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. If people are willing to continue to believe that this is somebody elses problem or that somebody is paying attention (we just don't know who) but somebody must be then we are not going to get very far..
I agree 1000% (is there such a number?). So, what can I do? What will you do? Other posters: chime in here. Don't be .
Originally Posted by dcashley No, I am not compaing a person to a nation (Stalin to the US). I am asking how can we ensure that our institutions can never be misused for political or economic gain.
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We can't - and that's the problem. There is no 100% guarantee of anything
I was crying at our inability to solve this problem.
Maybe someone using it for political gain would be a good thing in its own stinking, rotting, corpse like way.
I think one of the first things to get people to realize what is happening is to say, "You-hoo, wasting money over here!!" I think that if we sit down and calculate how much is spent on someone who is in a residential facility and use the cost of the number of "advocates/case managers" involved we would arrive at a number that says there is no need for that individual to be in any type of abusive situation. That individual should probably be eating lobster twice a day in a warm environment pursuing any little interests that they can.
We could calculate the cost of those that are in prison or in county jails. We could count the cost from arrest all the way down to the disposition and medication or treatment. We could even count the cost of those that are mainstreamed into schools where the IEP reads pick up pencil and set back down. But in order for it to make a huge impact that money has to be tracked. I mean as in from the government/s to the providers. This might make people say, "Didn't I just pay for that over here?"
Too, I think that this society needs an attitude change. For some reason it is easier to throw up an anecdotal picture of someone who is abusing the system (welfare, caddilac queen)and demand more accountability. Not so much when we look at agencies or "suits".
Maybe someone using it for political gain would be a good thing in its own stinking, rotting, corpse like way.
I think one of the first things to get people to realize what is happening is to say, "You-hoo, wasting money over here!!" I think that if we sit down and calculate how much is spent on someone who is in a residential facility and use the cost of the number of "advocates/case managers" involved we would arrive at a number that says there is no need for that individual to be in any type of abusive situation. That individual should probably be eating lobster twice a day in a warm environment pursuing any little interests that they can.
We could calculate the cost of those that are in prison or in county jails. We could count the cost from arrest all the way down to the disposition and medication or treatment. We could even count the cost of those that are mainstreamed into schools where the IEP reads pick up pencil and set back down. But in order for it to make a huge impact that money has to be tracked. I mean as in from the government/s to the providers. This might make people say, "Didn't I just pay for that over here?"
Too, I think that this society needs an attitude change. For some reason it is easier to throw up an anecdotal picture of someone who is abusing the system (welfare, caddilac queen)and demand more accountability. Not so much when we look at agencies or "suits".
I'm going to make myself immediately unpopular here. You all are talking out of your hats, and it is painfully obvious. How do I know? Because I actually worked in one of those institutions at the time de-institutionalization was just getting started. As a matter of fact, the head of that hospital and his second in command were leaders in the field.
I saw some stuff with the process that I didn't care for, but there was a lot that worked. None of you apparently know the historical perspective of what was going on. I'll relate it briefly:
At first, there was no aid in this country for the individuals who were insane or retarded, and the families were responsible for them. In many cases, that sort of worked. It made life hell for the family, and the best outcome was the quiet retarded person being put to a menial task. Violent family members were chained, housed in a barn or outbuilding, and treated about the same as any animal. I'm sure many of them were just killed outright.
When the towns started to recognize the problems of the indigent and disabled in the community, they set up poor farms and workhouses within each community. Generally farm owners bid on how cheaply they could house and feed the people, and each person was expected to contribute to their upkeep, be it helping in a garden, knitting, doing piecework, or whatever. Those who had been in the military were sent to military retirement homes.
The costs of keeping the residents kept climbing, and by the 1800s a lot of towns were clamoring for financial assistance from the state or a state run institution to relieve the burden.
The state institutions started either as hospitals or large homes and were added on to to house the people. Almost immediately the ward systems were implimented, so that the violent and dangerous were kept away from the older fragile incompetent seniors. Children were segregated into other wards.
In the institution where I worked, there was an extensive set of service tunnels for running food and laundry throughout the place. The items were usually sent up by locked dumbwaiters, and all wards were locked. When traveling through the tunnels I could see the cages and restraining rings set in the concrete, from the not-so-long ago time that the more severely disturbed patients were housed down there, in an attempt to keep their screams from reverberating around town. Some of the cages had been turned into storage lockers, but most just sat empty.
What happened to change things? In a word, drugs. Thorazine and Mellaril calmed the more outrageous behavior in many of the inmates, who now fit more the term patients. There was a lot of trial and error that was going on, and while lobotomies had been pretty much taken out of the schedule, electroshock and other shock treatments like insulin and cold water were used, with some good effect. However, it was the thorazine that was the savior of many.
Back in the 1800s and early 1900s, the hospital was able to partly defray costs with a huge farm, which was used to supply a lot of the food. Costs rose there over the cost of institutional buying, and working the patients was frowned upon, so the farm was phased out. At the same time, more and more patients were being admitted, to the point that it was a strain on state finances, and help from the Federal government had to be sought.
