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'The mad and the bad'

From Thursday's Globe and Mail

Canada often saddles mentally ill people with a double stigma, cycling them through the justice system without treating their underlying disorders ...Read the full article

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  1. Bert Russell Paradox, BC from Canada writes: The connection between addiction and mental illness is very interesting.
    One other area is the fact that Police Departments do have to become involved in dealing with these issues which tend to get out of control and then involve the Justice System ... which Politicians and Society seem to accept. Without a support system a lot of these people end up in jail; because as a Society especially in large cities, these people become part of the cycle left to the Police because no one else wants to deal with them.
    The example of Aboriginals ... if they have social problems in their own community, they often leave for a city and then get recycled into jail.
    It is not politically correct say this, but Reserves have no program to deal with these dysfunctions in families ... they become outcast to their own Culture. This is not to say that the general population deals with the problem of addiction,mental illness and islolation, any better.
    My career over a number of years has led my to believe that medication, cognitive therapy and close support are key .. the needle exchange is one step of many to be taken with leadership.
  2. Magnolia Fan from Canada writes: This is article was irresponsibly written as it ignores several points. First of all, there's the stigma associated with mental illness. Anyone who obtains treatment for anything like bipolar will loose friends. I talked to someone recently who got their life back on track, and they said that there were friends they had when they were a coke addict that wouldn't speak to them when they were diagnosed with bipolar. The second issue is the general incompetence of psychiatrists practising in Canada today. Patients generally have four or so diagnoses before somebody hits on the correct one. Unfortunately, psychiatrists often have the legal ability to force treatment, even the wrong treatment on patients, regardless of the risks and side effects. Personally, I think it's much more humane to send somebody to prison that to send them to a psychiatrist. It seems to me that Canadians look down their noses at the U.S. because they use their industrial military complex to stabilize their economy. The U.S. tends to buy more weapons when there's a recession to give the economy a boost. Canada on the other hand, used the health care system for recessionary spending. In my opinion, Canada is just as amoral if not more so than the U.S. Providing more forced psychiatric care means increasing suffering through locking people up, forcing drugs, use of restraints, and robbing them of their futures. Instead of using the industrial health care complex to prop up Canada's economy, why don't we just provide stable services, based on what people actually need. Besides, Ontraio, was the poster child for locking people up in psychiatric hospitals in the 1980s is still paying for that recessionary spending.
  3. John Cassidy from Canada writes: it is a heavy burden to expect the justice system and penitentiaries to act on let alone treat underlying pick up the pieces of a not overly healthy existence and presume to attempt to put 'fix' is disingenuous to believe that these people did not fall out of the cradle of their own social networks long before they reached the point of incarceration...
  4. Tyler Williams from seattle, United States writes: This article is confusing, in a math sense, and unsatisfying, in a mental illness sense.

    In terms of math, the body of the article states that men in prison have about a 10 percent prevalence of psychiatric illness. And yet the little box at the end of the article states that "57 percent of incarcerated men, aged 18 to 44, were found in an Edmonton study to have some sort of anti-social personality disorder".

    Which is it? After all, antisocial personality disorder aboslutely IS a mental illness.

    The answer is that about 57 percent of men in prison have an antisocial personality disorder, which fits roughly with other studies (in British prisons the rate was found to be 49 percent, for example, and an international study by Fazel and Danesh a rate of 47 percent was found).

    Fifty percent of male inmates is a lot higher than 10 percent! (Incidentally, the articles claim of a rate of "9 per cent in society at large" is way too high - that rate is in the 3 to 4 percent range).

    The article fails to say much about personality disorders in women, which are highly prevalent in prison - 42 percent in the study by Fazel and Danesh, with antisocial and borderline types predominant.

    So why is that important? Journalistically, why should it matter that about 50 percent of prison inmates have a personality disorder, mainly the antisocial type?

    The reason is simple: The newspaper article began with the GUILT-TRIP INDUCING LINE of "Canada often saddles mentally ill people with a double stigma, cycling them through the justice system without treating their underlying disorders".


