the massive size of the jail itself. The article examines the appropriateness or lack thereof of such an arrangement, mentioning an added layer of mental health screening, jail diversion options, and the admirable amount of “advanced mental health training” that the prison staff receives.

What immediately came to mind for me was not how jails can sometimes resemble mental health treatment centers, but how mental health treatment centers can come to resemble jails. I will share a true anecdote from a psychiatric hospital in a certain city in a certain Southern state in the United States. Without revealing too much, I will say that this particular state received a D grade for mental health treatment from NAMI in 2009.

The sad tale: An older woman of Asian descent, having immigrated with her family to America decades ago, receives regular government disability checks. Her physically and emotionally abusive father and sister demand that she turn this income over to them. If she refuses, they retaliate by having her committed to a hospital for being “crazy.” She is placed on a geriatric unit with older, far less functional individuals with dementia – many of them sleep through the day on heavy medication cocktails or are even placed in restraint chairs. Because English is not this patient’s first language, she has difficulty communicating her needs and story to the nurses and psych techs, and they often dismiss her as an annoyance. A rotation of fly-by-night psychiatrists have pressured this woman into receiving electric-shock therapy, a procedure that she hardly understands and instantly regrets. She complains of shooting pain throughout her entire body that makes it hard for her to sleep in the days afterward. Her involuntarily commitment order has long expired, and so has a follow-up legal request to hold her against her will. The doctors, nurses, psych techs, and social workers are ignorant of the actual legal steps to extend a legal hold, and no effort has been made to provide legal representation, or to inform the patient of her rights. She waits in an illegal, unethical state of limbo for over a month as she continues to receive pressure to conform to invasive and harmful procedures from medical staff that know almost nothing about her. Nobody cares. Nobody takes action. The facility never faces a single consequence. When insurance stops paying, the patient is discharged back to the home of family members who steal her money and beat her.

America’s Overmedicated Kids

overmedication

My first exposure to the impact of psychiatric drugs was in 4th grade. A classmate named Joshua, from a Jehovah’s Witness family, sat alone in the large grass field at school. Formerly more or less behaviorally on par with the rest of us elementary-aged boys and girls, Joshua was now sullen and isolated, spending all of his nutrition and lunch periods searching for four leaf clovers. He told me he was taking something called Ritalin. I have many memories through the years of other classmates from that time – how their personalities developed, what they ended up doing with their lives, etc. For Joshua, my memories end with him sitting in that field. He had become like the residents of the Doldrums in ‘The Phantom Tollbooth,’ a book I had read that same school-year, stuck in a ‘colorless place where thinking and laughing are not allowed.’

In an article on Governing.com, Chris Kardish reports that “more kids in the U.S., especially low-income and foster-care children” are on psychotropic medication than in any other country. That claim comes as no surprise to me, with our quick-fix mindset, our politically correct inability to blame anyone or anything for personal problems, our naturalism-materialism worldview that cannot conceive of anything other than a bio-genetic-evolutionary basis for mental distress, and our crumbling social infrastructure of intact families and the middle class.

The article is well worth a read. It primarily focuses on the increase in psychotropic prescriptions among low-income and foster-care children in the state of Kentucky, but touches on other states as well. Here are some highlights:

  • “I remembered thinking you shouldn’t be on more medications than your age.”
  • Children in the United States are on drugs for longer and more often than kids in any other country.
  • Between 1997 and 2006, American prescriptions for antipsychotics increased somewhere between sevenfold and twelvefold, according to a report by the University of Maryland.
  • A researcher at the University of Kentucky found that antipsychotic prescriptions for Medicaid children had increased 270 percent from 2000 to 2010, compared with 53 percent among adults.
  • “We’ve reached the limits of medicalization,” says Julie Zito, a professor of pharmacy and psychiatry at the University of Maryland. “We’re medicating poverty.”
  • Brenzel and others suspect that many of Kentucky’s prescriptions come from primary care physicians who haven’t performed comprehensive assessments to prove the drugs are appropriate.
  • … “atypical antipsychotics” promised better results with fewer side effects (both claims have been disputed), and aggressive marketing made them a common fix for routine depression and anxiety.
  • Children over the past decade have increasingly been given antipsychotics to combat aggression and other behavior problems, which are unapproved uses.
  • … the U.S. prescribes psychotropic meds at two times or three times the rate of Western European countries.
  • [In Connecticut, a report showed] a threefold increase in amphetamine prescriptions and a fourfold increase in antidepressants. Some of the children receiving prescriptions were as young as 3 years old.

Read the full article here.

The Perfect Bible Design

book-hi

I own approximately 18 Bibles, and that number is steadily rising. Bibles are certainly better things to collect than, say… souvenir shot glasses, but why bother? Every time I get excited about a new Bible purchase I start over at Genesis 1:1. And then I get anxiety about having to choose between which Bible to “remove” from my collection and tote around. Plus, there are the impulse buys with the risk of buyer’s remorse (Manga Bible NLT, anyone?) If the most important Bible is the one you read, what practical benefit is there to hoarding so many physical copies of God’s word?

Maybe I just haven’t found “the one.”

Sure, I’ve got my go-to travel Bible. I have my ultra-deluxe Bible that my progeny will someday inherit. I have my wide-margin Bible for jotting theological notes. I have several niche Bibles that fulfill very specific purposes. But what I really want is “one Bible to rule them all.”

As far as I can tell, my dream Bible does not exist. Not yet. But if any Bible publishers are out there reading this, here is my shopping list:

TRANSLATION: New American Standard Bible – forthcoming text update (NASB3?) or the Lexham English Bible (LEB).

BINDING: Black Highland Goatskin. Smyth Sewn. Semi Yapp. Three ribbon markers. Art gilt.

PAPER: 38 GSM Tervakoski Thinopaque Bible Paper with 84% opacity.

PAGE DIMENSIONS: 9 1/8 x 6 1/4 inches (235 x 160mm).

TEXT: Single-column. Paragraph format. Black text. Line-matching. Ideally, I would like a format identical to the ESV Reader’s Bible except for the inclusion of verse numbers (so perhaps closer to the ESV Single Column Heritage Bible). No text notes, cross-references, section headings, etc.

Nowadays it is possible to approximate certain aspects of my dream Bible using Bible apps and websites. But let’s face it – the perfect Bible should not require batteries, power cables, screen protectors, or WiFi. So, until a visionary publisher or Kickstarter entrepreneur creates my perfect Bible, I will have to keep playing Goldilocks. This one’s paper is too thin… this one crowds the gutter… this one has a lousy text block printed in China… this one has red letters… this one capitalizes divine pronouns…