Fornits

Fornits Home for Wayward Web Fora
An open discussion about the troubled parent industry

It's hard to come up with hard numbers, but these, below, are the best ones I can find about the risk of violence from psychotic people where the risk is put in percentage of the psychotic people who are violent and the effects of medication on the risk.

Keep in mind that some of these numbers are for habitual violence, some for violence in the past year or past four months, some for what percent had criminal convictions.

It's pretty hard to reasonably extrapolate a lifetime risk for a psychotic person to be violent from the available research.

But it's pretty darned sure that not taking your meds increases that risk *a lot*.

So if you're psychotic and don't want to go to jail, take your meds.

If your loved one is psychotic and you don't want them to commit awful crimes and go to jail, they need to take their meds.

The overwhelming consensus of research psychologists and research psychiatrists---who frequently work in academia and don't exactly have an incentive to get themselves more patients, as has been suggested----is that meds are strictly necessary to reduce the risk of violence in psychotic people.

The belief in "alternatives" as treatment for psychoses is very much a fringe belief.

Fringe beliefs have been right in the past when the mainstream was wrong----but it's not the way to bet.

Betting your life and the life of your loved ones and sometimes the lives of total strangers on the chance the fringe might be right this time would be a bad idea.

In the *abstract*, *hypothetically*---sure, play around with the idea that there might be non-medication treatments that can be developed that are effective.  But when you get down to real life cases based on what we know today, not giving your loved one psychiatric meds if she's psychotic is like praying over her bed instead of allowing a transfusion when she's been in a car wreck---or refusing to let her take the measles vaccine when there's an active measles outbreak in the community.

Yeah, sure, if there's no outbreak where you are, and you buy some of the links between mercury and autism, okay, sure, yada yada yada on the whole vaccine thing.  But when there's an outbreak right there in your community, you let the hypothetical people play in the fringe and you go down and get your kid the shot.

Yeah, sure, if your kid isn't actively psychotic, talk about the alternatives all you want, yada yada yada.  But if your kid is having delusions and halucinations you let the hypothetical people play in the fringe, and you bite the bullet and give your kid the meds.

Playing in the fringe has risks, and a lot of times they're much more serious risks than the actual treatment the fringe folk see as such a bogeyman.

----------------------------------------------

    *  A study of 133 outpatients with schizophrenia showed that "13 percent of the study group were characteristically violent." Having inadequately treated symptoms of delusions and hallucinations was one of the predictions of violent behavior. Specifically, "71 percent of the violent patients?had problems with medication compliance, compared with only 17 percent of those without hostile behaviors," a difference which was statistically highly significant (p< 0.001).

Bartels J, Drake RE, Wallach MA, et. al. Characteristic hostility in schizophrenic outpatients. Schizophrenia Bulletin 17:163-171, 1991.

    *  In a follow-up of patients released from a psychiatric hospital, Dr Henry Steadman et. al. reported that "27 percent of released male and female patients report at least one violent act within a means of four months after discharge."

Monahan J. Mental disorder and violent behavior. American Psychologist 47:511-521, 1992.

    *  A study of 348 inpatients in a Virginia state psychiatric hospital found that patients who refused to take medication "were more likely to be assaultive, were more likely to require seclusion and restraint, and had longer hospitalizations."

Kasper JA, Hoge SK, Feucht-Haviar T, et. al. Prospective study of patients? refusal of antipsychotic medication under a physician discretion review procedure. American Journal of Psychiatry 154:483-489, 1997.

    *  A 10-year follow-up of 1056 severely mentally ill patients discharged from mental hospitals in Sweden in 1986 reported that "of those who were 40 years old or younger at the time of discharge, nearly 40 percent had a criminal record as compared to less than 10 percent of the general public." Furthermore, "the most frequently occurring crimes are violent crimes."

Belfrage H. A ten-year follow-up of criminality in Stockholm mental patients. British Journal of Criminology 38:145-155, 1998.

    *  A study of 331 individuals with severe mental illness reported that 17.8 percent "had engaged in serious violent acts that involved weapons or caused injury." It also found that "substance abuse problems, medication noncompliance, and low insight into illness operate together to increase violence risk."

Swartz MS, Swanson JW, Hiday VA, et. al. Violence and severe mental illness: The effects of substance abuse and nonadherence to medication. American Journal of Psychiatry 155:226-231, 1998.

