Afterthoughts
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Often, after I post an entry I spend hours in bed, looking at the dark ceiling, trying to get the little snippets of thoughts that are (sometimes) tangentially related to what I've just posted, out of my head. Last night I was thinking about "The Big Rock Candy Mountain" and the lifestyle implied therein. In truth, being a hobo in the 20's would have been a dirty, dangerous, precarious existence. But in this instance, it isn't "Truth" that interests me, it is the perception of the lifestyle. I'm no authority on social conditions of the era, but what I've heard from my elders and what I've read suggests that farm life was hard and non-farm work was brutal. It seems to me that the appeal of the image of the hobo must have been related to intangibles not available to ordinary people: freedom, travel, no boss, not having to work for a living. And 80+ years later, we are still looking for the same things, only now we don't listen to the song, we buy lottery tickets.

by Cziltang 
Posted: Wednesday, April 28 2004 10:57:24 PM

Of Cigarette Trees and Alcohol Streams
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When I was a little kid and my grandparents still lived on the farm, one of my favorite things to do was listen to records. Grandma had an old Brunswick hand-cranked record player and dozens of old records, including some of those really old, thick Edisons. I've listened to every one of those records, but there were two I listened to over and over again. One was a song called something like "Little black shack back in Hackensack, New Jersey." (I've checked the internet, and a quick search only turned up one reference to it in a ukulele songbook.) The other was a song with quite a bit more history. Apparently in 1928 Harry "Haywire Mac" McClintock recorded "Big Rock Candy Mountains". I think this is the version I grew up listening to, but there are dozens of others. Burl Ives sang it in the 40's and 50's. It appears that it was based on earlier Hobo songs, and according to one source I found, McClintock himself may have lost a copyright lawsuit over the song. (He also my have been a travelling organizer for the "Wobblies." Anyway the version I found that I seem to remember comes from BluegrassLyrics.com

A couple of my favorite verses are:

In the Big Rock Candy Mountains there's a land that's fair and bright
Where the handouts grow on bushes and you sleep out every night
Where the boxcars are all empty and the sun shines every day
On the birds and the bees and the cigarette trees
Where the lemonade springs where the bluebird sings
In the Big Rock Candy Mountains

In the Big Rock Candy Mountains you never change your socks
And the little streams of alcohol come a-trickling down the rocks
The brakemen have to tip their hats and the railroad bulls are blind
There's a lake of stew and of whiskey too
You can paddle all around 'em in a big canoe
In the Big Rock Candy Mountains

In the Big Rock Candy Mountains the jails are made of tin
And you can walk right out again as soon as you are in
There ain't no short handled shovels, no axes saws or picks
I'm a goin to stay where you sleep all day
Where they hung the jerk that invented work
In the Big Rock Candy Mountains

I got to thinking about this song and whether or not it could get airplay today (I don't remember the version that was in the movie "Brother, Where Art Thou?" getting any airplay, but then I don't listen to country music radio very often) while I was being annoyed by another one of those Government Minding my Business "public service" ads on TV. This one in particular was about what a great thing the V-chip is so that parents can decide what is appropriate for their children to watch.

Here's a news flash: I don't need a V-chip. I've got an on-off button and a channel changer. If your five year old isn't couch-potatoed out in their room watching their own personal TV, you don't need a V-chip either. I distinctly remember my mother turning off some variety show on TV when I was a kid because Jim Croce sang the word "damn" in "Bad, Bad Leroy Brown." I thought then (and still do) that that was a bit excessive, but I'll give Mom credit. There was no question as to what she thought was appropriate for children to view, and she wasn't afraid of our opinion of her actions where TV was concerned.

One of the problems with the way we raise children today is that we don't want to limit their self-expression and we have to explain everything. "No" no longer means "no", it has to be followed by a lengthy explanation and we have to get the child's agreement in the cooperative venture that is the child's behavior.

