Tag: Mental Health

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Mean Girls and Bullies are a reoccurring theme in any depiction of American adolescence. They always seem to pop up as a potent, almost dictatorial, presence in high schools. They also seem to land at the top of the school hierarchy which, given their nastiness, seems odd. It baffles me.

Think about it. On the first day of school the teacher doesn’t announce to the class that you are going to start dividing yourself into people you like and people you don’t like. Some of you will get invited to all the birthday parties, others will not. Suzy will be the chief mean girl and Bill is the big bully. Let the school year begin.

It is a hierarchy created by the kids. It is cruel. It is pervasive and it is has an effect on a child’s life.

Adults can try to mitigate the social hierarchy but it happens regardless of their best efforts. Adults can tell kids to be respectful but how does a school control the in crowd and the out crowd. The creation of these groups, be it — Jocks, Nerds, Cool Kids, Stoners — is an act of group self-creation. Adults don’t make the decision.

How the hierarchy all sorts out is a mystery to everyone but, perhaps, the group itself. In reality, there may not be any rational explanation other than this is the chemical reaction of this particular group of kids.

The two things that interest me here is why does it happen at all and why do the same type of kids (jocks and cheerleaders) end up at the top and others (nerds and goths) end up near the bottom. The story, the one you see in the movies and read in books, always is the same. Mean Girls and Jocks take over and end up at the top of the teenage hierarchy.

This would seem like an unimportant detail. Who cares why some kids rise to the top and other kids don’t. It is just school but I am afraid it is very important because mean girls and bullies continue their reign of terror throughout their lives.

Explain Trump. He is a bully. Why is he tolerated? Why are people still willing to work for such an asshole even though he has made everyone perfectly aware that he has no loyalty to anyone except himself?

Maybe the whole problem with Trump, particularly for the people who are immune to Trump’s charm, is trying to find a rational reason for people putting their faith in such an asshole when it is more of an instinctual thing — irrational and subconscious.

He is the silverback who beats his chest in the most convincing manner and to our ape selves that is all that matters.

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Another assassination attempt was made on Donald Trump. The Secret Service shot the man down. Early reports about the shooter are depressing. He thought he was God so I am not sure whether he had a coherent world view which prompted him to take this action but I doubt it. People who think they are God are uniquely incapable of coherence so this leaves us with crazy.

Early in the week two teenagers stormed a San Diego mosque — killing three people and then themselves. They hated about everybody, given the way it turned out, even themselves.

I don’t know what to do about the crazy people in this country. As a nation, we have pretty much decided to lump them in with the regular citizens which means they are left to their own devices. They can own guns, sleep on the streets, do whatever the Hell they want until they cross a line and then, in the worst case scenario, they are gunned down.

This is how we want to live and, lets be clear, no decision is a decision. We would rather have the occasional blood letting to addressing why unstable people with guns keep creating such havoc. Limiting gun availability is off the table. Let’s face it the 2nd Amendment makes this impossible. Furthermore there are too many guns out there now and there would be way too much resistance to confiscating guns to make it worthwhile. It is, for now, off the table.

But what about the other part of the equation dealing with all the crazy people. Well, this would require political will and money. Why this is controversial is beyond me? Mental health requires some level of preventative measure. Identify the people who are sick and get them the help they need before they break.

Think physical health. For example, we can control high blood pressure through medication. The first step, though, is identifying people suffering from it before we can help them. The same practice apples for mental health. We need to know who needs help.

But freedom, people shouldn’t be forced into a psychological check. We could require a yearly psychological check as a part of having health insurance. This would, at least, help us address the vast majority of the population.

Who is going to pay for all these checks? The government or the insurance companies? Forget I said anything.

So you see nothing is going to happen. We just have to accept that mad men with guns will be walking the street until they break and then after they are done killing, we will kill them or they will kill themselves. A little messy but the problem is solved without raising taxes.

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The other day, I was discussing how violence seems to be a part of human nature. There is something about violence that attracts humans both to participate and to watch. It is an irrational strong urge and, because of that, must be fed in some way. My speculation there got some confirmation today when I saw this post about chimps getting violent. Scientists are mystified on why these chimps, who were co-operating in the past, now were attacking each other. There is some talk about resource sharing but nothing seems to explain this sudden violent turn. On the face of it, it seems irrational.

The problem here might be trying to find a rational basis for this violence. Maybe there just isn’t any good reason other than animals sometimes have to express themselves violently and that, humans being mammals, the same irrational instinct is present in us. Why do football players continue to play football when there is substantial evidence that playing the game damages their future health. People stopped smoking after they learned more about tobacco, why hasn’t the same turnaround occurred with football.

