Tuesday, October 27, 2009

Impassioned father advocates reforms in mental health care

There was an interview published today in the Palo Alto Daily News with Pete Earley, the author of a new book called, "Crazy." He uses that word to describe our system in dealing with and treating mental illness.
Earley became intimately familiar with what he calls "America's mental health madness" after his son had a bipolar disorder breakdown during college — and ended up charged with a crime.

Just about anyone who has ever had a family member with severe mental illness knows just how stupid and heartless our system is. The result, very often, is tragic, as the story (I write about below) from Boston, today, demonstrates.

This snippet of the interview is spot on:
Q: How difficult is it to find help for a person with mental illness?

A: We know how to help most people with mental illnesses, but we simply are not doing it. Many of the solutions are cost-effective, and would save us money. Instead, we have a system that only responds when there is a crisis, and forces people into emergency rooms, homeless shelters, and jails and prisons — which are costly and ineffective.

Q: What reforms are needed?

A: We need to re-examine civil rights laws that require a person to become dangerous before we can help them. Involuntary commitment laws that require "imminent danger" ignore that a person can be very, very sick and harmless. This results in people who are psychotic roaming our streets, helpless. It also results in people becoming dangerous because they are not being treated.

We need to offer persons with severe mental illnesses, such as bipolar disorder and schizophrenia, access to services that are based on their individual needs. For some it may mean access to jobs and housing, and for others, access to clubhouses and places where they can socialize. Along with affordable medications, these programs help a person recover and rejoin society. Some 20 percent of persons are not helped by medication and remain ill — even if they receive services. We must find a way to help these people live dignified lives and not abandon them on our streets.

Boston crazy man tries to murder his doctor

There was yet another story in the news today about a mentally ill person committing a heinous crime:
BOSTON – A man stabbed a doctor while being treated at a psychiatric office at a Boston medical building Tuesday and was fatally shot by an off-duty security guard who saw the attack, police said.

"During the course of the stabbing incident an off-duty security officer who was armed interceded. He produced a weapon and ordered the suspect to drop the knife. And when the suspect did not comply, he shot the suspect," said Boston Police Commissioner Ed Davis.

If we want to prevent crimes of this nature, we need to start taking care of the mentally ill. The largest aspect of taking care of them is to take the approach that they cannot be in charge of their own lives: that they need guardians to care for them; that they should not be warehoused in homeless shelters or left to fend for themselves on the streets; that they should not have the right to refuse to take medications; and if they are determined by psychiatrists to be dangerous to themselves or to others, they need to live in locked psychiatric hospitals.

While the unprovoked attack which took place in Boston could theoretically occur in a locked-up setting, it would have been harder for the stabber, Jay Carciero, to get ahold of a knife in a hospital.

It did Mr. Carciero no good to be "free." Now he's dead. He might have been helped had society taken charge of his care. But because of the ACLU (and really the lack of concern by just about all Americans), no one took charge of his affairs for him. Instead, we just waited until he nearly murdered a doctor and he was necessarily killed.

Thursday, October 15, 2009

The fear of DNA by 'privacy advocates' is total nonsense

There was a fascinating story in today's San Francisco Chronicle about the use of DNA technology to solve a crime which took place 11 months ago in Berkeley, where a brutally violent man (involuntarily) left DNA behind at the scene of one of his attacks, an attempted carjacking, and his genetic markers were matched with his DNA sample in a database. When the two were put together, police knew he was the beast they had been looking for:
Paul Anthony McGruder, 52, was arrested at his home on the 5900 block of Camden Street in East Oakland. Police say McGruder pulled a gun on a woman in the parking lot of Whole Foods Market at 3000 Telegraph Ave. on Dec. 30 and ordered her into her car. Once she was inside, the woman screamed and the carjacker punched her in the face, said Officer Andrew Frankel, a police spokesman. The woman stabbed him in the neck with a pair of scissors, police said.