People who tout the V-chip point to working poor parents who can't be home all the time to monitor their children's TV habits. I suspect that this is one of those arguments that sounds good, but in practice sort of evaporates when you think about it logically. (Yes, I know I'm speculating here, but if you wanted research, you would be at a different web page...) I suspect that unsupervised TV watching is more of a problem for middle and upper-middle class families who have a TV in every room of the house and the cable package that has 900 channels. And that is what infuriates me about the V-chip. It is one more thing that the government is responsible for. I don't have to tell Billy Bob that he can't watch "Freddy massacres all of Jason's friends and neighbors with a Texas Chainsaw, Part 19", I just program the V-chip and the government will do it for me. That way Billy Bob won't think I'm a mean horrible person and he will still like me. Which is the most important thing in middle class parenting, isn't it? I mean, if your kids don't like you, you've failed, right? So, thank God the government is protecting us from our childrens' scorn.

OK, the rant is over, and I've just got one weird, quirky little thing to share. While looking into the Big Rock Candy Mountain lyrics, I discovered that the US Government's National Institute of Environmental Health Sciences has a web site for kids. Among the many pretty cool features is a "sing along" song section. There must be a few hundred songs in midi format available for kids to sing along with. Among them just happens to be "The Big Rock Candy Mountain." Of course, it is the government, so they couldn't just leave well enough alone, so they added this disclaimer:

Words and music written and performed by Harry "Haywire Mac" McClintock; copyrighted. Mr. McClintock's song dates back to the 1920's. It was written from the perspective of a "hobo" of that time period who did not hold a steady job, and instead traveled the roads looking for handouts and possibly getting into trouble with the law. Remember, although this is a fun song to learn and sing, having such easy access to cigarettes and alcohol would not actually be a "good" thing. Smoking and alcohol addictions are harmful to your health.

(I could get off on another rant here about the tendency for government to be less concerned with truth than with convenience, but I have to go to work tomorrow, so I'll leave that for another day.) Meanwhile, I'll be thinking about the concept of singing about what's near and dear to your heart.

 

by Cziltang 
Posted: Tuesday, April 27 2004 09:22:15 PM

Correspondence and Notes
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I want to thank those that have written about the essay on Mental Illness in Corrections. I appreciate the comments.

One of the flaws in my writing is that I tend to spend an inordinate amount of time building things up and then I tend to gloss over the conclusions (as if they were forgone...). I think I was guilty of that in the MI essay. The mentally ill are out there. We as a society are responsible for them. While I guess the ideal situation would be for families to take care of their own, there are always situations where there is no family available, and frankly, a number of my clients are beyond the skill and patience of all but the strongest of families. So you and I are responsible and we are going to deal with the situation one way or another, although it is just my cynical nature that suggests that we will choose to ignore the situation and gladly pay for the prison system to just make it go away for us. Judging by my correspondence, I'm not alone in my cynicism.

On a personal note, my entries here have been very sporadic over the last month. For once, it isn't that I can't think of anything I want to write about. The problem is that I changed jobs about a month ago. I still work for the same organization, I just took over the security staff (if we were a prison, they would be called guards). In a lot of respects, I'm back in my element. I'm a reasonably decent teacher, and a lot of our security staff are fresh out of college and new to corrections. I did this job several years ago, and was probably better at it than what I have been doing for the last 5 years or so.

Given the need to get to know my staff, I've been working all sorts of crazy hours on all three shifts. I'm just not physically able to do that kind of thing without a lot of down time anymore. I also set up a web site for the staff to make comments and to post potential policy and procedure change ideas. So, the short version is that I'm working harder and longer than I have in quite a while.

By the way, if anyone out there knows of an elegant way to copy an outline into an HTML page, let me know. All I've come up with so far is a series of nested "blockquote" commands. Any better ideas would be appreciated. (And no, it doesn't have to work inside BLOG. I do the static pages in straight HTML.)

by Cziltang 
Posted: Monday, April 26 2004 09:36:54 PM

More Thoughts on the Mentally Ill in Corrections
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I had occasion to spend yesterday evening at a workshop for social workers on co-occurring disorders. I came away from the evening even more depressed about our prospects for successfully dealing with the mentally ill in corrections. I realize now that what I've been wanting isn't going to happen and it isn't entirely due to what I perceive as the mindset of mental health service delivery system. I guess I was hoping that mental health diagnosis and treatment was a lot more precise than it appears to be.