Which makes me think our whole strategy on violence might be misdirected. Our base assumption is that nobody wants violence and, logically, this makes sense. Who wants to have their bodies beaten up? Who wants to watch this type of game? But, the truth is: people do want to participate and they do want to watch. Perhaps what we need to do is find a way that people can express these violent urges without, or at least limiting, the physical pain to other humans.

I know that violent video games have a bad reputation for the dehumanization of people but it is infinitely preferable to killing and maiming actual human beings. What I am saying is maybe we need to expand our tools in dealing with violent behavior. Yes people shouldn’t want to hurt other people however our very nature might predispose us to some forms of violence. How do we do we deal more effectively with that reality?

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Every time there is a mass shooting I have this momentary reflexive fear that the killer might be someone who I agree with politically because partisans will say that the problem is the politics of the person and not say something more directly responsible like guns. It matters why the person doing the shooting, did it. But, it doesn’t matter. All mass shootings are bad and the killer’s reasons are irrelevant. You can’t ban white men or trans people for the matter.

No one reason can explain every mass shooter’s motives. The shooter’s politics changes from instance to instance. The killings, however, continue. Of course, the recent shooting at the Minnesota Catholic school have charged partisans up and the problem is either white men or trans men depending on the political agenda of the writer.

Unfortunately, these identifications are unhelpful in helping prevent future mass shootings because the vast majority of white men and trans people aren’t going to shoot Catholic school children praying in church. In fact, 99.9999% of these people will never shoot children at any point whatsoever. So what makes this small number of people break, take up a gun and shoot strangers for no good reason?

The availability of guns is part of the problem. There is very little that can be done here as there is constitutional protection to carry arms, it is difficult to change the Constitution and there isn’t enough public support to even bother. So Gun Laws will not change. Any solution that calls for this is doomed to failure — at least right now. By all means, continue to bang your head against this wall but you are only going to get a bloody head.

These leaves us with addressing the mental health element which is another part of the problem. People who want to kill small children, for whatever reason, are mentally ill. There is no question in my mind and I think most people would agree with that. The question then becomes how do we stop crazy people from using their guns?

The most difficult hurdle to clear would be an acceptance that people need to submit to mental health assessments — particularly young people who are more susceptible to this type of behavior. This also involves a more restrictive take on mental health. Right now most people would say that going for a mental health check up is an option and not a requirement. You are free to be a crazy person — no matter that you are living on public sidewalks, no matter that you are a schizophrenic carry an AK47. Until you are actually hurt someone, you are free to be as crazy as you wish.

Personal rights and public safety are difficult issues to balance. I would argue because we have constitutional protection for gun rights than the government has a responsibility to assess a person’s psychological ability to responsibly carry them. It becomes a health issue instead of a gun rights issue. Every year of high school, every student needs to take a psychological evaluation. Not only could this help with mass shootings but also may help address homelessness, drug addiction and array of other social problem before they become serious problems.

If mental illness is the cause of school shootings then what is the mental health solution? So far the political class seems mired in pointless struggles about gun control and finger pointing at the the other side’s toxic politics neither of which is likely to change. What if we determine that good mental health is a personal responsibility and if we, as a country, can get early intervention with this very small number of people willing to shoot down small children we can address this without affecting anyone’s right to bear arms?

But you don’t have a right to be a crazy person — whether that manifests as shooting up a school or sleeping on public sidewalks.

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So another school shooting in Georgia. Tragically, the FBI actually had this boy on their radar, interviewed him and everything. Yet he still managed to go on his rampage. However, unlike other school shootings, the authorities were on the right track before the massacre and might have prevented it which makes this one worth more than the usual shrug of the shoulders and sigh of deep regret.

It is pointless to bring up new Gun Laws because it just isn’t going to happen. Hearing people saying this wouldn’t happen if only we had right Gun Laws. Right. Keep talking but the right people aren’t listening. It is doubtful that they ever will. Easy access to guns, even for adolescents and mentally ill people, is something that a significant portion of the American Electorate is willing to live with coupled with some ambiguous language in the Constitution makes new gun laws difficult to implement.

I do like the approach of holding parents responsible for the actions of their children. Michigan recently punished the parents of the Oxford High shooter and the father of the Apalachee High School has been arrested on charges too. Parents are, at least in theory, the adults with the most contact with their child. If a parent is worried that their child is dangerous and has access to guns, they have the responsibility to stop that child from using those weapons. This allows the parents to still own guns but puts them on notice that they will be held liable if their child uses those guns illegally. It is a very small step in the right direction.