After she fended him off a la Johnny Depp, McGruder immediately went after more victims:
The man ran off and tried to carjack another woman, but failed in that attempt as well, Frankel said. Finally, he stole a man's 2008 Subaru and escaped, police said. McGruder is being held on suspicion of three counts of carjacking or attempted carjacking and one count of kidnapping during the commission of a carjacking.

If it were up to the ACLU, evildoers like Paul Anthony McGruder would be free to terrorize other innocents. This AOL story reports that the ACLU has filed suit to restrict the collection of DNA in California to only those serving time for very serious crimes.
Thanks to the passage of Proposition 69 in 2004, California now mandates the collection of DNA from anyone arrested in connection with a felony -- regardless of whether that person is later charged with a crime.

"I'm not sure the voters understood that they were empowering the police to take DNA from innocent people," said Peter Meier, an attorney at Paul, Hastings, Janofsky & Walker, a San Francisco law firm that has partnered with the American Civil Liberties Union in a lawsuit against the state.

Meier wants the court to restrict California's DNA collection mandate so that it only applies to convicted felons. He cites the Fourth Amendment, which protects against unreasonable searches and seizures.

If serious crimes were only committed by people who have already been convicted of serious crimes, I wouldn't have a problem with the ACLU's position. However, the truth is that most murderers and rapists and carjackers, like Paul Anthony McGruder, have a long history of minor brushes with the law before they spend time in prison. Collecting their DNA when they are still low-level criminals will allow law enforcement to solve the crimes they commit down the road, protecting society from these predators. If they never graduate to rape and mayhem, they have nothing to worry about knowing their DNA is in a computer database.

Last month, the Los Angeles Times reported a story about a program in Orange County in which arrestees for minor crimes were being given the choice of having the charges dropped in exchange for submitting a DNA sample. The motivation of the DA's office in Orange County is twofold: first, to save money by not having to prosecute minor offense. That saves on lawyer time, court costs and keeps the jail free for serious offenders; and second, the DA wants to expand his DNA database -- in order to increase the chances law enforcement in Orange County will find a match when the crime being investigated is more serious:
"There'd be no necessity for a guilty plea, and a dismissal, or anything like that," Orange County Dist. Atty. Tony Rackauckas said. "It's advantageous to the defense, and it's advantageous to us, because we're able to handle more cases with fewer resources." The DNA sample could act as a deterrent for potential criminals and be a useful investigative tool for law enforcement, Rackauckas told supervisors. The plan applies to people arrested for nonviolent misdemeanors, including petty theft, trespassing and low-level drug-possession felonies.

The story indicates that some cops don't like the idea of dropping charges on people they've arrested. Civil liberties advocates also object to this program, because it "would allow prosecutors to wrongly pressure people who have not been convicted of any crime to give the government a DNA sample."

I don't get that objection at all. What pressure? I don't see how the police having access to a sample of DNA or the DNA violates anybody's rights. DNA amounts to a series of letters and numbers. It's not like the cops are coming to my house and forcing me (or anyone else) to give them a sample of my blood.

Does the ACLU think someone is going to plead guilty to a crime he didn't commit because he figures, "Well, them cops got my DNA. Might as well just go to prison for the next 15 years rather than defend myself"?

If it didn't cost money to collect and store DNA from every American and it weren't a hassle to do so -- it would be a waste of resources, for example, if everyone had to go down to a police station and submit blood or saliva for no reason other than to universalize the database -- I would have no objection to a more comprehensive database.

But the truth is, of course, that it does cost money and would be a hassle*. Because of that, and because 97 percent of people never will commit or be accused of committing any serious crimes -- the bad 3 percent commits all of the serious offenses -- a universal plan is not worth pursuing.

If the DNA database at least has samples from everyone arrested for crimes, most serious criminals will eventually make it into the DNA database, and that makes it safer for the rest of us and safer for any innocents who are wrongly accused of crimes in which DNA can prove their innocence.