    *  A four-state (NH, CT, MD, and NC) study of 802 adults with severe mental illness (64 percent schizophrenia or schizoaffective disorder, 17 percent bipolar disorder) reported that 13.6 percent had been violent within the previous year. ?Violent? was defined as ?any physical fighting or assaultive actions causing bodily injury to another person, any use of lethal weapon to harm or threaten someone, or any sexual assault during that period.? Those who had been violent were more likely to have been homeless, to be substance abusers, and to be living in a violent environment. Those who had been violent were also 1.7 times more likely to have been noncompliant with medications. As has been found in other such studies, the women with severe psychiatric disorders were almost as likely to have been violent (11 percent) as were the men (15 percent). Because the data on violent behavior were collected by self-report, the authors suggested ?that our findings are probably conservative estimates of the true prevalence of violent behavior for persons with SMI.? They concluded ?that risk of violence among persons with SMI is a significant problem? and ?is substantially higher than estimates of the violence rate for the general population.?

Swanson JW, Swartz MS, Essock SM et al. The social-environmental context of violent behavior in persons treated for severe mental illness. American Journal of Public Health 92:1523-1531, 2002.

    *  In reviewing many of these studies in 1992 Professor John Monahan concluded: "The data that have recently become available, fairly read, suggest the one conclusion I did not want to reach: Whether the measure is the prevalence of violence among the disordered or the prevalence of disorder among the violent, whether the sample is people who are selected for treatment as inmates or patients in institutions or people randomly chosen from the open community, and no matter how many social and demographic factors are statistically taken into account, there appears to be a relationship between mental disorder and violent behavior."

Monahan J. Mental disorder and violent behavior. American Psychologist 47:511-521,1992.

    *  There is very little data which can be used to estimate the percentage of severely mentally ill individuals who become violent. The best study used the Danish psychiatric case register, covering the whole country, and convictions for criminal offenses. Between1978 and 1990 6.7 percent of males and 0.9 percent of females with "major mental disorders" (psychoses) were convicted of a violent crime ("all offenses involving interpersonal aggression or a threat thereof"), compared with 1.5 percent males and 0.1 percent females among individuals with no psychiatric diagnosis. Since these are only convictions, it can be assumed that another unknown percentage committed a violent act for which they were not charged or convicted.

Hodgins S, Mednick SA, Brennan PA, et.al. Mental disorder and crime. Archives of General Psychiatry 53:489-496, 1996.

    * The incidence of violent behavior among severely mentally ill individuals in the studies discussed under II above includes:
          o 11 percent in the survey of NAMI families
          o 13 percent among outpatients with schizophrenia
          o 8.9 percent in treatment and 17.4 percent not in treatment in the MacArthur Foundation Study
          o 17.8 percent among inpatients with severe mental illness
    * In light of the above, it seems reasonable to estimate that at least 10 percent of males with a severe mental illness exhibit violent behavior at some time during their illness and a lesser percentage of females. Since there are at least 4 million individuals in the United States with schizophrenia and manic-depressive disorder, then approximately 200,000 ? 250,000 severely mentally ill individuals are or have been violent.

Timoclea

Here's the site:
http://www.psychlaws.org/BriefingPapers/BP8.htm

I hold it to be the inalienable right of anybody to go to hell in his own way.
--Robert Frost, American poet

http://www.ripoffreport.com/default.asp#

Just found this site.  If you're a parent and were ripped off by a bad RTC, you can file a report (free, but you have to register on the site) so other people will know to avoid them.

Timoclea

The most important bill in our whole code is that for the diffusion of
knowledge among the people. No other sure foundation can be devised, for the preservation of freedom and happiness.

--Thomas Jefferson

Well, I'd originally intended to put together a piece about why I have grave misgivings about most of the facilities in this industry, but enough other people are doing that that I'll just reprint (with permission, of course) the best piece I can find.

What I don't see, that there is a need for, is survival, resistance, escape, and evasion resources for teens.

There will always be bad parents, and it will be a long time before there is a federal law to shut down the few states using abusive facilities as a "cash crop" to bring in money from other states.

Fornits does a good job getting the word out to parents who aren't totally impervious to common sense.

I wonder what the best ways are to get the word out to kids in the goth culture or other counter-culture or alternative lifestyles (or just normal teens) that they need to be prepared in case one of their parents' "friends" recruits their previously somewhat sane parents into the Program cult.

I would think, correct me if I'm wrong, that a kid would *mostly* get through the system minimally scathed if he/she had a carefully prepared "story" of completely false faults to "confess" to in therapy, was a hard case standard "rebellious teen" for about a week (random number of days) after arriving and then gave a good crocodile tears performance of caving in and haltingly confessing to things on the false list, and any real things he/she'd done in the past that his/her parents narced him out about, then was absolutely (on the surface) obedient and respectful with the full understanding that the movement through levels was a lie and he/she would only get out when Mom and Dad ran out of money or he/she turned 18.

