Just to take Eben’s comments today in a little different direction regarding mental illness and the option of a right to treatment: I realize there are no easy answers, and my observation is that, at the time that case was decided and especially prior to it, I’m not sure that this “right,” if exercised, would have produced even close to the type of result that people afflicted and their loved ones hope for. Having a mother who spent most of her adult life in and out of mental hospitals and halfway houses, my impression of her “treatment” options from the 1950s on – shock treatments, drugs that induced the incapacitating stupor that simulates the “incapacitation” that prison sentences produce – was that they were not options that most people would seek out, if given a choice. My sense is that for most people who are considered severely mentally ill, “treatment” options have historically been ineffective (but, new drug options give me hope). What I do think would have benefitted those who are mentally ill far more than the right to “treatment” would have been the right to free housing, necessities, and transportation. Not that I think one should be denied treatment. It’s just that treatment, as it was known leading up to and at the time of the decision, didn’t amount to much in terms of benefits to the recipient and, despite researchers’ efforts to find more effective drugs, ended up producing benefits largely to others in the form of “social control” rather than increased functionality to the patient. Maybe my impression is skewed, though. If so, what am I missing here? Eben? Others? Any thoughts?

-- BarbPitman - 31 Jan 2008

I agree. I wonder, however, what a change in the law would have done to that reality. If treatment were a right, perhaps additional resources would have been invested in figuring out how to treat people effectively.

-- AdamCarlis - 31 Jan 2008

I agree with Barb. I worked for some time in Washington, D.C.'s St. Elizabeth's Hospital investigating the claims of patients who had been committed against their will and the biggest issue which prevented us from winning a hearing on their release was not the fact that they were a danger to themselves or to others but that they had nowhere to go. Working with the Public Defender Service, one of my primary duties was to contact social workers who would help us house our clients, who had been held against their will in a less than humane environment. Many of them were elderly and going through the stages of dementia. Some of them had experienced trauma in their lives and were self medicating themselves with drugs bought on the street. An even greater number of them, however, were homeless people that the police brought into the hospital in order to get them off the street. We could always count on an influx of patients at winter time. This is not to trivialize the need for the government to provide treatment for the mentally ill. Not at all. However, in my experience, the mental hospital also serves as a dumping ground for undesirables. Some of which had treatable mental illness which the staff could confront. A good number of them, however, had no evidence of a mental illness or they had some physical illness brought on by drug use or,in one case, a traffic accident which affected their mental state in some way. Actually, one patient I remember had been brought in because he had been crying in public and cursing God. He had recently lost his whole family in New Orleans due to Hurricane Katrina. He had no where to go, and only by the generosity of a half-way home which expanded their living quarters were we able to get him released and into a new situation. If our society provided a better infrastructure for those who had fallen on hard times and become homeless,provided better medical treatment for drug addiction, and took care of those elderly persons who can no longer afford their homes or their prescriptions then I think we would not have so many mis-diagnosed and forgotten patients in mental health facilities today. Until we address those "social work" type issues there is no effective treatment for making those who society labels as "incapable of living independently", capable again.

-- JenniferClark - 31 Jan 2008

This is an important question that needs addressing. There are always going to be people who, for whatever reason, can't 'succeed' in the market. What are we, as a society, going to do with them?

Insofar as we are a civilization, it seems we ought to provide for them. There is no inherent justification for a market economy - we picked it because we believe it works best, but where it clearly fails, shouldn't we have other solutions?

-- ErikaKrystian - 1 Feb 2008