*The reason I object to our policy of non-discrimination at airport security checks is because they create a big hassle for people who not only are perfectly innocent, but who completely don't fit the profile of the terrorists we are supposedly trying to catch. If the TSA would simply profile -- focusing their efforts on people who look insane, Arabs, other Muslims and random males who are in the age category to commit violence -- they would weed out all of the trouble. No more than 10 percent of fliers fit the profile, yet 100 percent of people are forced to take off their shoes in security lines? That doesn't benefit anybody. Nor is there any gain to be had by prohibiting those of us who never would be jihadis from carrying on board, for example, a bottle of sunscreen. (I had to hand over a $12 container of SPF 45 in Maui, just because some crazy Muslims in Britain tried to blow up an airplane using a liquid explosive.)

TSA's policy of treating everyone the same means that my 87 year old mother, who is terribly hard of hearing, has Alzheimer's and weighs about 99 pounds, has to remove her shoes and get scanned for weapons every time she flies. You think a little senile 87 year old woman poses the same threat on an airplane as the three Islamic terrorists pictured above?

A fair question to ask is this: Would I feel the same were I an Arab who looked more less like the guys pictured above? The answer is, "I don't know, but probably no." The reason for objecting would not be that I would have to waste a lot more time being checked for guns, knives or explosives each time I get on a plane than I have to waste now. In fact, if the TNA discriminated and did not bother to check, recheck and hassle endlessly the 90 percent of fliers who don't fit the profile, then I, as an innocent Arab, would be processed much faster. However, the reason I wouldn't like a policy of discrimination is because no one likes to be singled out in that way. It's much less humiliating if 100 percent of fliers have to go through the same check system. So the question then for society is, recognizing this cost of humiliating a minority, is that humiliation cost higher than the cost of wasting our time and resources on the 90 percent who don't fit the profile? I think the answer to that is that the humiliation cost is much lower, but it's still a real cost, and thus we ought to profile. A follow-up question is, wouldn't profiling lead to terrorists changing tactics, using attackers who don't look like the men pictured above? The answer is, the profile is not just based on the person's looks. The profile includes place of origin, religious affiliation, behavior, and other factors that expert profilers can look for. That's the method Israel uses, and it has kept El-Al quite safe for decades. Hopefully, some time not too long from now, Muslims will not be associated with this horrific type of crime. I don't think Islam is inherently violent. No more than any other faith. But I think there is a very large subculture in a lot of Islamic countries which justifies criminal acts of the terrorist sort; and until that subculture is subdued by Muslims who object to violence, this profile will make sense.

Sunday, October 11, 2009

UCLA madness: It's Va. Tech all over again

Fortunately, the homicidal maniac at UCLA, Damon Thompson, who tried to murder a fellow student a few days ago in an organic chemistry lab, slashing her in the throat with a knife, was unsuccessful in killing his victim. And even more fortunately, Thompson did not have a cache of guns, like Seung-Hui Cho, the mass murderer at Virginia Tech had when he slaughtered 32 innocents and wounded many others in April, 2007.

But the essential facts of this case are the same: The killer was a mental case who had lost touch with reality. Many who knew him thought he was out of his mind. A professor had reported him to UCLA authorities 10 months ago, telling them he was off his rocker. And the authorities did absolutely nothing.

What was the result of their inaction? Here is the L.A. Times:
Nothing so far points to a direct motive for what appeared to be an unprovoked knife attack in an organic chemistry lab class on Thursday afternoon. The 20-year-old victim was reported to be recovering Friday. Thompson is being held on $1-million bail on suspicion of attempted murder and is expected to be arraigned Tuesday.

Most of the blame for this incident belongs with UCLA administrators, who failed to remove a student from their campus they should have known was mentally ill and dangerous:
The UCLA media relations office released a terse statement after reports that Thompson sometimes behaved erratically, including keeping odd hours and sometimes making disconnected-sounding outbursts. "While Thompson was known to our Student Affairs Office prior to the incident, privacy laws preclude us from discussing it," the statement said.

However, in a broader sense, the blame is with all the rest of us and our legal system for our irrational approach when it comes to dealing with mentally ill adults. As a society, we pretend they are responsible for their actions and they have the right to all of the freedoms sane people have. And that on both counts is nuts.

