The Power of Institutions vs. the Power of the People

“While nothing is easier than to denounce the evil-doer, nothing is more difficult than to understand him.” – Fyodor Dostoevsky

We all have the capacity to commit crimes, but it is our very systems and institutions that create deviant behavior. It is through the broad influences of political, economic, and legal power that the human character is transformed into an “evil-doer.”

Psychologist, Philip Zimbardo, argues that our society needs to shift away from our medical model at looking at crime and deviance, and adopt a public health model that recognizes situational and systemic vectors of disease.

I personally see the parallels in how we treat our most marginalized, the incarcerated, as mirroring many of the very acts that we’ve lauded throughout time as being inhuman and unethical.

Humanity is everyone’s business. True heroes are ordinary people whose social action is extra-ordinary, that act when others are passive, and who give up ego-centrism for socio-centrism.

We can no longer passively sit by and accept that that our criminal justice system is an effective deterrent or punishment for crime, but see it for what it really is… a flawed system that is in need of desperate and immediate revision.

It is impossible for mental health courts to function as the be-all-end-all in fixing the myriad of concerns in our penal system; however, I strongly believe that it is a step in the right direction. The likelihood of a full system upheaval is slim to none; therefore, any movement in the right direct creates a course for change and improvement – which is bound to having lasting positive affects for our society as a whole.

“The degree of civilization in a society can be judged by entering its prisons.” – Fyodor Dostoevsky

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Welcome Back to The Dark Ages…

This past week, the nation was shocked to learn of the story of Stephen Slevin.

Slevin

After suffering from years of severe depression, Mr. Slevin (59) awoke one morning and decided to drive cross-country with no set route or destination in mind. On August 24, 2005, he was arrested on aggravated DWI charges and for driving a vehicle that he did not own, which landed him in the Dona Ana County (New Mexico) Detention Center. He was immediately placed naked, with only a suicide smock on, into a padded cell to await processing. Slevin was then moved for 2 weeks of observation before being placed in solitary confinement. For the first three months living in a segregation cell, Slevin was able to write letters; some to his sister and others were sent to his very own jailers politely requesting assistance for medical attention, trouble sleeping, and increasing panic attacks.  Within 3 months of solitary confinement, he became delirious and had profound symptoms of psychosis. Slevin lost the ability for most meaningful communication, was no longer able to write, and spent the entirety of his days rocking back and forth. Initially, he was able to get out of his small cell a few times a month, but he eventually would go for periods up to four months without ever walking out his cell doors. Slevin was given food and medication, but was not bathing, had fungus growing on his skin, developed bedsores, and even had to perform his own tooth extraction due to severe decay.

During May 2007, Slevin was sent to a psychiatric facility for two week where there was drastic improvement in his cognitive and mental functioning due to the proper care, socialization, and medication he was provided. Unfortunately, he was returned to his segregated cell at Dona Ana Detention Center, where he  once again rapidly decompensated. On June 22, 2007, Slevin’s case was finally brought before a judge and was eventually dismissed.

The news story that swept the nation was not the shocking fact that Stephen Slevin spent 22 months in solitary confinement under inhuman conditions; instead, it was headlines of him being awarded $15.5 million in a lawsuit that caught the media’s eye. Slevin, who was recently diagnosed with lung cancer and given 1 year to live, suffers severe post traumatic stress that this windfall of money can only offer minimal relief from.

One has to wonder how many other Stephen Slevins are currently lost in our criminal justice system, not receiving proper care, treatment, or case management? A quick search on the internet yields a startling number of local news stories, blogs, and videos on this very topic. Most of these tend to be “after the fact” stories… like those of Armando Cruz or Tony Lester… who’s suicides could have been prevented with the appropriate mental health care received prior to or during their incarceration.

I am left wondering who is to blame for the downfall of our system? The US is plagued with ineffective policy, legislation, and improper funding towards every aspect of mental health treatment and care; maintains a longstanding stigma on the incarcerated and mentally ill;  supports a broken punitive-based judicial system; and endorses the misguided privatization of our very jails and prisons.  The answer appears to be as vague as the path to fix it, as this has become everyone’s problem – from policy maker, to consumer, to tax payer.

For informational purposes, I’ve decided to include two of my favorite videos on this very matter…

FRONTLINE: The New Asylums (2005)
America’s severely mentally ill, who once would have been in state psychiatric hospitals, are now in state prisons. Why is this happening? And what is mental health care like behind bars? FRONTLINE goes deep inside Ohio’s prison system to examine a troubling and growing issue.
Direct link where additional information and continuous video play pack available HERE.

Fault Lines: Mental Illness in America’s Prisons (2009)
Al Jezeera’s correspondent Josh Rushing goes deep inside one of the largest prison systems in the United States to look at the criminalization of the mentally ill.

There is no single answer that can once again take us back out of the Dark Ages in how we mistreat and subsequently criminalize the mentally ill. But in the coming weeks I look forward to exploring one significant step that we can take as a nation to address our most vulnerable people – the movement towards the creation and regulation of Mental Health Courts throughout all of our federal, state, and local jurisdictions!