Unfortunately, it is a reactive measure. The damage has already been done. Is there a way to stop the child from acting and this is where this incident gets interesting. The FBI questioned both the boy and his father about the boy’s intentions. Reading the transcript of the FBI’s interview is heartbreaking because the father claims to have talked to his child about school shootings and was convinced that he understood it was wrong. This is where it stopped though. The father reassuring the cops that nothing would happen.

I would be curious to know if any mental health examination of the child occurred. Nothing, so far, would indicate that one happened but diagnosing mental health issues might be a way to prevent some of these massacres from happening. It would be difficult to argue that someone suffering from schizophrenia has a right to bear arms. If someone is hearing the voice of God and brandishing weapons, I think most reasonable people would say the government has a right to intervene.

It also might encourage a more robust mental health care system. The present mental health system is based on family or self-diagnosis before the person breaks. The mentally ill child might not be the best person to measure his own sanity and parent’s might succumb to wishful thinking about their child. Since most mental illness begins to appear during adolescence and children are required to go to school until 16, a massive program of mental health diagnosis for middle and high school students offers a rare opportunity to comprehensively complete this task with some possibility of success.

This could address an array of mental health issues that the country is facing besides school shootings — homelessness, drug addiction, and alcoholism all have a mental health component and could be addressed. Presently, some school districts require medical examinations and immunizations. Adding a mental health aspect makes sense because children are moving into the adult world, knowing the mental health of a child would give both parents and the schools an opportunity to address any potential issues before they get too far out of hand.

Is this a perfect solution? No. Will it be cheap. No to that. There is no perfect solution and I think it is long past due that we expect policy to be perfect. If that is your criteria, then it will never be met and nothing will ever get done. It will be a first attempt to detect mental health issues in children and to make addressing these mental health issues a public responsibility. A good citizen has an obligation to address mental health issues in themselves and in their families before they become a public danger.

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My doctor and I have been working on the best way to handle my acid reflux. Antacids work but some are better than others. The one that I have had the most success with can also damage the liver. Our discussion turned to what do I do if the new antacid fails to work. He said then I would have to make a decision – is the toxic antacid worth continuing for relieving the symptoms of my acid reflux or should I take the less effective and less toxic antacid and learn to live with acid reflux which also carries the possibility of esophageal cancer. What is the better choice then — liver problems or esophageal cancer.

As I get older, I’ve been noticing that a lot of my healthcare decisions are like that — the choice isn’t an obvious good versus an obvious bad. It is two imperfect choices where I have to sort through the information and weigh the good and the bad to come up with an answer for me. Which got me thinking of chronic pain and addiction. There is this default preference for living with the pain over becoming an addict.

But why, particularly if the choice is being unable to have a normal life because the pain is too great versus living with addiction and having a normal life. The important question here is what makes the person more functional. Can they enjoy their lives with the pain or is it better lived with the addiction? There is something in the American Mind which fights the idea of addiction. Addiction is bad. Addicts ruin their lives and the lives of their families. At all cost, we must avoid addiction.

But can addiction be better than the alternate.? And, importantly, can addicts lead normal lives while addicted to drugs? Surprisingly, at least to me, most addicts lead pretty normal lives. They hold jobs and they take care of families. Now I am not saying it is ideal because it isn’t. It would be better not to be addicted to drugs. Life long drug use is associated with younger death — somewhat like the experience of cigarette smokers which is an addiction that is tolerated and we get along just fine. The problem with addiction is when the addict’s drug of choice is illegal or regulated by people who want to discourage addiction (think Oxycodone). Then the addict has to deal with dangerous suppliers, unregulated doses of their drug and getting arrested. These would all go away if we just let them use it legally.

And, yes, there will be deaths but would there be more than there are now. Certainly we would have reduction in deaths to turf wars between drug lords and wrong doses. It also opens up the possibility of working with addicts to get them off drugs whenever possible. Think again about cigarettes. An aggressive anti-smoking campaign has been successful in cutting the number of smokers dramatically. All while cigarettes were legally available and easily accessible.

I know several people that have chronic pain. They are in their 70’s. Their doctors try to find a way to stop the pain without addictive pain killers. The pain is still there which leads to the question what is worse chronic pain or drug addiction. And is getting off of drugs made more difficult by the return of pain? What is the point of 70 years not getting addicted to drugs? I know very few people in this age bracket that isn’t already taking a life long drug.

Personally, I have 4 prescriptions that I will take for the rest of my life. One of these is anti-depressant which if I stop, I will have problems. I am sure I can deal with them but it would be a difficult week or two and, if I do quit, would my depression return. So am I an addict and, if the addictive drug, allows me to be lead a normal life, why would I quit. If an addictive pain killer can do this, and everything else has been tried, why keep people from an effective, but addictive, pain killer.