    What needs to be explained to readers is that THERE IS NO TREATMENT FOR SUCCESSFULLY TREATING those personality disorders! Folks with antisocial personality disorder are manipulative, selfish, and without a sense of right and wrong, and psychiatry can do little to normalize them.
  5. Kim Philby from Ottawa, Canada writes: Tyler Williams: I'm not sure if, by antisocial personality disorder, they mean psychopathy. Psychopathy is generally considered to be an untreatable condition, and should not be lumped in with other mental conditions like schizophrenia, depression, and bipolar disorder.

    However, the article may be referring to something other than psychopathy when referring to APD, in which case it may be referring to something treatable.
  6. MR. oz from Canada writes: And I always thought that criminals go to jail to be punished for the crimes they committed!
  7. John MacK from Canada writes: If only we took all froms of mental illness as seriously as we do for all forms of cancer and other less devastating illnesses maybe there would be some relief to the terrible suffering and cost it causes all of us. Tyler Williams points out loudly that there is no cure or treatment for antisocial personality disorders. It would be more accurate I believe to say there is no KNOWN cure for ALL types of antisocial personality disorders. I am old enough to remember when there was no cure or treatment for what was then known simply as insanity. But today there are successful cures or maintenance treatments for a number of different forms of mental illness. I only wish my mother had the benefit of relief of the depression she suffered that I have. Mr.Williams I am affraid falls into the usual human trait to blame the patient when the doctor does not have the cure - I remember too well the days when classmates with what is now recognized as learning dissabilities where punished for being "bad" people. As long as any group of mentally ill people are simply written off as being "bad" then it will be hard to encourage society to give mental health reseach and the people struggling to provide help to the mentally ill the support and prestige that is deserved. Who would encourage their child to become a psycharatist or mental health researcher rather than an oncologist or cancer researcher?
  8. jan bakker from Canada writes: The picture of before and after, says it all, drugs will ruin you,your brain,you're health, and your looks. Several hundred thousand Canadians are living proof of this fact, never mind the thousands that have died due to drug abuse. And yet we have the "intellectualls?" who advocate safe injection sites and or legalizing drugs. A smattering of commonsense will reveal that we must take the epidemic of drug abuse much more seriously, to halt the wanton destruction of so many.
  9. greg simmons from toronto, Canada writes: As a person living with HIV/HCV, ADHD, Depression, non-using drug addict, who served 13yrs and 8 months of a 16 1/2 yr sentence, I found that this article missed its mark. The World Health Organization (WHO) and the U.N., have policy's that state that prisoners are too receive the same medical treatment as people receive in society. In Canada, Corrections Service Canada (CSC), does just enough treatment for the mentally ill, to not be held responsible. That in its self is despicable, but the blame is spread around to the Federal and Provincial Political party in power at the time when a policy is enacted, that affects the way prison health care deals with those affected by mental health or other ailments (HIV/AIDS, HCV, TB, Cancer, etc..). In provincial prisons you have Administration (Wardens, Deputy Wardens, etc) making decisions on how Health Care will Deal with these different ailments. I could go on, but I would be just be leading up to the same thing, "THE SYSTEM IS BROKEN AND NEEDS FIXING BY THOSE THAT ARE MOST QUALIFIED". Until the different levels of government start allowing Prisoner Rights Groups (stop rolling your eyes), to participate in the dismantling, and then the rebuilding of the Prison Health Care/ Mental health system they will keep doing it from the political point of view and nots whats for the prisoners and society. Canadian Society tends to forget that upwards of 90% of these same prisoners are released back into society either the same or worse then they were, and then something bad happens and the finger pointing starts. We are all to blame too! Did I just say that. Until we realise that rehabilitation is the only way that we can help these people, no othe rpolicy is going to work. Stats don't lie, and they say that the present system isn't working, and the scary part is that the Harper Government would like nothing better then too model our justice system after the U.S.A.. lock em up and forget about them, human rights, ha
  10. Tyler Williams from seattle, United States writes: Kim Philby, contrary to your post, antisocial personality disorder (APD) is indeed a psychiatric disorder defined by the field's standard text (Diagnostic and Statistical Manual).

    The degree to which it can or cannot be treated makes it no less a disorder. There are plenty of medical diseases that cannot be successfully treated and yet they are still diseases.

    And the article is clearly referring to this disorder at the end, where it quotes the 57 percent figure.

