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Sane Asylums [1]
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Date: 2023-05-12
Today, May 12th, the man who choked to death Jordan Neely on May 3rd, was finally arrested. He will be charged with manslaughter. According to the New York Times:
The death of a New York City subway rider who was placed in a chokehold by another passenger on Monday was ruled a homicide, the city’s medical examiner confirmed on Wednesday evening. The man who died, Jordan Neely, was homeless and had been screaming at passengers when the other rider wrapped his arms around Mr. Neely’s neck and head and held him for several minutes until he went limp. Mr. Neely died from compression to his neck as a result of the chokehold…
Daniel Penny, the man arrested said he never intended to harm the victim. Regardless, this tragedy is a microcosm of America’s failure to deal with poverty, homelessness, and mental illness. According to the Daily Beast:
Neely was homeless at the time of his death, which the medical examiner ruled a homicide. Records show he was arrested for past incidents on the subway, but the nature of those arrests is unclear. Loved ones of Neely described him as sweet and loving, with a hobby of impersonating Michael Jackson. His family acknowledged that Neely struggled with mental health issues since his mother was murdered when he was a kid.
If we say someone is crazy or insane, we think there is something wrong inside their head, some sort of mental illness or brain dysfunction that makes them do or say strange, weird, irrational things. In other words, the crazy is in them.
Only that’s not the case. No one can be crazy alone. It takes two to tango. When one person cannot relate to another because they don’t like and/or understand why they are talking and acting that way to the extent they no longer want to deal with them, then we label the other as crazy or insane. Calling someone crazy is tantamount to saying, “Go away. I can’t deal with you.”
Castaway in foreground; Wilson in back.
Consider the movie Castaway, starring Tom Hanks. The story was about a modern man castaway alone on a tropical island. With no one else around, there is no one to judge him as crazy—except, of course, the audience, who can’t interact with him. Absent anyone else, insanity cannot exist. There is only behavior that leads to survival or behavior that doesn’t. So if our marooned hero talks to his only friend Wilson, a Wilson volleyball decorated with a face, who is to say whether that’s nuts, or something necessary for survival? Even his aborted attempt to commit suicide seemed rational, as he didn’t want to live alone for the rest of his life, and his chances for being rescued were almost nil. Nor did it seem crazy for him to risk his life trying to escape the island—especially since he defeated the odds and was able to do so. In one key emotional scene his volleyball friend Wilson gets away from the raft. Our hero swims after him in an attempt to rescue the ball, but he realizes he will drown if he tries to save Wilson. Greif-stricken, he swims back to the raft without Wilson, his only friend for years, in order to survive. Crazy? Again as the audience we judge yes or no, but totally alone, insanity cannot exist, only survival.
This doesn’t mean there aren’t people so weird we can always manage to deal with them. I have dated several crazy women. Rumor has it I am attracted to crazy women. That’s not exactly true. Crazy women are attracted to me. I joke that a woman has to be crazy to want to be with me, but the truth is, I am more affected by how good someone looks, than how strange someone acts. Being crazy doesn’t turn me on; it simply doesn’t turn me off. However, after being with someone with strange difficult aberrant behavior for a while, I have often reached the point I concluded they were crazy, meaning I just couldn’t deal with them anymore. When we say the other is crazy, we are basically saying “I’m OK, you’re not.”
What most people don’t know is that the first asylums weren’t insane asylums. Asylum means refuge or sanctuary, a place where you can safely go when there is no other place to go for assistance, whether it be food or shelter, or escape from enemies.
Back during the Middle Ages work was considered a virtue and unemployment was considered a sin. If you lived in a town and couldn’t get a job, you weren’t just considered unlucky; you were considered a sinner, and if you didn’t leave voluntarily were likely to be kicked out. So many people who couldn’t find work for one reason or another often went to a big city. Too often, however, they didn’t find work there either. Calling them sinners was insufficient, as something needed to be done. So before long institutions were established to provide sustenance and care for those whom, at least for the present, weren’t able to fend for themselves. These institutions were first called hospitals or asylums. The word hospital denotes hospitality, a place to stay where you are welcomed. The first hospitals were not medical hospitals in the sense we mean today, although many might have needed asylum because they were too sick to work. In most cases families took care of the sick or injured. “In Robert Frost’s poem, The Death of the Hired Hand, there is the haunting line, “Home is where, when you have to go there, they have to take you in.”
But people in cities recognized they needed to do something for those who didn’t have families to take care of them. Who, unlike the hired hand, didn’t have a home to go to. Granted some of the people in asylums may have had emotional and behavioral problems that prevented them from working, but the purpose of the first asylums was to provide “three hots and a cot” or in other words food and shelter. Those who provided these services also dealt with the medical and emotional problems of their subjects. The community often supported such asylums simply because that way they didn’t have to personally deal with people they didn’t want to deal with. “Don’t come to me begging for work or food; go to the asylum.”
In modern times, we have gotten rid of asylums, or if you prefer sane asylums. We have replaced them with either medical hospitals for health problems or insane asylums for problems relating to other people. (Of course, we could have easily called Medical Hospitals Medical Asylums, just as we today call insane asylums Mental Hospitals. Unlike the all-purpose asylum of several hundreds of years ago, those specialized facilities were not exactly fun places to stay in. The people in insane asylums were severely mistreated and beaten. Over the centuries things haven’t gotten much better. Today you’d have to be crazy to go to an insane asylum.
