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Greg, Those are the same arguments used to freeze or cut spending on education and healthcare Who needs an educated citzenry? Who needs a healthy community?

Westsider, those are the same arguments? I have never heard it argued that no one would go to school or a doctor unless forced to do so; I have never heard it argued that being educated or healthy prevents crime. Sources for your assertion?

George, Greg makes the argument himself: "That's an interesting argument...and it's made to justify most spending. That's why all spending has been reclassified as "investment.""


Is there any indication that he wanted treatment and was rejected because of $ ?

I have never heard of that. And barring that, Greg is correct. He could not have been forced into treatment and only if he had requested it, (might have) received it.

That, and all spending--er, uh--investment is for the children.

Of course Greg knows that Arizona has adopted mental health commitment procedures and standards, ARS 36-501 et seq, that meet constitutional minimums. To force a mentally ill person to undergo treatment the standard is the county attorney must prove by clear and convincing evidence that the person is a danger to self, a danger to others, persistently or acutely disabled, or gravely disabled, at a hearing with full due process rights. As a practical matter, high-functioning mentally ill do not get treatment without their consent or the request of those with whom they are living. Nevertheless, the money spent in this regard for those who do come to the attention of the "system" is necessary and yes, the system is not adequately funded based on the need.

The existence of Arnold vs. Sarn reveals the historic inadequacy of the services available to persons with diagnosis of Mental illness. (http://www.azdhs.gov/bhs/sarns.htm)

The set aside of the court monitor is because of budget issues not because the system was fixed. The parties will be back court in October 2012 to evaluate the ongoing provision of services.

Greg, Curious minds want to know if there is any connection between your bringing this up in your blog right now and the budget discussions at the legislature about reinstating the Mental Health budget cuts from last year.

Not that these minds are cynical, you know :)

Keynesians can never spend enough. Bow down and obey...whatever the cost!

Roads and schools existed prior to FDR despite what liberals want to believe.

Wouldn't you have to have some sort of court proceedings in order to force the medication on the hapless patient? I don't follow this argument. This is circular reasoning, isn't it?

Jared Loughner's act was logical once you understand what he was thinking. He just wasnt' very good at articulating his thoughts but those thoughts and the intensity of which he partook of them gave him an incredible sense of superiority over us mere mortals. A nihilist, Loughner feels that we are all so many inconsequential flecks of dust and that his act had no meaning at all. Not much discussion of holding these philosophies accountable for this debacle.

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Westsider, simple "yes" or "no" question: Would more funding have helped Loughner?

PaulS, We don't know because it is unclear if there is a direct connection between money spent and result. Greg's thesis is : "The implication being that more money spent on mental health treatment prevents huge costs in the future." If Loughner had been properly triaged we might not be spending thousands of dollars a month as taxpayers right now for his care. This article by Gladwell argues that the social services system in this country fails to properly triage people who need services. The current "one size fits all" approach seen at CPS, mental health services, homeless services isn't working. We need to figure out who the 20 percent are that are using up 80 percent of our resources: human, physical and financial. This is the discussion that is being ignored in our communities.

So your logic is that, EVEN THOUGH Loughner never asked for help (the only way he could have been 'triaged' - and compelled to receive it), he might have been helped had we just spent more money.

Tell me, exactly how would spending more money have forced him to either be diagnosed as needing treatment or to have been compelled to accept it? Don't forget - the question relates to BEFORE he committed the act. Afterwards, it's really easy compel him to accept it.

And apparently, reading for comprehension isn't your strong suit; Greg's thesis is NOT "The implication being that more money spent on mental health treatment prevents huge costs in the future" - it's spelled out in the last sentence: "He doesn't want help and the state couldn't have forcibly medicated him simply because he acted strange." The fact you seem unable to acknowledge is that this is exactly the case.

PaulS, I didn't say we should spend more money. Where did you read that in my post? Here is my question to you, Should we spend any money at all on Mental health services?

PaulS, I didn't say we should spend more money...

Neither did Greg say we should spend less money. So your original argument falls flat.

Oh, one more thought. In answer to your question "Should we spend any money at all on Mental health services?" - that's actually a nifty strawman. Who has suggested that we not spend anything? Greg certainly hasn't.

What he has suggested - and the true thesis of this article - is that more spending would not necessarily have prevented Loughner's crime, since he could not have been forced to undergo treatment in the second place, nor did he seek out treatment on his own in the first place.

