Posts
Thursday, June 23, 2011
Wednesday, June 22, 2011
Neglected Strays: How to Rescue Our At-Risk Children
Every community has an animal protection agency that picks up stray animals to feed and house them until they are rescued and given a home. Some 15 million five to ten year-old children in America are estimated to be neglected. State child abuse and neglect reporting laws do not specify the age at which a child can be left home alone. Therefore, no consistent community standards exist to describe when and under what circumstances children can be left alone or in the care of other children.
But any teacher can give you a fair estimate of the number of children who go home to a latchkey, single parent home. Many simply don’t go home. They head for the streets. In terms of guidance and basic human care, they are strays. And too often, they are abused emotionally and physically. Who will rescue and protect them?
Stray children often live in an environment where crime is an everyday event. The U.S. Department of Justice reports that crime reaches its peak appeal for kids aged 14 (which is also the peak dropout age) to age 24. About 70 percent of these abused and neglected kids drop out by the 7th grade. They then stand at the brink of illiteracy, poor health, unemployment, crime, and prison.
The fact that they come from low-income homes does not relieve any one of us of the responsibility to provide the guidance and support they need to grow into contributing citizens. The U.S. Constitution declares that every child is a citizen with rights that cannot go ignored. A public school education is one of those rights. The law makes it compulsory.
A Difficult Life is Not Predestined for Any Child in America, and Poverty is Not a Contagious Disease
Americans are a generous people. Whenever catastrophe strikes, Americans answer with food, clothing, and money. Yet, we are ignoring the plight of millions of neglected child citizens. Looking away costs us billions of dollars every year, and it wastes the lives of potentially useful citizens.
Total taxpayer investment in K-12 education in the United States for the 2004-05 school year was estimated to be $536 billion, according to the U.S. Department of Education, which is more than twice the U.S. investment for 1987. This expenditure has been the foundation for the nation’s success and leadership in the world. For our major cities, it is no longer paying off. A substitute method of education has settled comfortably into America’s poor cities. It’s the one that’s taught on the streets. The reward is not a diploma. It’s usually unemployment, ill health, a jail sentence, or an early death.
A family home may not be the anti-toxin it once was. Nevertheless, life for a neglected five-year-old sitting alone in front of a television set in a single-parent home is not predestined. America has won the fight against diseases like polio and smallpox. We can win the fight against failing K-12 education, too.
The High Cost of Doing Nothing to Rescue Stray Children
Add up the costs for neglecting a substantial minority of American children. America is already the world’s biggest jailer with more than seven million people housed in its prisons. For example, the Washington State Institute of Public Policy reports that in 1975, each taxpayer spent $200 to cover his/her part of the criminal justice budget. By 2000, that annual cost had skyrocketed six times to $1,200, even though crime rates have stayed about the same.
According to the Bureau of Justice Statistics Bulletin, it costs $100,000 to build a new prison cell. It costs $200,000 over 25 years to pay interest on the construction debt and more than $22,000 per year/per cell to operate. Overcrowding is forcing the early release of state and federal inmates back to the streets where they first engaged in crime.
As a taxpayer, you are affected in other ways. Social services for elderly and families with children are cut when state and federal budgets explode from failed criminal justice policies. Such waste can shorten your public library hours, or your access to education and medical care. Property losses through theft and vandalism are soaring. Fear alone of crime and violence is dampening America’s economy.
Of course, the most tragic victims of neglect are the children. Black men are disproportionately the victims of violent crime. In July 2009, the unemployment rate for high school dropouts was 15.4 percent, compared to 9.4 percent for high school graduates and 4.7 percent for those with a bachelor’s degree or higher. According to the Alliance for Excellence in Education, if the high school students who dropped out of the class of 2009 had actually graduated, the nation’s economy would have benefited from about $335 billion in additional income over their course of their lives.
Dropouts are more likely to be unemployed, have poor health, live in poverty, be on public assistance, and be single parents. Therefore, they are more likely to produce more neglected children who, in turn, are more likely to drop out of school as well. National leaders keep demanding that schools, communities, and families take major steps to retain students. Yet, the dropout rate remains high and keeps getting higher. Every 29 seconds, another student gives up on school, adding up to more than one million American dropouts a year, or 7,000 every day.
This trend can be reversed. The health of our society can be restored. But it can only be revived if we pledge to do everything in our power to change it.
Proposal: A Program That Matches At-Risk Kids with Successful, Role-Model Teens
Grade school children, no matter how mistreated, respect and listen to teenagers. These inner-city teens were pre-adolescent just a few years before. They experienced the same problems that their younger neighbors must face every day, and in similar conditions.