By definition, mentally ill people are not responsible. They can't differentiate reality from imagination. They hear voices inside their heads and think someone is talking to them. They think people are out to get them. They invent crazy conspiracy theories to explain why everyone is against them. Some of them act out violently -- with no obvious motive -- because they have paranoid delusions.

Instead of taking care of the mentally ill for their own good and for society's benefit, we give them their "liberty." Very often, that means life on the streets or life in prison. They cannot hold a job. They don't understand the benefits of anti-psychotic medications. They ultimately either kill themselves or kill someone else. What we call freedom is total hell for the mentally ill and for their families which love them.
A student who had some interaction with Thompson in a UCLA dorm last school year described him as "an eccentric guy" who would wake up at 3 a.m. and start tidying up other people's possessions. This student, who asked not to be identified because of the circumstances of the case, said Thompson sometimes made statements that seemed to have little bearing on reality.

What we need to do is address the mentally ill like they are children: We need to protect them. We should not give them the option of taking prescribed medications. They can't decide what is in their best interests. They ought never be allowed to have weapons, especially guns. They should not be able to decide where they want to live: We should provide shelter for them. And if the very best psychiatric care cannot stop them from acting crazy, we need to keep them in a locked up mental hospital where they will receive proper care.

People like Damon Thompson, as horrific as his crime at UCLA was, don't belong incarcerated. Prisons are for punishing people who can understand why the act they committed was wrong. He has no sense of that reality. Thompson is clearly dangerous. He might become manageable at some point if he were on meds and he were monitored. Yet he should never again be fully free, on his own. If he can't be managed, then he needs to be locked up in a psychiatric hospital. But ideally, some day he will be cared for by a guardian, who can force him to see psychiatrists and to take medications and to manage his affairs, just like responsible adults manage the affairs of children.

Thursday, October 8, 2009

Down goes the dollar -- at last

In this July 22, 2009 column, I wrote: "There is no doubt the price of goods and services we import has to rise; and the costs of our exports needs to fall. That means a much weaker dollar in the coming years."

Two and a half months have passed since I forecast the dollar's decline. This week, the fall began. Here is today's story in Forbes:

The dollar fell to a 14-month low against a basket of currencies, as positive news about the global recovery enticed speculators to test how much they can pressure the greenback.

Currency traders have their eye on the dollar's technical borderlines, anxiously waiting to see if the euro will punch through $1.485, and if the yen can fall to 87.50. It's getting close, as the euro rose to $1.481 Thursday, while the yen fell to 88.31.

The Dollar Index, which measures the greenback against a number of other currencies, fell by .8%, to 78.81. Yet, in the intensity of inter-day trading and the heated geopolitical and economic climate, it's easy to forget the dollar is sliding to its pre-crisis levels. Prior to July of 2008 the euro was on a multi-year march to $1.599, while the Australian dollar reached 97.93 cents.

For the United States, the short-run implication of a declining dollar should mean higher interest rates on our public debt. Why? Because foreign investors own much of our massive debt. They won't want to purchase our treasury notes if those notes are paying a negative real interest rate. And if the dollar is declining in value -- say by 5 percent -- and the notes are paying 4 percent in interest -- then the real interest rate is negative.

The major players in this will be the central banks in China, Japan and Russia, as well as major dollar investors from OPEC. China holds $800.5 billion in American government debt. Japan owns $724.5 billion in U.S. treasuries. And Russia, which has sold off some of its U.S. government bonds, still possesses $118.0 billion worth.

To me, the surprise is not that the dollar is falling. The surprise was that when the world economic crisis hit in 2008, largely a byproduct of the collapse of mortgage backed securities originated in the Unites States, that the dollar rose. It was seen as a flight to security. However, given our immense red ink, I don't see the dollar as a safe investment.
The move out of the dollar is understandable. The macro picture is improving, and the turmoil over the past year led investors to flock to the dollar as a safe-haven play.