I still believe that the correct way to deal with the problem is to expand mental health services in the community. I also believe that that isn't going to happen, at least not to the level that would be necessary. So, I've become even more convinced that dealing with the problem of the potentially violently ill in corrections will fall to those of us who work in corrections. And given the fluid nature of mental health diagnosis and treatment, we are going to have to be much more observant and involved in the process than we had any idea was going to be necessary.

Keep in mind that I am only familiar with the way things are around here. In other parts of the country, the situation may be better.

by Cziltang 
Posted: Thursday, April 22 2004 07:30:39 PM

Ode to Bob
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First off, this isn't really an ode. I don't know why I chose that title, other than it satisfies a certain need for perverse irony I feel when I'm angry about something. I started writing this piece several months ago and then quit because I was too angry to write about it. I'm still angry, but it is far enough away that I think I can get through it. Second, there is no Bob, or at least that's not his real name. Bob is just the generic name I use when I can't think up anything catchy. Keep in mind that while in some respects I am talking about society in general, I am most concerned with individuals who end up in my facility. Also, I had intended to post this in multiple parts, but I've got it done, I'm having trouble with the "cut and paste" from Word Pad, and I've got the time to mess with it right now so you get the whole thing.

BOB

Recently we had a mentally ill client at our facility. Actually, we had (and still have) several. Bob was sort of a microcosm of the main issues we are dealing with when we have mentally ill clients at the facility. Bob was't the brightest guy around, but his intelligence was more than adequate to be functional, and certainly sufficient to get him into trouble when he tried to be sneaky. Bob was in the system and in our facility in particular because he had committed a few relatively minor crimes and had a history of violence. It was really a very simple deal. All he needed was regular medication and qualified trained individuals to work with him on dealing with his illness.

Bob went to jail. This happened for several reasons. Among them, we couldn't get professional assistance to stabilize and monitor his medications to see that they were working. The local Mental Health Department couldn't or wouldn't provide services to him. They kept promising assistance to him and then kept rescheduling his appointments. (We have documented a certain reluctance by mental health professionals in the community to work with potentially violent clients. Now they would never come out and say they don't want to work with these individuals because they are afraid of them, and I would never openly accuse any of them of being cowards, but, it is surprising how effectively an individual can be excluded from basic mental health services if there is any hint of a history of violence in their past.)

Eventually, Bob got frustrated. We couldn't let him leave our facility to live in the community without medication, programming and housing in place and he couldn't get any of those things. As he grew more and more frustrated, he eventually got to the point that he was unable to maintain control of his own behavior. (Of course we will never know if it was simple frustration or whether his medication was not working.) He eventually threatened another client and had to be sent to jail. Now it may be that Bob isn't really a very nice person and he may, in fact, deserve to go to prison, but I don't know that, because we never got a chance to see whether he would take responsibility for his actions because we never got to see him function under the influence of stabilized medications. Because of Bob, I came face to face with the nature of the beast, so to speak.

THE NATURE OF THE BEAST

In the middle part of last century, mentally ill people went to the hospital. Asylums, Sanitariums, State and private hospitals, and there may be more names I'm not familiar with, but still hospitals in some sense of the word. I vaguely remember the social stigma attached to being crazy in that time. You sent your crazy relatives to the hospital "for their protection" but that was code for "so they don't cause a scandal and embarrass us." There were well over half a million people in state mental hospitals in 1959. Based on a population of over 177 million at the time, that was roughly 0.3 % of the US institutionalized due to mental illness. The shift to "de-institutionalization" had dropped the public psychiatric hopital population to around 70,000 by the late 1990's, or roughly 0.02% of the current US population.

"De-institutionalization" came about for a variety of reasons. I think part of it was due to the general social climate. As the sixties moved on, it was less scandalous to have a crazy relative. After all, how scandalous could it be when there was rock and roll, hippies, drugs, free love, psychedelic everything, including art, music, drugs and clothes. There was also a growing perception that psychiatric hospital were problematic. In the public mind, hospitals became equated with human warehouses, where there was minimal upkeep, because all the patients were heavily medicated, drooling zombies who spent their days doing the "Thorazine shuffle". Hospitals were also expensive. Even if they are nothing more than human warehouses, they still take a lot of staff to operate.