Too often, the at-risk kids are looking up to the drop out teens managing their streets. But millions of other teens are successful and thriving in school. They would make ideal role-models, providing the kind of relationships that may be beyond the means of a single-parent household.
Unlike Big Brothers Little Sisters, this mentoring program would focus on matching young, troubled children with successful teens. Call it Big Dude/Little Dude Program, Little Kid/Big Kid, or whatever you like. The point is this: the teen will gain poise and self-esteem by helping the younger child mature and the stray child will have someone to live up to. The mentoring teenage girl or boy has an opportunity to realize that great quality of helping and serving that is inside each of us. Call it “applied citizenship.”
Postscript for Such a Program
To qualify for the program, the teen high school or college student would need to maintain a 2.5 grade average. Their teachers must recommend them. A full-time program staff would need to conduct background checks. Each tentative pairing would be monitored for measurable achievements. Other considerations: Is each student able to walk easily to the other student's home and school? Do they have shared interests? Are their backgrounds similar?
After the relationship has been given time to develop, teachers and program staff should see improvements in the younger child’s performance. Attendance, reading and math skills, and involvement in school activities should all be showing improvement. Teachers should be reporting a lift not only in grades, but also in behavior and morale.
Naturally, such a program would have to be supported by a not-for-profit, tax-exempt organization fully endorsed and supported by the city’s board of education. Ideally, clubs would organize in the schools to draw participants away from the appeal of gangs and the streets. These clubs must be led by the most respected students in the school. A certified faculty person must serve as club adviser. Parents must be encouraged to participate.
The push provided by mentoring teen parents, teachers, administrators, and counselors is indispensable to achieve this specific goal: to guide drifting children safely through the years that will shape their behavior and that will determine their attitudes toward education and a social life. Much time and effort will be required, but the lives of millions of at-risk children can be saved by a program that works with established institutions with no need to form any new bureaucracy.
This program can rescue stray children from our inner city streets by giving them access to positive relationships that build character, that help self-esteem develop and grow, that empower them to face an unknown future. The home and its spirit must be restored if the public school is to be revived and revised.
Tuesday, June 21, 2011
What Is Causing Our Epidemic of Mental Illness
If the psychoactive drugs marketed and prescribed to correct mental illness actually worked, the epidemic would be declining, not rising.
When 25-year-old Stephanie Moulton was murdered in a Boston group home in November 2010 by Deshawn James Chappell, a psychotic man off his medication with a history of violence, people wondered whether the system had failed both the suspect and the victim. An article written by Deborah Sontag for the June 16, 2011, issue of the New York Times asked, “How had Mr. Chappell been allowed to deteriorate without setting off alarms? Should he have still been living in a group home, or did he need the tighter supervision of a hospital?”
The murder occurred days before Massachusetts Governor Deval Patrick released the proposed budget that would slash mental health spending for the third year in a row. And it raised the timely but uncomfortable question of whether such continuous spending cuts played a role in Ms. Moulton’s death in a state that has been in the mental health vanguard since it opened the country’s first large public asylum in the early 19th century. More than any other state, Massachusetts has established a robust community system — group homes, outpatient clinics, day treatment centers — to replace its shut down hospitals.
Such budget cuts have forced the mentally ill into crowded emergency rooms, homeless shelters and prisons. For treatment, the sick have to now depend on recent social work graduates and workers who do not have even own the college degree that Ms. Moulton earned.
Her murderer was diagnosed and prescribed antipsychotic medication years ago, but he did not take his medication consistently because the side effects bothered him, his mother reported. With the advent of psychoactive drugs in the 1950s, states began deinstitutionalizing seriously ill patients so as to offload considerable expense to the federal government. Institutional care was never covered by Medicaid, although community care is often insured.
An Epidemic
Mental illness is now a plague that infects every community in the nation. Forty-six percent of adults met criteria established by the American Psychiatric Association for having suffered at least one mental illness during their lives, according to a survey conducted between 2001 and 2003 by the National Institute of Mental Health.
Americans who are disabled by mental disorders and who qualify for Supplemental Security Income or Social Security Disability Insurance increased nearly two and a half times – from one in 184 to one in 76 — between 1987 and 2007. In that same 20-year period, the rate of mental illness among children soared 35 times, making it the leading cause of childhood disability today. What caused this epidemic?