The other thing a kid "at risk" of ending up in one of these places needs to do is set up some sum of money he/she will be able to access with a phone call and a bank transfer on turning 18.  Basically, save money from a part time job or allowance or babysitting or mowing lawns and put it in something accessible to only the kid.

There's a great law to do this.  It's called the Uniform Gift to Minors Act

http://invest-faq.com/articles/tax-ugma.html

What you do is have a married couple who are skeptical of your parents' parenting skills set this up for you, with the express provision, depending on the state you're in when you set it up, that the money turns over to the minor on his/her 18th birthday (you *may* depending on the law be able to establish legal turnover at a younger age.)

You want a savings' account or a free checking account or a CD so that service charges don't eat up your balance.  You can find this information out by calling local banks.

So anyway, you hand the cash to one member of the couple at the bank, forex the wife.  Maybe you want to pick a gay couple because they're more likely to understand that parents *can* be malignant assholes.  Anyway, the wife opens the account under the UGMA provisions and names the husband as trustee.  The husband now has a legally enforceable fiduciary responsibility to the minor---he can't just withdraw the money and spend it, or gamble it on horses, or do anything else stupid with it.  Make sure the bank isn't going to try to steal the money if the account is inactive for several years--sometimes weird stuff happens with "inactive" accounts--check the fine print.

Anyway.  

Then you find out if there's a way you can prove your age to the bank and have it recorded so they already know when your 18th birthday is and can put some kind of identifier on the account so if you don't have identifying documents they will know you're you---even over the phone.  Perhaps the way to do it is to have your trustee establish the account with a bank with web access.  Then you can walk into any public library, pull up the website, and have them wire a western union draft somewhere for you?  Check the rules.  The bank and your trustee will be able to help you figure it out.

Then, if you get dumped out on a road with your "exit plan" at age 18, you have *your own* exit plan your parents didn't know about.  You need enough *at least* for a Greyhound ticket to a major city with public transit, city bus pass for a month, deposit on an "efficiency" apartment, first month's rent, and three weeks of food, plus anticipated inflation until your birthday.  Then you need at least two minimum wage jobs.  One day and one evening.  Until you're on your feet.

On the other hand, you don't have to go minimum wage for long if you can type 50 wpm and use a word processor.  With a pair of black slacks, decent shoes, black socks, and three presentable shirts from a thrift store, you can sign on with most any temp agency and get paid more.  Or if you know cars.  Or if you are strong enough to work construction and your 18th birthday is in the summer.  Or if you can cut hair.  Or if you can cobble together any other vocational skill.

Prior Planning Prevents Piss Poor Performance.

If you have lousy parents, the better your contingency plans, the safer you are.

Still, *any* money in your custodial account with your trustee is better than none.

And even though you can sue your trustee if he steals your stuff, or *can't* sue him if he cuts a check to your parents to pay your "tuition" at the brainwashing farm, you *must* have an absolutely trustworthy trustee.  Preferably one with strong kid-rights views that has a lot of integrity but isn't fond of your parents.

You really only need to be able to trust your "grantor" (the one that deposits the money) to keep his/her mouth shut and deposit the money with you standing right at his/her shoulder before you get sent off.

And if you never get sent off, you *still* get your money back on your 18th birthday---provided, if the state the account is in's age of majority is 21, you follow the rules setting up the account to specify 18 as the turnover age.

Plan.

It's a lot easier for a kid to resist if you know you have your own money coming back on your 18th birthday, your parents don't know it's there, and they couldn't touch it if they did as long as your trustee doesn't let them.  In case they drag your trustee into court somehow or something, leave a signed letter with your trustee that you don't want the money used for *anything* even if it's allegedly for your benefit--you want it to remain in place in the account until your 18th birthday.  Get the grantor to give the trustee a similar letter.  If a court case somehow arises, it might help for your trustee to be able to show your wishes and the grantor's purpose in setting up the trust.  But your best protection is for your parents to never know it's there.

Hrms.

Any other survivor tips you actual survivors can think of for a concerned kid to plan in advance?

I'm sure really screwed up kids are not likely to plan ahead like this, but kids who definitely shouldn't be placed---like kids with a hostile or otherwise abusive step parent, or kids that end up with custody transferred to the "bad" parent---may  actually plan ahead like this.

