Monday, March 9, 2009

The Limits Of The Nanny State

Here's a story about a a mentally ill woman dying after being left unsupervised at a bus station. I used to work in the mental health field, and if she was in my particular area, I would have gotten her on the bus.

And then she would have died somewhere else.

I don't know if any of them ever did die somewhere else, but I figure the odds are pretty high. Bringing them to the bus station was actually one of the nicer tasks. I sometimes had to wait ages with them until the bus came, but at least it felt like I was getting something done. The really painful tasks involved bringing people to homeless shelters. They need tuberculosis tests and some type of I.D., and you wouldn't believe how often the social worker in charge of their care wouldn't bother.

Then there were the revolving door patients. Many seemed to enjoy the amenities of a state hospital better than what they could get on the outside.

Also, there's no real indication the treatments work. The longer you are in the field, the more you begin to notice the side-effects of the drugs. They are sedated, quieted, etc, but in many case it seem more likely this is for the benefit of others and not for the benefit of the patient. Often they are suffering just as much or even more than they were before. They are just less onerous to those around them.

My work involved pushing the day of reckoning back. Get them on the bus. Get them their medicines. Get them housing. Sometimes it was obvious the social worker just wanted me to get them to a different part of the city. It's inevitable, though, that they had to get off the bus, or make their next appointments, or behave well enough to stay in whatever housing they had.

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