Just for the record, Mental Hospitals have now branched off into two divisions. Regular mental hospitals where they load you up on drugs, in the name of treating mental illness with medication; and drug-treatment centers that treat addiction where they get you off the drugs you might have gotten from the Mental Hospital. I’m not joking. I knew one young woman who bounced back and forth from one to the other. In one institution they asked, “Why did they put you on all these drugs?” In the other they asked, “Why did they take you off all your drugs?
Remember One Flew Over the Cuckoo’s Nest? This true-to-life novel illustrated the insanity of locking up people in an insane asylum. Once inside, all the staff sees is a crazy person. And if you aren’t crazy to begin with, the conditions will soon make you crazy enough to belong. As people became more enlightened—and as insurance companies became more and more reluctant to pay mental hospital bills—millions of people were released in the name of out-patient treatment. Translation: Here are your drugs; here is your freedom; you’re on your own.
There was a problem with this “solution.” Many people who left the institutionalized mental hospitals, run by Nurse Ratchets, or were never admitted in the first place, aren’t able to make it on their own. Patients became free from mental hospitals, but went out of the frying pan of cruel incarceration into the fire of homelessness and poverty.
In both my professional and personal life I have met many people who shouldn’t be locked up in a mental hospital, never did anything bad enough to go to prison, but can’t make it on their own.
So America now has a new underclass. I had heard about it, and read about it, but not until I went to a seminar in California to deliver a paper did I fully appreciate it. The seminar didn’t teach me the lesson. The time difference between the East Coast and West Coast did. In Santa Monica I woke up at 5:00 AM, as to my biological clock it was 9:00 AM. So I decided to run down the beach before our morning sessions. It was summer and the white sands of the beach extended for hundreds of yards to the ocean. But about every fifteen feet apart slept thousands of homeless people. I had heard about homelessness, but had no real comprehension how many people in America were homeless. Naturally they slept on the beach. The weather was warm, even at night, and the sand made for comfortable sleeping. By day, homelessness disappeared, or at least appeared to, as they blended in with the crowds, as everyone looked normal milling about in Santa Monica, Malibu, and Venice Beach.
Years later when I went to Vegas, did I realize L.A. wasn’t the only city with a huge homeless population. The homeless end up in places like L.A. and Las Vegas because places like these provide hope for employment, warm climate to keep from freezing at night, and hopefully enough social services, or people to beg from, to survive. Beggars were everywhere in Las Vegas, a clear reminded that in America, the extremely rich are just a stone’s throw away from the extremely poor. One man’s sign read, “I need money for a prostitute. At least I’m honest.”
Rumor has it that the lack of mental health services means the mentally ill have no place to go. Although there might be some people who do need more mental health services than they are getting, the real problem is homelessness. Mental health plays a small role. Lack of adequate employment and housing plays a huge role. And things are only going to get worse unless we rethink this whole problem through.
One day, driving with my mom, we saw a homeless person. Then my mother said something that dismayed me. “I would never let that happen to me!”
She didn’t get it. No one decides, “When I grow up I want to be a homeless person.” We need to believe it can’t happen to us, as though somehow using pluck and determination we will never fall on such hard times. Or that no matter how bad things get, we can always pull ourselves up by the bootstraps. However, by thinking, “It can’t happen to me because I’m better than that;” we can justify turning our back on homeless people, because deep down we have convinced ourselves, “It’s their own fault.” Hundreds of years have passed, and we still hold onto the old religious beliefs that anyone who doesn’t work is a sinner, regardless of whether they are able to work, or able to find work.
We need to give such people sane asylum. Not a mental hospital. Not an inadequate homeless shelter. Not prison. But a place where you can go for immediate food and shelter and help getting back on your feet, without fear of being locked away indefinitely. Moreover without being coerced to consume any psychiatric drug or undergo any medical procedure like ECT without full informed consent. I knew someone who was told he would be kicked out of the half-way house where he was staying if he refused to take the psychiatric medication he told me was making him worse. That type of asylum is insane. Sane asylum respects the integrity of the individual to decide for himself what is in his own self-interest.
Moreover, by first providing a safe place to live, many who are unemployed are then able to get jobs or other services they need.
Here are some ways we can deal with pervasive unemployment.
Lock people up in prison where they can be taken care of.
Lock people up in mental hospitals where they can be taken care of.
Pay out significant guaranteed income or welfare checks.
Leave thousands out in the cold (or extreme heat) without food or shelter.
shelter. Provide cost-effective housing called sane asylums.
According to a Central Florida Commission on Homelessness:
It’s cheaper to give homeless people homes to live in than to let the homeless live on the streets and try to deal with the subsequent problems.”
This commission found out it cost three times as much money to police homelessness, and to provide a home and a caseworker.
Only I don’t see why it would always be necessary to provide a caseworker. The idea of a sane asylum is to provide a decent place to live and a supportive staff to provide assistance. Such assistance could include counseling, medical referrals, social work, help finding employment. The biggest differences between such supportive housing or sane asylums and insane asylums would be three-fold:
Residents would be free to come and go as they please. They are neither patients nor prisoners who are locked in. No one would be assumed to be mentally ill or incapacitated. Anyone could refuse any medication, treatment, or other intervention they didn’t want, without fear of consequences such as losing “privileges” or being expelled.
The most cost-effective way to help the homeless is to give them homes. Addressing housing directly is cheaper than relying on cops and emergency rooms.
What I call “sane asylums” others call “supportive housing.” There are two major benefits.
Improve the lives of the residents who were previously homeless. Reduce the financial costs for the rest of society, lowering tax expenditures.
Although keeping someone in prison or a mental hospital to provide them with food and shelter, is vastly more expensive than letting them go around free; Americans are more comfortable with locking people up, than with providing far less expensive government services.
We need sane asylums.
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