Kudzu, Kudzu Everywhere…

Maybe kudzu can patch that broken window?

Just about every law, invention, treaty, and large-scale action has unintended consequences, which often alter society as a whole through a butterfly effect – like the ripples after a rock is thrown into a calm body of water.

The 19th Century French economist, Frederic Bastiat, warned of the dangers of unintended consequences in his classic essay That Which is Seen, and That Which is Not Seen. He taught that, “in the department of economy, an act, a habit, an institution, a law, gives birth not only to an effect, but to a series of effects. Of these effects, the first only is immediate; it manifests itself simultaneously with its cause – it is seen. The others unfold in succession – they are not seen: it is well for us, if they are foreseen.”

It wasn’t until the 20th Century that American sociologist Robert Merton popularized the concept of unintended consequences and provided several possible causes: ignorance in that not every possible outcome can be anticipated, error from incorrect analysis, immediate interest that take priority over long term goals, basic values that prohibits certain outcomes, and self-defeating prophecy where well-meaning worrywarts attempt to fix a problem before it even comes to fruition.

If we focus only on the visible effects of a proposed policy, we may not recognize the invisible effects until the harm is done. How is it our policy makers seem so oblivious to the latent effects of choices supposedly made for society’s benefit?

Just a few infamous examples:

Prohibitionnascar-pepsi-400

  • Prohibition brought us bootleggers/gangsters and NASCAR (lest we all forget that moonshine runners were the originators of stock car racing!)
  • Passing NAFTA decimated Mexico’s agriculture industry and crippled their economy, leading to the vast influx of illegal immigration to the US.
  • The failed 1990s “War on Drugs” only served to solidify and consolidate the profitability of drug cartels.
  • Rent controlled housing was meant to help secure housing for low-income tenants, but essentially created a drought of quality in housing for most major cities.
  • Creating antibiotics saved millions, but now our bodies are unable to fight of “superbugs” that are resistant to our greatly outdated antibiotics

After undergrad (and in a former life) I worked in government relations and public policy for a medical non-profit in the DC-area. Fresh from a small town, I was completely content traipsing around the Capital for hearings, meetings, and the typical “schmooze fest” where every move  made was well calculated and micromanaged in order to have the best odds at “winning.” Our goal was simple, pharmaceutical companies had long abandoned research and development on antibiotics (something you take for only a short period of time) for the more lucrative medical innovations like Viagra, breast implants, and medications that secure a life-time of use. Most antibiotics still used today were originally invented in the 40s and 50s, and for that reason the levels of antimicrobial resistance continues to skyrocket. The bill introduced to US Congress aimed to create a number of incentives for pharmaceutical companies, and urged them to abandon the bottom dollar in exchange for the common good. I organized lobby days, press briefings, trips to the CDC and pharmaceutical companies, and attended countless meetings with Congress and their limitless legislative assistants. Our initial support was huge – because you couldn’t deny the scientific evidence! Our thought was if you ran a facts-based campaign, how can anyone vote “nay”? As voting day arrived, I sat nervously waiting for the results. The bill was voted down. It didn’t just die… it was slaughtered, burned, tarred ‘n feathered! Over a year’s work was gone and I sat stunned, holding back tears. I started the job thinking that the opening theme of Mary Tyler Moore was my background music, yet here I sat with only a funeral dirge playing on repeat. My mentor, my boss, had been through this rodeo several times before. He merely shrugged and said, “Next time.” I stammered, “But why?” His response was simple, “Pharmaceutical companies are the top financial backers of the elections,” and re-elections were right around the corner. I was so disheartened and jaded by the process of our government; I left the job (perks and all) to find a new career path.

Let me go back for a second to Bastiat and the Broken Window Phallacy. The salient point is that destructive policies will  destroy prosperity, regardless of the amount of “spin” that someone puts on the visible consequences. This short video does a great job of summarizing a highly debated theory:

It was almost two years later that my former boss contacted me out of the blue.  A prominent congressman had lost a loved one to MRSA (the antimicrobial resistant strain of staphylococcus). He just so happened to be one of the early backers to our bill who appeared to thoroughly enjoy our lavish dinners and “legal donations,” yet ended up one of the turncoats that voted against us. He wrote my boss a cryptic letter that apologized for his “oversight.” He quoted Bastiat, and made sure to point out that he and many of his fellow senators had voted for their own immediate best interest. It wasn’t until that a “nasty little infection” affected his own life that he was able to say, “Oops, My bad.”

In some hypothetical alternate universe, our country would have an “Oops, My bad” list to save us from the bipartisan blame-game and come clean about negative unintended consequences. I’m pretty sure if the south has anything to say about this list… the US bringing Kudzu over from Japan would be near the top! This fast growing plant brought over to help with erosion has since created substantial environmental and fiscal consequences as the “Vine that ate the South.”

Kudzu3

We teach our kids that it’s okay to make mistakes because it’s just part of the “growing pains” of life and meaning-making towards lessons learned and self-preservation. I would not only trust, but respect, my own government if they would just admit their own mistake. As Winston Churchill stated, “those who fail to learn from history are doomed to repeat it.”