Yet, as Greg correctly points out, Loughner is being used to justify increased spending, when - as you yourself acknowledged - " it is unclear if there is a direct connection between money spent and result."

In short, using Loughner as a poster boy for increased spending is, at best, ill-advised (at worst, it's downright exploitation).

I never used Loughner "as a poster boy."

Maybe Gallegos would be a better example of our failed mental health system.


I find it both shocking and disgusting, but not surprising, to read Mr. Patterson's remarks in light of the fact that he sits on the elected board overseeing the Maricopa Integrated Health System.

I have worked in the health care field my entire career and the past decade with MIHS. In his position, Mr. Patterson SHOULD know a little something about how much of the taxpayers money is spent on care for mentally ill people. He obviously has no clue.

Perhaps he ought to take a short stroll through the hospital some day. (Never seen him there, myself, nor has anyone else I work with.) Ask in the Emergency Department and the Medical ICU about how many psychiatric patients they treat, how many overdoses and suicide attempts they see, and how much is spent on them. Does Patterson know how much it costs to treat a serious drug overdose?

He could even visit the Arizona Burn Center and ask how many seriously burned patients they've seen in the last decade, patients who set themselves on fire in suicide attempts, ask how many millions of dollars were spent on their care, and God forbid, ask who paid the bill. Taxpayers? He might even ask if some of this expense might have been prevented by a better mental health care system, one that might have intervened before someone swallowed the whole bottle of Tylenol and the whole bottle of six other drugs, before they slashed their wrists or shot themselves, or before they poured gasoline on themselves and lit the match.

"The treatment myth." I've seen the failures of Arizona's mental health care system very up close and personal. Treatment is not a myth. We spend millions and millions because of a failed system. Patterson labels treatment a myth. When he's in a position to see the bills when treatment fails.

Ignorant bullshit. From someone in a position to know better.

Leave it to Espresso Pundit to proclaim treatment a myth.

Perhaps he ought to have a chat with our beloved Headless One in the governor's office. Ms. Brewer's son has spent his entire life bouncing around mental health care system, and now resides in the Arizona State Hospital. I wonder if Jan Brewer would agree that treatment is a "myth?" After an event like the Tucson shootings, Brewer still managed to slash funding for mental health care and throw tens of thousands of people off of AHCCCS. What a fine lady.

Jared Loughner fell through the cracks of a very poor and very leaky system. He was kicked out of Pima Community College and physically banned from the campus not just for erratic behavior but because instructors and classmates felt threatened. The situation cried out of a mental health evaluation. Loughner was a danger to others, an undiagnosed paranoid schizophrenic. A good system would have recognized that and acted before he opened fire and killed six people. As far as anyone can determine, the last time he saw a health care professional in any capacity was for a physical in his freshmen year of high school. Where exactly do you see a "myth" in this?

I see only six people's lives taken, including a child's, and many other lives horribly impacted. There's nothing very mythical about it. It could and should have been prevented.

"I never used Loughner "as a poster boy."

I didn't say you did.

What I said was that he IS being used as one, and it's simply not the argument to use, since there was no way he could have either been diagnosed OR treated against his will prior to the act.

And Robert Woodman, under what law could Pima Community College FORCE Loughner to be either evaluated to treated? "The situation cried out of a mental health evaluation." Perhaps. Even probably. But as far as I know, there's no process by which someone other than a family member can force someone to undergo either evaluation or treatment without their consent.

Maybe his real Dad, Sherrif Dupnik, could have gotten him into treatment.

You can't miss!

PaulS, Please educate yourself about "involuntary commitment." Yes, people other than family members can commit people for evaluations. Happens all the time.

1. Who has the authority to commit someone like this? Does a college have that specific authority?
2. Who, specifically, could have committed Lougher?
3. Why didn't they do so?
4. Would any change (increase or decrease) in spending on public mental health services affected their decision in this specific instance? How do you know for sure?

See, the point we're all making, and which you don't seem to understand, is that in this specific case, a change in spending levels would not have changed the outcome. Therefore, it's unethical to use Loughner to promote increases in spending.

PaulS, This answers your first 2 questions: http://www.azdhs.gov/bhs/pdf/Involuntary-Evaluation-and-Treatment.pdf

You would have to ask Pima Community College why they didn't use the involuntary commitment process.

Question 4 cannot be answered by me - I was not there.

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