The answer apparently seemed obvious. We would provide care in the community. It would be less expensive, more humane and the patients would be able to lead more fulfilling lives.

Well, I think it is safe to say that it didn't work out to be the Mental Health utopia advocates envisioned. First, community programs were never sufficiently funded. Second, mental health advocates assumed that mental health patients in the community would have access to appropriate medications and that they would take them. Sane, rational people have trouble understanding that if you think you are Jesus Christ or you think God is talking to you, you probably don't think you need medications. (I realize that that was an overly dramatic statement. Most mentally ill individuals don't think they are Jesus, but the point is that one of the features of some mental illnesses, especially schizophrenia, is the lack of insight into the disease. In other words, you don't know you are sick. And if you don't know you are sick or don't believe you are sick, why would you take medications? Especially ones that tend to slow you down and make you groggy, which most of them do, to one degree or another.)

The third major problem was that: "Advocates assumed that mentally ill individuals would voluntarily seek psychiatric treatment if they needed it. As it turned out, about half of the patients discharged from psychiatric hospitals did not seek treatment once out of the hospital. Many of those who suffer from schizophrenia and manic-depressive disorder do not believe themselves to be ill. These untreated individuals constitute most of the mentally ill population who are homeless or in jail, and who commit violent acts."(source) And that is the error in thinking that is most relevant to my work, that mental health advocates somehow forgot or ignored the fact that some mentally ill individuals are violent, especially when un-medicated.

THE RIGHT TO BE CRAZY

Apparently we all now have the right to be crazy. And that right was established for us by out friends, the lawyers. In essence, a series of legal rulings have established (generally speaking, of course) that you can't compel individuals to medicate themselves and you can't intervene until after they have done something violent. There are laws in some states that provide for "outpatient commitment" requiring a mentally ill individual to take medication in order to stay out of the hospital. However, "Lawsuits brought by the American Civil Liberties Union and Washington-based Bazelon Center for Mental Health Law have changed most states criteria for outpatient commitment. Individuals must be classified as an imminent danger to themselves or others before they can be involuntarily treated, either in the hospital or in the community; this criterion is strictly applied. Most psychotic individuals, who are merely making threats against others or living on the streets and eating out of garbage cans, are not deemed legally sick enough to qualify for outpatient commitment."(source)

WHERE DO THEY GO?

So where are all those violent mentally ill individuals? Eventually most of them end up in the legal system. While making threats against others isn't sufficient grounds to get you the help you need (whether you want it or not) it is against the law. "Bureau of Justice Statistics for midyear 1998 reported that an estimated 283,000 mentally ill adults were incarcerated in the nations prisons and jails, and another 547,800 adults with histories of mental illness or treatment were being supervised on probation.3 Nearly one-third of mentally ill offenders in the study also abused alcohol (a "dual diagnosis"). Growing numbers of mentally ill offenders have strained correctional systems, which are not designed or staffed to manage them." (source) (I might point out here that "dual diagnosis" is not the current euphemism of choice. Now the buzzword is "co-occurring disorders".)

Because we won't deal with the problems of the mentally ill, either in the community or in appropriate institutions, violent mentally ill individuals end up in the Courts. A basic principle of the Adult courts system is that the Court should do what is best for the community (as opposed to the Juvenile system, where, due to a perceived lessened degree of responsibility due to immaturity, the Court is supposed to do what is best for the juvenile.) Violent mentally ill individuals throw a huge monkey wrench into the Adult court system. Few judges are willing to hold mentally ill individuals fully accountable for their actions due to a perceived lessened degree of responsibility due to their illness.

Judges, then are faced with a nearly impossible task of appropriately sentencing violent mentally ill individuals. Sending them to state psychiatric hospitals is generally not an option, as many state hospitals won't accept violent mental patients (yes, I know that sounds ridiculous, but at least in this state, it is true) or will discharge them within a few days (after medicating them) because they are no longer a danger to themselves or others while medicated.

Judges can't ignore their responsibility to the community. They just can't ignore the potential danger to citizens. Yet, they can't ignore their responsibility to taxpayers, as it is expensive to send violent mentally ill persons to prison and most of them don't need to be in prison as long as they are medicated. (see a pattern here?)