The introduction of thorazine and mellaril allowed the staffing to be reduced, the physical strength of the staff to be less of a concern, and the opening of some of the wards. Those patients on the open wards were quite often perfectly fine while on medication, and some of them went home, and some went to group homes in the community.
That process continued over the years until the remaining patients were either the "criminally insane" or severely brain damaged. Funding remained level or was cut. At the same time, the Federal standards for care were constantly upgraded, so that the cost per patient was offsetting much of the savings from de-institutionalization.
At the current time there have been attempts to close the hospital entirely and transfer patients. Eventually, it will probably happen, but the problems will just be moved.
Of the people who were released, I never heard of a single one who took up life on the street. There was one who used to make a pest of himself hitchhiking between two towns, but the bulk of the patients lived quietly in small group home settings. If you look at the street people, they are typically younger than those who were institutionalized.
Would massive institutionalization work again? No. The costs to comply with guidelines is just too great for any state to bear, and just like the prison system is now a major drain on the economy, these institutions would create a major economic loss, while degrading the quality of life of the patients.
How did the patients live in institutions? Well, it depended on what ward they got stuck on. Almost all were dormitory, day room, and dining room situations, with a few private rooms, that were used to reward patients on open wards, and secure patients on the violent wards. If you got stuck on the wrong ward, interesting things could happen. One patient was sleeping in a dorm, when another approached him and bit off his big toe. Sleep was catch as catch can. There were always patients dozing in the day room because they had been awakened during the night by some event. The big things to do were: Sit. Sit and watch tv. Sit and play cards. Eat. Go to therapy sessions. Sit. Sometimes go for a group walk, typically looking like a Van Gough character with straw hat to prevent the sun from interacting with the thorazine. A lot of the patients were basically stored zombies. The alternative was to have them acting out and dangerous.
Are there some people who would be better off in an institution? Sure. There were a few that had difficulty in the group homes and came back. They were a small minority.
There is no one answer to the problems being discussed. Suggesting that bringing back huge institutions is a solution is simply a case of not understanding the depths of the problems and the downsides of that course of action. But that is typical for what passes as American today. Black and white thinking that has been brought on by divisive politics and ranting drug-crazed radio hosts seems to be the popular group insanity. If you bring back the institutions, better make them REALLY big.
... the historical perspective of what was going on. I'll relate it briefly:
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Thanks for the information....that helps my understanding a lot. ...but, for the love of God, do not be angry with anyone trying to understand and help people. Most of the stuff I know started out with conjecture which then led to fact finding.
I agree 1000% (is there such a number?). So, what can I do? What will you do? Other posters: chime in here. Don't be .
I am actually working on another issue that does not at this point, but will in the future, coincide with this particular issue. The first thing that can be done is to ask questions.
Starting with the group homes/facilities that are within a persons area, develop a set of questions to email the department about. Part of this information can be gleaned from websites if they have them under the employment section. Sometimes they will also include information for funding.
The information to be gleaned from available information (or asked directly) is the education level for different positions and the salary. Do not be afraid to ask where funding comes from if it is not listed. You want to be able to ask what types of training are available after hiring and if it is continuous. If they have volunteer staff, ask what their requirements are to be volunteers and if they receive training. Shelters, hospitals, etc.
Another item to look for, and I do not foresee any organization willingly giving out this information, is the legal actions that have been taken against this organization or complaints or alleged abuse.
Too, you want to ask if there are any limitations to the cases that they accept. What criteria does an individual have to meet? What role does lack of insurance play? Who takes care of the individuals basic needs? Where does their clothing come from?
If it is possible see if you can spend a bit observing the interaction between staff and people. Ask what they believe are the biggest challenges that they face. In fact, ask that question of both local and state angencies that handle these cases and psychiatrists/psychologists etc. Keep a record of this. Collect any stats that are available on the subject.
Once enough information has been gleaned then approach your local newspaper with it, in fact they might allow a written peice to run. And keep your eye on those on-line and written responses to that piece. You may find responses that are born out of frustration from dealing with it or work in that industry and that may open you up to a different level of characters. With collected information approach your representative. Go from there.
I'm going to make myself immediately unpopular here. You all are talking out of your hats, and it is painfully obvious. They were a small minority.
There is no one answer to the problems being discussed. Suggesting that bringing back huge institutions is a solution is simply a case of not understanding the depths of the problems and the downsides of that course of action. But that is typical for what passes as American today. Black and white thinking that has been brought on by divisive politics and ranting drug-crazed radio hosts seems to be the popular group insanity. If you bring back the institutions, better make them REALLY big.
I would love to hear what you have to say, but I can't get any information from you because the above drowns out everything else. You may not insult me. You may either speak to me intelligently or not at all but do not make an accusation such as that.
Last edited by Pandamonium; 05-24-2009 at 08:00 AM..
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