This is a valid choice between options. I could live in pain and be addiction free or can live in pain with a dependance on drugs to keep me that way. I suspect this is already happening in the wink, wink nudge, nudge world we live in it. Doctors and patients are already making this decision but if Medicare and the insurance companies decide to monitor this more stringently, this wink wink nudge nudge deal can end tomorrow. Why not just come clean and say sometimes drug addiction is the best option in some cases.

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The Supreme Court determined that it was legal to ban people from sleeping on city streets. This will somehow cause the homeless problem to go away, at least if they are sleeping. I am not sure what happens to them when they are awake. This just moves them along during the night time hours. It reminds me of something the city of Coronado used to do with its homeless. They gave the homeless a bus ticket to San Diego. Problem solved. Until of course a few radio personalities found out about it. They, then, gave the homeless bus tickets to Coronado.

This law is a marketing ploy to give the illusion of action. The public sees the cops taking away the sleeping homeless and think something is being done. But where are they going? What’s to stop them from sleeping outside the city limits and coming back the next day? What happens to repeat offenders? Do they go to jail for illegal sleeping? Then the homeless will have both a home and plenty of food all on the tax payer dime.

This is a waste of time for everyone involved. More work for the cops and the courts. More hassles for the homeless. The public will only have temporary relief from the homeless on their streets. Drug addiction and mental illness will still drive people out into the streets because these are difficult problems that require a bit more thinking, more energy, more money and more time. The public is being tricked into believing something is happening when nothing at all is really changing. But it is a very good trick.

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Aerial flying airplane and sky landscape close-up in China

I have this phobia about air travel. I am pretty certain that one day it will break me and I will end up on one of those videos of air travel meltdowns. Don’t get me wrong, I think these people are behaving like assholes and, by and large, deserve whatever justice was meted out to them. On the other hand, flying is both stressful and uncomfortable. There really is nothing good that can be said about it except that it can be fast if going long distances. I have pretty much given up on it for short distances (1 to 1 1/2hours via a plane) because rarely is enough time saved to warrant the stress endured.

Air travel is an odd combination of urgent deadlines and long stretches of boredom. At first, it is all a rush. Making sure your house is in order (iron turned off, plants watered), checking if you have everything you need (passports, luggage, boarding passes, prescription medicine), then getting transportation to airport in a timely fashion, weighing in traffic and time of day, getting everything out of transportation and into the airport. Rush, rush, rush.

Once you reach airport you still have the flight departure time to worry about so you are still in a rush but you must wait in a series of lines. This leaves you in a state of anxiety because your fellow passengers seem to always have problems that causes every clerk for the airline to huddle around the computer trying to figure out what to do for them. Or these passengers might be looking blankly into the the easy-to-use check-in technology wondering what to do next, trying to get the attention of the clerk who is helping someone else. Leaving you waiting and wondering what could be taking them so long? In the end it doesn’t matter because you have to wait for them no matter what. So your body waits while your mind is rushing on to the next step.

Which is security. You think about all the things that you will need to get through security — ID, boarding pass, have you removed everything that will set off the scanners? You try to be ready, coins out of pockets, technology out of carry-ons, shoes and belts off. Putting my ID and boarding passes in an easy accessible place. Then you wait in a line that resembles cows going to the slaughter. Once you have run the security gauntlet, you then have to then collect everything you put on through the scanner and put them back in the right place for you to retrieve if you need again.

Then it is a race to the gate which is rarely outside of security and almost always a mile hike through a crowded airport full of confused people. It may also require a decision. Is it faster to take the airport tram or is it just easier to walk to the gate. If you take the tram, you wonder is this the right tram? Is the tram going in the right direction? Maybe I should just walk and forget the tram. Whatever you do, you will be wrong and by the time you get to the gate, sweat is dripping off you because you either ran to the gate or you worried so much about the tram getting you there on time.

Then you wait at the gate. Mostly because you arrived at the airport so fucking early because you didn’t want to feel rushed. Now you are bored. So you try to eat and pee because you don’t know when you are going to be able to do either again. Wait some more. When your flight is finally called, you wait in another line to board. Once on board, you have struggle to find overhead space, under the seat space, retrieve any items in your carry-on that might relieve the next hours of endless boredom. Once seated you resign yourself to being crammed, into a space, that lets face it, no human being should have to endure. I don’t really now what configuration of 3 people can sit comfortably in an economy seat in a modern airplane, but I have yet to experience it.