Judges often try to put violent mentally ill individuals on probation. When this happens, they usually order the individual to participate in mental health counseling. (Which may not be available, or they may not be able to pay for, or which they may not qualify for, because they are 1) violent or 2) a criminal. As I alluded to earlier, one could come to the conclusion that mental health service delivery systems only want to deal with "nice" crazy people.) Judges also usually order these individuals to take medications as prescribed. Except that they may not have access to the medications (because they usually don't have a steady income and are not likely to maintain employment without supervision) and even if they have access, they may not take regularly (either because they are not capable of maintaining a regular medication routine or because they don't think they need them.)

This sort of probationary supervision sometimes work for a while, as long as the client isn't too ill, the meds are available, there is regular professional assistance (e.g. counseling and monitoring medications), the client has a regular source of income (either through family, state assistance, or they are lucky enough to find a job they can do and keep), and the probation officer knows what they are doing (i.e. they under stand the nature of the illness, they prioritize treatment of the illness, and they don't try to hold the mentally ill individual to the same standards of behavior as "regular" clients). Usually some link in this chain breaks. At that point it is only a matter of time until the client violates the orders of their probation (often violently).

The Judge ends up with little choice but to send the individual to prison. Now we have a significant portion of our mentally ill population warehoused in our prisons. (see quote above) It is hare to argue that this warehousing (mixed in with true criminals) is in any way more humane that the state hospitals of the 50's.

NOW WHAT

Where do we go from here? Well, get out your wallet, it is going to cost money no matter what we do. It really amounts to a "pay me now or pay me later" situation.

One possibility is to improve the delivery of services in the community. We could adequately fund the necessary programs. We would have to have a change in the Mental Health system mindset, however. The new mindset would have to be that violent mental health patients can't be excluded from services, a realization that they won't participate voluntarily and some level of coercion is necessary (the courts would be fine in that regard), and the system would have to get over the "it's the client's choice" mentality when dealing with these individuals specifically. When all is said and done, it may actually be easier to come up with the money than to change the mindset.

The second possibility is to improve probation. We could fund programs to train probation officers to correctly supervise violent mental health patients. We could fund the placement of mental heath professionals is the probation system to provide services within the framework of the probation system, who could operate in the "non-voluntary" world.

A third possibility is to expand the state hospitals. If we are going to warhouse violent mental health patients, it would seem better to do it in a state hospital. They would be more likely to get adequate treatment and would be less likely to be victimized by hard-core criminals.

The fourth possibility is to do nothing. If so, the number of violent mentally health patients in prison will continue to expand. We will end up paying later for more prisons. The only real advantage in doing it this way is that the cost is hidden, because the violent mentally ill felon just shows up as another criminal in the system. This gives "law and order" candidates something to rant about at election time, because on paper it looks like the crime rate is going up and we need more prison beds.

Of course, I have an opinion on the matter. I think ideally, the first option is the best. The mental health system is already there. Theoretically it is best equipped to deal with the problem. It's just that I have absolutely no confidence in the mental health system's ability to adjust their operational mindset (or at least not in the short amount of time necessary). Frankly, I don't think it will happen.

I think the most viable option is to improve probation. Probations officers are used to dealing with a variety of social problems. With appropriate resources, they can probably handle it. The real weakness of this approach is that it doesn't address the needs of the violent mentally ill individuals who are not yet in the system.

I don't think expanding state hospitals is an option. It would require massive funding to expand their capacity. It would take a massive re-thinking of our rules for admission and length of stay criteria for the hospitals. The necessary changes are probably not viable under current civil liberties law.

My best guess is that we won't do any of those and will end up building more prisons to take the problem off our streets and out of our sight. But, make no mistake. We will end up paying for it The violent mentally ill are going to be dealt with one way or another.

by Cziltang 
Posted: Monday, April 19 2004 06:02:40 PM

Partition Boy Strikes Again
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I'm really depressed.