Psychiatry is Unwittingly Promoting This Epidemic
Psychiatry grew out of medicine, which is odd as so little behavioral malfunction can be traced to physiology. Medical education and training do not provide for a broad view of human behavior. A lab rat does not have an ego, which is a psychological organ unique to humans. Psychosis generally refers to players on the social stage who refuse to — or are unable to — perform according to our cultural plot due to a damaged or broken ego, a severely impaired or ravaged sense of “I.”
Dr. Ernest Becker, the noted cultural anthropologist, called psychiatry a pseudoscientific discipline dealing largely with behavioral styles that are formed socially and culturally. Because behavioral malfunctions rarely have physiological causes, medical professionals are not trained to treat most of the broad categories of mental illness. These are (1.) anxiety disorders, such as phobias and post-traumatic stress disorder; (2.) mood disorders, such as major depression and bipolar disorders; (3.) impulse-control disorders, including behavioral problems and attention-deficit/hyperactivity disorder; and (4.) substance abuse disorders, including drug and alcohol abuse.
Medical doctors treat mental illness now with psychoactive drugs. Some of their patients take as many as six psychoactive drugs every day. Few psychiatrists practice psychotherapy. If they believe that psychotherapy is required, they may refer the patient to a psychologist or a social worker.
Why Talk Therapy is a Treatment of the Past
For the past 40 years, the predominant theory has been that chemical imbalances cause mental illness, and these imbalances must be corrected by drugs. The medical profession came to this belief along with the media and the general public back in 1987, when Prozac came to the market as the remedy for a deficiency of serotonin in the brain.
Over the next ten years, the number of people treated for depression tripled. Today, some 10 percent of Americans over age six take new antidepressants such as Risperdal, Zyprexa, and Seroquel. These drugs have replaced cholesterol-lowering agent as the stop-selling drug class in the U.S. If they actually worked, the pervasiveness of mental illness would be declining, not rising.
A Brief History of Psychoactive Drug Development, Marketing, and Prescription
In 1954, Thorazine, a tranquilizer, was the first psychoactive drug introduced to calm down psychotic patients in mental hospitals. Miltown, a milder tranquilizer, followed as an outpatient treatment for anxiety. To treat depression, Marsilid was marketed by the pharmaceutical industry as “a psychic energizer.”
None of these drugs were developed to treat psychosis, anxiety, or depression; yet they forever changed the nature of psychiatry. All three were derived from drugs designed to treat infections. Later, they were found to affect the levels of certain chemicals in the brain.
Your Brain’s Neurotransmitter Functions
Here, it helps to understand something about how your brain’s billions of nerve cells, called neurons, all arrayed in complicated networks, are in constant communication with one another. Research showed that depression results when the brain’s neurons reabsorb too much of the serotonin they release. Drugs like Prozac and Celexa prevent too much of this reabsorption so that more serotonin remains to activate other neurons in the synapses.
Neurotransmitter function appears to be normal in mentally ill people before drug treatment begins, suggesting that rather than developing a drug to treat some abnormality, the pharmaceutical industry chose an abnormality to fit the drug. In his book, Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations About a Profession In Crisis,” Dr. Daniel Carlat implies that this proposal is similar to deciding that fevers are the result of not taking enough aspirin.
How FDA Approval May Contribute to the Epidemic
If two trials conducted by a drug company show that a drug is more effective than a placebo, the U.S. Food and Drug Administration will usually approve it. Companies are free to sponsor all the trials they like when most fail to show the desired effects. They just need to present two positive test results. These successes are published in medical journals. Negative tests are filed away and ignored.
Irving Kirsch, conducting research for his book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, employed the Freedom of Information Act to study the FDA reviews of all 42 placebo-controlled clinical trials, positive and negative, for the six most used antidepressants approved between 1987 and 1999 — Paxil, Prozac, Celexa, Zoloft, Serzone, and Effexor.
Results: The Placebos versus Antidepressants
Overall, as measured by the Hamilton Depression Scale (a widely used score of depression symptoms) placebos were 82 percent as effective as the drugs. The average difference between placebo and drug was a mere 1.8 points on the HAM-D, which is statistically important, but clinically meaningless and unimpressive. The positive studies were publicized. The negative studies were hidden away. Doctors and their patients became convinced that the six drugs were powerful antidepressants.
All six drugs produce side effects, such as a dry mouth. Therefore, patients taking the drug, not the placebo, could probably guess that they were being treated, making them more likely to report improvement.