    As I noted in my earlier post, this article is confusing, in a math sense, and unsatisfying, in a mental illness sense. The article gives a false impression, as if there are treatments for the mental illness in jails. There is no successful treatment for the personality disorders mentioned, and they are the MOST prevalent of mental illnesses in jail. Folks with antisocial personality disorder are manipulative, selfish, and without a sense of right and wrong, and psychiatry can do little to normalize them.

    It is disappointing that the article failed to discuss these matters, opting instead to use a byline that makes it sound as if all the mentally ill in Canadian jails are somehow not getting existent treatments: There are no successful existent treatments for the most prevalent mental illnesses afflicting those in jail, and their getting into trouble with the law cannot be understood without an understanding of those prevalent illnesses. The article is unsuccessful at illustrating those key points.
  11. Tyler Williams from seattle, United States writes: Contrary to the suggestions of John MacK, I do not "blame the patient when the doctor does not have the cure", and I in no way suggest that "any group of mentally ill people simply (be) written off as being bad".

    I simply discussed weaknesses in the article regarding the prevalence and therapeutics of personality disorders.

    And I do fully support that research be done in these areas of illness.
  12. GlynnMhor of Skywall from Canada writes: The woman should not forget that the justice system isn't 'about her' and her problems. It's there to protect the citizenry from the criminals, not to make life easier for the criminals.
  13. M' edea from Canada writes: So what's changed? She's still on drugs, only now her doctor is the pusher. If she tried to get off the drug she's on, she'd find out she's addicted to it.

    What a lie this poor woman has been fed.
  14. You're most likely redundant from Canada writes: Tyler, I wouldn't place that much faith in the DSM - it's merely a compendium of information, as collected by psychiatrists, that is frankly out of date (has yet to be vastly improved in recent time) along with being originally funded largely by pharmaceutical companies.
    Its purpose advises that laypersons should consult the DSM only to obtain information, not to make diagnoses. If anything, by becoming the defacto medicalizing standard, written by and for psychiatrists, the DSM posists mental health without its larger social repercussions, namely societal and financial.
  15. Tyler Williams from seattle, United States writes: Um, like it or not, the "DM" part of "DSM" stands fro "diagnostic manual", and so, yes, it its purpose is to be a standard to "make diagnoses", and that is how psychiatrists use it.

    But more to the point, forget about the DSM and ask yourself a more fundamental question: Work with hundreds of psychiatry patients over the years and then ask yourself, do you think, based on your own dealings and experiences with them, that there is such a thing as a borderline personality disorder or an antisocial personality disorder?

    My experience was YES, ABSOLUTELY. The distinctive features become so recognizable after a while that it can become as obvious as trying to recognize a three foot tall dwarf from a person of average height.

    Complain about DSM all you want: Those personality disorders are real, and it will not be surprising, with future research, to learn that they share biological etiologies as characteristic as the features seen in the office chair. And yes, environmental events may well trigger them and maintain them - as is the case for a great many disorders of the body!
  16. May Loo from Calgary, Canada writes: Let's face it-mental illness is not a sexy issue. The law-and-order types we have in power are more interested in 'convict, jail, and throw away the key' than helping people who will likely leave jail even worse off than they were going in. Oftentimes, I don't think they care whether someone is even guilty of the crime they're convicted of - as long as someone is punished for it.
  17. Action Jackson from Canada writes: "And I always thought that criminals go to jail to be punished for the crimes they committed!"

    Yeah, that's how our ancestors thought about it in their ancient, cave-man conceptual scheme. Later ancestors of ours' added some truly bizarre concepts to this weirdo brew (you know -- the nonsense about a nonphysical "soul" fluttering around in the head that could make its own "free" choices).

    Now all that garbage has been exposed. We're purely physical machines that should be fixed by medicine when we malfunction.
  18. mary wells from Canada writes: Now i want to know how many of you good people want to sit beside this so obviously "mentally ill" man who just stabbed and sawed the head off the teenager sitting beside him in the bus.I think if it was your child,youd want this maniac locked up ....forever.Im not his mother and i want the maniac locked up,(not really but we dont have capital punishment here).
  19. Jenny Biggar from toronto, Canada writes: mental illness is a serious impairment to criminals but it helps in gettings parts of the job done...

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