Wednesday, November 12, 2014

Help People With Intellectual Disabilities? That Is Just Crazy

Solving Intellectual Disability and Drug / Alcohol Dependency Problems

What should we do with Harrisburg Hospital?

In looking back, it may have been a long term mistake to have closed it. While it serves as a symbol of failed intellectual disability (i.e. as mental health) programs, as highlighted by its depiction in the movie “Girl, Interrupted”, we have since made great improvements in intellectual disability treatments. We now know more about intellectual disabilities and how to more properly treat them. We also have developed more effective treatments and we have improve awareness of how to better counsel people with intellectual disabilities.

We need more intellectual disability facilities.

We need to apply the common sense wisdom of the past, which was hampered by a lack of knowledge, with the knowledge we have gained although we have lost the common sense wisdom.

The common sense wisdom is when someone has a problem, we should try to solve that individual’s problem. The lack of common sense is that everyone’s problems should be dealt with in the same manner (i.e. “throw them in prison and throw away the key”). We are now in that era where common sense is lacking.

There are, and have been, people who were unable to conform to societal norms to such a degree that the Commonwealth of Pennsylvania places them into a state institution. A few decades ago, about 90 per cent of people institutionalized were placed into an intellectual disability facility. About 10 per cent of those placed in a state institution were placed into state prison. This is how things were when George Leader was Governor. I credit George Leader for pointing this fact out to me.

Several decades ago, many people in intellectual disability facilities were badly treated. They were abused and or neglected. These facilities, correctly, were closed. Many patients were released into society. Freed, many had difficulties adjusting to society, found poor housing from landlords who ripped them off, experienced high rates of sexual and physical abuse, wound up using drugs and/or alcohol, became homeless, and were incarcerated.

Since then, great advances have occurred in counseling, psychology, and psychiatry, There is a greater understanding of various problems and how to better treat them. Great strides have been made in knowing how to provide better treatment for drug and / or alcohol dependencies. Yet we have generally not applied these advances in services to those who need them.

Today, about 90 per cent of people institutionalized by the Commonwealth are in prison and about 10% are in intellectual disability treatment. This is a tremendous turnover from just a few decades ago when those percentages were reversed.

We as a society have decided to take away counseling for those with difficulties. We instead have decided to both imprison more people, and to keep them in prison for much longer terms. Prisons have sparse and inadequate counseling services, When released from prison, a person likely still has the same intellectual disability behavior that brought that person to prison. That difficulty has usually not been adequately addressed. Indeed, prisoners often are released from spending time with other criminals having learned how to become better criminals.

As we better know how to treat troubled people, we have deliberately chosen instead not to provide help to people in overcoming their problems. We instead have moved towards the more expensive alternative, which is increasing incarceration.

Providing counseling is the least expensive, by far, means of dealing with these problems. The sooner problems are identified, such as when a troubled person is still in school, the more likely the problems can be resolved and the person may go on to lead a more productive life with fewer difficulties.

Incarceration is the most expensive method.In recent decades. It has been one of the fastest growing costs in state budgets as few in the public have questioned these huge costs as we keep electing “anti-crime” elected officials. (As if their opponents were “pro-crime”, yet that is a separate discussion on distorted election perceptions and creating fear among voters in order to win votes. There is also a separate discussion to be had on the politics of campaign contributions and awarding contracts constructing prisons and in operating justice facilities. The “kids for cash” scandal where judges received kickbacks for ordering children to private juvenile justice facilities is a prime example.)

It is indeed ironic, on the other hand, that while voters often claim that education is a priority to them, we have turned our backs on valuable school counseling programs.  In this era of tightened school budgets, funds have been severely cut for counselors and health care professionals who should have been serving those children with problems.

 Children with developmental problems that are not resolved often fall behind academically, fail to fit in with their peers and become more socially awkward as adults. These often are the adults who may find themselves with crime as a career choice and drug / alcohol dependency as a life choice.

I recall speaking with an official at Columbine High School years ago following shootings there where several died. He spoke at a conference where it appeared nearly all attending agreed that more early intervention school counseling programs could prevent further similar tragedies. Most teachers, school nurses, and school psychologists can identify around fifth grade which students are having problems adjusting. This does not mean each such student will become a murderer. Yet by providing appropriate counseling and treatment, these troubled students can learn to adjust, improve their grades, and have better futures.

With each successive tragedy, I see scholars, academicians, and others getting together and each time they arrive at similar conclusions. We need to get more children into counseling and treatment programs earlier in life, Yet, nothing is done in achieving what needs to be done. It is time we finally stop talking about obvious solutions and create these solutions.

Unfortunately, there is no mass movement of people with intellectual difficulties and dependencies organizing to obtain support of programs supporting them. We need to advocate for those who can not help themselves or do not yet know they will need these services. We need to speak for those who can not speak for themselves. We do not need more tragedies where we agree something needs to be done, then forget about it until there are more tragedies, thus repeating this fruitless cycle. We need to act in the interests of people with current and future needs as well as in our own interests as long term taxpayers and as potential victims of people with problems. When people realize they will improve so many lives, and save themselves money, there hopefully will be an outpouring of support.

Footnote: There are career criminals who are a separate category from the above discussion. Some Criminologists believe that about one half of one percent of prisoners are career criminals who have are made a decision to engage in and remain criminals. Some Psychologists have found some success with empathy treatment to get criminals to learn to identify with their victims and understand the hurt they cause.



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