Volatility in equities, commodities and fixed income markets have served to mask the dollar's weakness but now all that's propping up the dollar is the world's willingness to keep investing in it. China and other surplus producing countries (particularly in the middle east) stand to lose trillions should the dollar fall too far too fast. Exporting nations would also benefit from a stronger greenback though there's some evidence that the traditional exporting role of the emerging markets is being tested.

Before the crisis hit in 2008, our massive public debt plus our ever-increasing trade deficit suggested to me that the dollar had to fall. However, since the crisis, every policy pursued by the U.S. government has served to make the dollar much weaker. We have a much more severe federal debt, today, in the wake of Bush's bail out program, Obama's bail out and the stimulus package. The erosion of fiscal discipline in the United States will mean two related things in the future: consumer price inflation and a much weaker dollar.
The dollar is inherently weaker than it was before the crisis, as the Federal Reserve has lowered interest rates to bottom-barrel levels, while the U.S. Treasury has taken on significant debt in an effort to save the financial system from collapse, as well as revive the economy. On Thursday the Congressional Budget Office reported the federal budget deficit reached a record $1.4 trillion, due to a drop in tax revenue, as well as the government's massive bailouts.

The weaker dollar will bring about big changes for the U.S. All commodities will cost American consumers a lot more money: food will be much more expensive; gasoline will sour in price; and things like foreign travel will become cost prohibitive. On the other hand, goods and services which we export will be cheaper to foreign buyers. We will export more cars, appliances, agriculture and raw materials. It will make more sense for films and TV shows to be produced in the U.S. in the years ahead than it does now.

A weak dollar by definition means a much lower standard of living. It would not surprise me to find 20 years from now that the median standard of living in the United States in 2020 is lower than it was in 2000.

Tuesday, October 6, 2009

Punishing the parents?

The Sacramento Bee reports today:
The parents of a Vacaville toddler who was accidentally shot to death by her older brother have been arrested. ... Investigators say the Shanahan's 2-year-old daughter, Ayana, was killed Sept. 23 when their 8-year-old son accidentally fired a handgun. ... Solano County Deputy District Attorney Jeff Kauffman says the parents are facing up 13 years in state prison if convicted.

I have thought in the past in cases like this that the parents, by losing a child in what is obviously a horrible tragedy for their family, have been punished enough by their own stupidity. However, I've changed my mind.

I think the Shanahans deserve to be prosecuted and to be held publicly accountable for leaving a loaded weapon with no safety lock in a place in their home accessible to their children. This needs to be a very public prosecution and needs to send a clear message to all of the other idiots who have unprotected guns in their homes*.

The question is what is the appropriate penalty in order to get that message out?

Thirteen years in state prison, the maximum possible, would send that message. However, it's very expensive to imprison anyone for that long; five years would do the job; and I think there is a better way for them and for society.

Were it up to me, I would give the Shanahans, upon conviction, a choice: either you serve 5 years in state prison and hand over all of your property to the state for an auction sale; or be shamed.

What does it mean to be shamed? The couple needs to go out in public, rain or shine, in prison garb for 8 hours a day, 6 days a week, for 52 weeks. Any single day they fail to appear for 8 hours adds 1 week to the sentence of shame.

If they fail to fulfill their 8 hour daily obligation 10 times during the year of shame, they will have to immediately go to prison for five years with no chance of parole; and all of their worldly possessions will be sold at auction for the public benefit.

They need to go to shopping malls, the county fairgrounds, schools, major intersections, the post office and other highly trafficked locations in Solano County, under the guidance of the county sheriff. They need to carry large signs which say, "I let my children have access to my loaded gun. My son used it to kill my daughter. Don't be stupid like I was."

The Shanahans might get some sympathy from strangers who see them. That's fine. They deserve some sympathy. However, most importantly, they will as extensively as possible get the message out that leaving a loaded gun in your home and letting kids have access to it results in tragedy.

That is a far better outcome than time in prison.


*A parallel case is with parents who keep vicious dogs as pets and then allow those dogs to maul their children or the children or pets of their neighbors. For such idiots, I would apply the exact same punishment: five years in prison or one year of shame. Let the criminal decide.

Monday, October 5, 2009