I would have if I'd ever thought about it.

I knew damned well my parents were in lala land and I was the closest thing to an adult in the house.  At 38, looking back, I still believe that was the case.  I was mentally ill, but I still had a much better grip on some aspects of reality, even then, than my parents did.  Or even do today, though I love them dearly and they're very nice people.  And nice people who are good at the things they're good at---but still in some ways in lala land.  Let's just say I didn't get my mental illness from the milkman.

If some program wacko had tried to sell a program to my parents as necessary to save my life (really necessary to save the program wacko a month's tuition)--they might have bought it hook, line, and sinker.

If I'd known it was a risk, or I was a teen today, I'd *definitely* be foregoing immediate spending to get a nest egg together, along with a good proactive survival plan.  I'd have used my grandfather as trustee--he would have believed a trust was sacred and kept his mouth shut---and let him pick one of his good close-mouthed friends as a grantor.  Alternately, I'd have used a friend's over-21 brother who was a local jail guard and let him pick one of *his* close-mouthed buddies to use as grantor.

There's always a recently-turned-21 new adult, older brother or sister of a friend, with integrity who still remembers how stupid and unwittingly destructive (to their kids) some of his friends' parents were.  And it's hard for a trustee to fuck up when all he/she has to do is leave the savings' account alone and let it accrue interest (at below inflation, but you can't have everything---unless you really trust your grantor and trustee and have learned a bit about investing).  I'd have it set up with my trustee to have the money in a solid common stock (in a deep discount brokerage account) like a utility holding company and, if I *was* in a facility, to sell the stock in my brokerage account three to six months before my 18th birthday and just leave the money in the account for me.

Yes, if you're a minor you *can* own money or stocks.  You just have to do it through a trustee---who can be an honorable adult, young or old, who is just a stubborn and ornery cuss or thinks your parents are really fucked up.  And all account correspondence can go to your trustee--the  financial institution doesn't have to have your home address *anywhere* to inadvertently screw you up.  Your parents *don't* have to know you aren't spending your cash on clothing accessories or junk food.

Heck, if it's a relative (like a grandparent) that knows your parents and heartily disapproves of their parenting policy and would *never* believe a kid as together as you would be as screwed up as your parents will *say* you were, you may even be able to persuade them to make small birthday or Christmas money gifts to the account.  Or even put in bits of money or stock they might someday want you to have.  Or maybe you could talk them into matching your savings on a percentage basis---like one for one, or if you could get them to put in a dime for every dollar you put in, you'd *still* be ahead of the game.

If your parents are flakes or making a stupid second marriage, usually *some* responsible, trustworthy adult in your immediate circle of acquaintances knows it.  Political beliefs in the sacredness of individual choice and people's right to go to hell in their own way, along with a *general* tendency to keep their mouths shut, and personal financial sense (without greed), are the best indicators of a good trustee.

Sure, there are a lot of kids who won't think ahead enough to do it.

But any who do are *much* better protected than if they don't.

If I was a teen with a dating single parent, or flaky parents, I'd be busting my butt for this kind of financial insurance policy.

Timoclea

All penalties for drug users should be dropped...Making drug abuse a crime is useless and even dangerous...Every year we seize more and more drugs but the quantity available still increases...Police are losing the drug battle worldwide.


--Raymond Kendall ~ Secretary General of Interpol 1994

What is the usual experience nowadays when a child incarcerated in a Program turns 18?

What *usually* happens?

I and my friends have a friend in a program who's coming up on her birthday, and want to ensure that if her ordeal does not end *before* that date, that it certainly ends *on* that date, and that she has money and transportation to get to wherever she decides she wants to go---that she has the resources necessary to make a free choice.

What should we expect?

The parents have made noises about her coming home before then, as I understand it, but since the story has changed, repeatedly, on other issues related to her incarceration, nobody can really count on that.

Anybody on here who experienced their 18th birthday in a Program?  Anybody have 2nd or 3rd hand accounts of people who have experienced their 18th in a Program?

It is *possible* that she'll be in a foreign country on her 18th.  How would that complicate things?

Are they likely to let her go, or if they don't, what legal strategies have proven effective in the past?

How do you get access to someone in a Program who's just turned 18 to ask her if she wants to leave? (legally, I mean)  What if they move her or even just say she's not there?

Any help of people describing their 18th birthday in Program experiences would be very helpful.

Thanks.

Men seldom, or rather never for a length of time, and deliberately, rebel against anything that does not deserve rebelling against.

--Thomas Carlyle