In his book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Dr. Robert Whitaker concludes that these drugs are not only ineffective. They may be harmful. The evidence is in the dramatic rise of those disabled by mental illness since 1955, when the prescription of psychiatric medication began to skyrocket. Schizophrenia and depression, once episodic, became lifelong and chronic.
Anyone who has experienced the breakup of her extended family through death, illness, or divorce has also experienced depression. Any individual at any time may affirm a continuous identity by turning it into a negative one in some last ditch effort to sustain his life’s meaning even if it requires self-denunciation.
Is it best to treat this illness, which may disappear like a bad cold the moment the sufferer’s self-esteem comes to the rescue or a new object appears to be willingly held and fondled, with a drug? Or with tender, loving care?
And what about the patient with a history of violence who has been diagnosed a paranoid schizophrenic, who refuses to stay on his meds due to their side effects, and who appeared to become even sicker after being medicated? Should he be left alone in the care of a petite, young female social worker? Or should he be housed as he would have been so long ago — in a special hospital, where he may actually have felt somewhat comforted, staffed with trained professionals who knew how to protect him and all those around him?
Resources:
Carlat, Daniel, Unhinged: The Trouble With Psychiatry – A Doctor’s Revelations About A Profession in Crisis, Free Press, New York, 2010
Kirsch, Irving, The Emperor’s New Drugs: Exploding the Antidepressant Myth, Basic Books, New York, 2009
Whitaker, Robert, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Crown Publishers, New York, 2010
Becker, Ernest, The Birth and Death of Meaning: A Perspective in Psychiatry and Anthropology. Free Press of Glencoe, New York, 1962
Wednesday, June 15, 2011
Friday, June 3, 2011
Visiting Your Sister
A man (who is me) says
To his daughter (who would be you),
“Let’s go visit your sister (who is named Alice)
And her husband (who is called Seth).”
And where do Alice and Seth live?
They live by the sea near Seattle
With their teenage children
(Who would be my grandchildren
Just as they must be your nieces).
The girls are beautiful and perfect.
Jane is the oldest.
She plays both piano and cello
With the Seattle Symphony
While Sandra speaks impeccable French
And captains her debate team.
We six arrive at the dock and set out to crew
On a picnic sail into the sea
Aboard the boat owned by Seth and Alice.
We toast the dolphins we follow
With ice cold champagne
As Alice and Seth serenade us with Vivaldi
And Jane accompanies on her cello
While Sandra serves us chilled oysters.
We talk of the people we love
And wish there was room for them as well.
You recommend my latest book
Which of course they claim to have read,
Exclaiming how it moved them to tears.
Once we anchor and swim to shore,
We walk the broad white beach,
Where you stub a pretty painted toe
And say, “It’s nothing,”
And though your nieces
Tease you, you just laugh
And ask, “Can I suffer from
Too much happiness?”
We all answer together,
“Not now. Not here.
Not now and here together.”
That night, once your sister and Seth
And your nieces (who are my granddaughters)
Have gone to their beds
We talk about all those I just made up
Just as I made up you.
I turn in the bed that creaks.
Words That Kill
Let’s go men!
By two I’d mastered me and mine and I
But all three needed grub
To thrive and grow.
Ma said so next you’ll need
An object called miss right
Who’ll fill your objectifying self
With words of love and praise,
A necessary swap for mother’s milk
To nourish the insatiable reflexive,
Self-validating self
For it must live anxiety-free
In complete control
Or it will shrivel and then just die.
At last in flight
Nearing earth’s blue troposphere
I saw a cloud above
And mistook it for true substance.
What terrible disappointment
When I entered your white veil --
Just dust and vapor,
All icy nothingness
And there I lost my stimulating color
As my warm air passed above your chill,
Denigrating into a deadly dull and quiet calm,
Indulging my merest privations
To condense, and then evaporate,
All omnipotence long gone.
Oh, I heard your frosty whisper squall:
You’ve lost the plot!
You forgot your lines, imposter!
You can’t sustain the fiction
And don’t deserve your rank.
I escalate the mimic and the mime,
Because though they be false
They promise one might be true
To make more of me,
But I’m not here for you.
I don’t respect you
So pass through, go on.
If I had skin,
You’d make it crawl!
I’ve turned from writing fiction
To preparing useful stuff:
Sprinkle with well ground glass
Then finish under boiler
Until puffed and golden brown.
Now cut asbestos cloth
Into nice thin strips and
Place inside gas dryer.
Before leaving, drop copper coin
Directly into fuse box.
I asked you,
One more for the road?
And then re-boarded
To fly higher with warm wind.
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