And this is if everything goes right. Throw in flight delays, missed connections, and cancelled flights and the stress becomes even more intense. So while I can’t approve of these people’s meltdown behavior, I can fully appreciate snapping at some point during the air travel experience. Indeed, I am surprised that airport meltdowns aren’t more frequent. All of which to say that I might be persuaded to wear a t-shirt with your company logo on it for a price because when I do breakdown I am fairly certain there will be an internet video involved because if I am going to be banned from air travel for good, I am going to make my rants and raves worthwhile. So even though I will be ranting and raving, I will guarantee that my t-shirt will get the needed attention it deserves. Keep in mind, there is no such thing as bad publicity.

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Conservative columnist Heather MacDonald recently bemoaned the mentally ill people roaming the streets of our city. She describes the failure of civil institutions to protect regular people from these people. Texas Republican Governor Abbott thinks that better mental health care is the solution to mass casualty shootings plaguing his state. Mental Health is the solution to these twin social ills the country is facing.

Better Mental Health certainly would help. The problem is what exactly are the solutions these Mental Health critics offering to meet these problems. Where will these mentally ill people be housed? Who will pay for their housing and medical care? How will their legal rights be protected? How do we identify the mentally ill? What will be the standard for involuntary institutionalization? These all call for the expansion of government oversight and infrastructure. They also all cost money.

How does this happen given the Conservative and Republican distaste for government regulation and taxes? Would they support an increase in taxes to insure that the mentally ill had suitable housing and healthcare? Would they support the psychological testing of gun buyers to determine if they have violent psychological problems? If protecting citizens is the goal, how much money are they willing to spend to achieve this goal? How do they propose protecting citizens from the criminally insane without a massive expansion of mental health and judicial systems? Prisons are not mental health clinics, putting the criminally insane into prisons

It is all well and good to point the finger at the mental health crisis but what are the mental health solutions? There are a lot of unanswered questions. Until these critics provide proposals to address these questions, their criticism is just loud noise to distract from the emptiness of their vision. They have absolutely nothing to offer that will solve these problems.

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The CDC found that over 50% of all Americans will at some point in their life be diagnosed with a mental health disorder, that 1 in 5 Americans will have a mental health disorder within a given year. A recent study from Indiana University found that 45 % of all emergency room patients are also suffering from mental health issues.These are large and significant numbers of people who need help. These are people falling into drug addiction and alcoholism. These are people who might snap and take a loaded gun into a shopping mall. Because mental health diseases are so widespread, almost ever American is affected by them. If these were physical ailments, alarms would be blaring across the country.

A yearly physical check-up is routine for most Americans — particularly after you have reached age 40. The check up is done whether the person is feeling healthy or sick. The yearly check up allows a doctor to evaluate what is going with the patient from year to year in the hopes of catching and treating hidden diseases earlier than waiting until the patient develops full blown symptoms.

Mental health, on the other hand, is almost always a reactive action. The person breaks down and his condition, now obvious, has to be addressed. This is hardly an effective approach. Early treatment is a better, cheaper and less toxic approach. Why wait until the person has mentally fallen apart when, if the person had periodic psychiatric check ups, any mental health issues can be addressed before a person has hit bottom.

Working with young people is a great place to start such a practice as mental illness often emerges after adolescence. It is also during people’s youth that they are free from parental control and are experimenting for the first time with alcohol and drugs. These illnesses and addictions would be found earlier and hopefully addressed before irreparable damage is done to the person. One of the reoccurring horrors of American life is mass shootings. Every time these shootings happen, people ask the question — what can we do to stop this from happening ? Since gun control is off the table, why not require universal mental health checks for every American — particularly young men who are most prone to these crimes. If mental health is the problem, then we need a mental health solution. A mental health check up fits the bill.

A lot of people still believe old ideas about mental health. It is a personal weakness not a disease. They claim that people didn’t need mental health professionals in the good old days. People were stronger. They just toughed it out. None of which is true. There is absolutely no evidence that people were tougher or stronger in the good old days. First, nobody measured it in the good old days so there is no way to prove this assertion. Also families hid away their problem members if they could so Grandmother never talked about crazy Aunt Alice. There is no better example of the widespread addiction problem in the USA in the good old days than Prohibition. The level of alcoholism was so bad that Americans actually banned alcohol consumption. The good old days weren’t so free from mental health diseases and addiction.

The good old days were free from effective treatment of these disorders. And this is why it is time for Americans to move away from the shame model of mental illness and go to the proactive treatment of mental illness. Nobody wants to be sick from cancer, the same thing applies to mental health. Nobody wants it. It is a horrible experience. Once of the principal reasons that cancer survivability has dramatically improved in the last century is medical professionals are now monitoring their patients and catching it faster. Why not try the same approach with mental illness?