Several years ago, when our organization was not as computerized as it is now and when the IT department was much looser, a couple of us who knew a bit about it did most of the maintenance and upgrades on the computers at our facility. Nothing fancy, mostly upgrading memory and video and sound cards, things like that. At the same time I was re-building my own computer at home. It was a nearly complete upgrade. Starting with the motherboard, I upgraded most of what I had. The crowning glory was a new 133 mhz processor. In the process, I partitioned and re-formatted my hard drive and re-installed my operating system (Windows 95). (I know I'm showing my age here, as I started on Windows 3.1, but then I have an Apple II computer in the basement. Of course I also remember when phones were rotary dial.) Anyway, the point of the introduction is that I was telling one of the IT guys about my upgrade, and for some reason he thought that me knowing how to format and partition a hard drive made me somehow dangerous. So the IT guys started calling me "partition boy". I'm not really sure why, but for a while, it stuck.

A couple of days ago I was tired and pretty toasted from work, so I did what I always do to clear my head: I found a project that would make me think about something completely different for a while. I have two hard drives on my computer and the second one is partitioned into two parts. The second part is extra storage for things like mp3's. On the first part I had installed Mandrake Linux. I never really got comfortable with linux and there were a lot of programs I wanted to install, so I thought it would be easier to just re-install it with all the stuff I wanted, rather than go through program by progam (or package by package, in linux terms). So that's the project I started on.

I guess I was a lot more tired than I thought. In the installation process there is a part where you re-format the partitions to wipe out old data for the new installation. Apparently my attention was wandering a bit, as I elected to wipe all the partitions, including the Windows storage. I realized what I had done about a half second after I clicked on the button that started the process. Unfortunately, that was about three quarters of a second too late. So, I lost a couple of GB worth of mp3's. (cough, cough) Not that I had any illegally download material (cough, cough, just in case anyone from the RIAA is reading this) but I did have lots of copies of my CD's grouped into playlists, etc. and I had a couple of legitimately downloaded Grateful Dead shows (which on a 56k modem take all night to download).

Right now, I don't feel like starting the process of replacing all that material, so I guess I'll just have to use my CD player. The Grateful Dead shows will have to wait until I get a high speed internet connection.

I must still be really tired, as when I started typing this there was a point to this story, but now I can't remember what it was. Update: 4/18/04 7:00 PM: It occurs to me now, that if there was no point to the story, there was no point to posting it. I'm sure my father would agree with that, but then he doesn't know I do this. I'm not sure why I've never told him about it. I guess its kind of like a bumper sticker I saw around town when I was growing up. It said, "Please don't tell my folks I work in the oil fields. They think I play piano in a whorehouse." It also occurs to me that I should cut off this stream of consciousness now before it gets really out of hand.

by Cziltang 
Posted: Sunday, April 18 2004 05:57:39 PM

...with an accordion
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I was planning to write about "Concealed Carry" tonight. The Kansas Legislature is mucking about with a bill that would allow concealed carry. Given that this is only one of four states in the nation where under no circumstances can a private citizen legally carry a concealed weapon, it is something I've been following for several years.

I had planned to write a fair amount tonight, but I ended up having to do other things, including fetching Rat, Jr. from work because her car suddenly developed the inability to retain liquid in the radiator. (I was actually quite surprised when I checked it, as I didn't know that 15 year old cars were allowed to have silver colored metal inside the radiator. I thought it was a law or something that they had to be that reddish-brown color...). And as usually happens when I have something I really want to get off my chest, real life interferes.

So I'm sitting here at 2:00 in the morning getting ready to write rather than sleep and I noticed that its been a week and a half since I made a post and that was about installing the RSS feed. It struck me as sort of silly.

Then I remembered something I saw a while back. If you go to www.google.com and enter "french military victories" in the search bar, then hit the "I'm feeling lucky" button, you get this page. If you follow the link, you get to this page at a website called albinoblacksheep.com. Down near the bottom of the page is this quote:

"Going to war without France is like going deer hunting without an accordion. All you do is leave behind a lot of noisy baggage."

The reason I thought of this is that it seems to me that (to paraphrase the quote) me putting an RSS feed on this site is sort of like deer hunting with an accordion.

Make of it what you will. I'm going to bed.

by Cziltang 
Posted: Monday, April 05 2004 01:54:00 AM

link

test

by Cziltang 
Posted: Sunday, April 04 2004 06:12:57 PM