Are you ready for Big Marijuana?

Photo: Reefer Madness via Wiki Commons

Big Marijuana is ready for you.

The fact is that Big Marijuana has been ready for some time. Now it is on the cusp of near-universal legalization in America. And that spells trouble, especially among the mentally ill, as we shall see.

But not just for the mentally ill. As we shall see.

Here is a quick annotation of what I mean by “trouble”:

To legalize, in our consumer-dominated society, is to legitimize. To legitimize is to strip away any considerations of risk—any considerations whatsoever, except price.

To legitimize, in short, is to commodify.

Consumers are paying for this particular commodity—this exciting new product being rolled out, or rolled up—in various ways. Some pay with their credit cards. Some pay with cash. Some pay with their sanity. Some pay with their lives.

As of September, twenty-nine states—three-fifths the total—and the District of Columbia have moved to legalize cannabis1 “Cannabis” is essentially the same as “marijuana,” a Latino variation. use under varying conditions. With a few exceptions on either side, only the Great Plains states, parts of the Midwest, and the Deep South have resisted legalization. The rules are complex in those states where it is approved. Many states, for instance, restrict it to medical use, as a relief for chronic pain.

Yet few players in what is now being called, without irony, “the industry” doubt that most if not all of these holdouts will eventually fall into line. And that the rules will relax. Some already are being flouted with impunity.

This is what happens when a “substance” becomes a commodity. Money begins to talk; and money, big money, is drowning out the rest of the conversation surrounding Big Marijuana.

The volume went all the way up to eleven when hip and youthful Colorado (2014) and then massive California (2016) became the fifth and sixth states to legalize pot for recreational use. California is expected to be issuing licenses for pot shops by January 1, 2018. Canada—Canada!—is working on legislation. The money people are lining up, clutching their open checkbooks.

They will be writing checks in the aggregate billions.

The “commodity” cachet of cannabis is being reinforced by such impeccably establishment periodicals as Forbes, which in May was pleased to advise its elite readers concerning “The Top 5 Financial Leaders in the Cannabis Industry.”

As the reporter Tristan Green wrote last July in the online magazine Finance: “It’s difficult to determine exactly how much money there is in the cannabis industry. A report from Forbes states that North American sales totaled $6.7 billion in 2016. Investors looking for an emerging industry that’s worth billions, doesn’t have stiff competition from major international companies, and is as close to a ‘sure thing’ as possible need look no further than cannabis. The Motley Fool expects a 300 percent increase in cannabis revenues, in the US alone, over the next five years. That figure could increase exponentially if more US States legalize cannabis for adult recreational use.”

 

I suppose I should say here that I don’t oppose marijuana use because I think it’s immoral. As a young Chicago journalist in the 1970s, I found it commonplace among the people I knew and liked. In my beloved adopted state, Vermont, I sometimes wonder whether the blue haze over the Green Mountains is mist or smoke. Yet I have never judged anyone on the basis of race, color, or tokes. Hell, I toked up myself. Once. It made me hungry for a pizza. I lost interest after that. In grass, not in pizza. Yet I was never “against” it. It was none of my business.

I’ve lately changed my mind. I have come to believe that marijuana poses a critical societal threat. Not to our morals, but to our public health—particularly the health of the mentally ill among us.

And the bedrock reason that it poses a critical threat? Commodification.

By this, I don’t mean to say simply that legalizing pot makes it easier to obtain. While that is certainly true, the deeper threat is more insidious, and more troubling. The deeper threat is increased potency. The cannabis on the market today is mind-altering on a scale far higher than the weed puffed by the counter-culture in the 1960s and 70s.

Cannabis’s main psychoactive component is tetrahydrocannabinol, commonly known as THC. You will find a variation of “cannabis” inside that name. Cannabinol is a chemical that interacts with receptors in the brain that are associated with pleasure. It is an adversary of dopamine, the neurotransmitter that controls (among other things) reward-motivated behavior. An overflow of dopamine, triggered by stress, trauma, or—oh—too much THC in the system—can produce psychosis.

(Because no two highly complex neurological systems are identical, some people—me, for example—are not as affected by THC as others.)

Over the long history of pot consumption, the THC level in cannabis plants averaged out to something under ten percent. This relatively benign percentage held through the years of love-beads and “Power to the People.”

That was then. In recent years, researchers have found that the THC in legalized-sale states is three times that percentage. This means that today’s puff produces a higher high—but also a threefold increase in the likelihood of psychosis due to interference with dopamine.

Photo: Marijuana via Wiki Commons

And this is not the only change in the plant. Another component of cannabis is cannabidiol, or CBD. This secretion, traditionally only 0.28 of each plant’s makeup, is responsible for marijuana’s cachet as a benefit to patients who suffer extreme pain. Legalization for medical purposes would be meaningless without it. CBD’s presence in the blood system reduces pain and anxiety. It also is found to block the psychotic potential of THC.

Guess what: lately, those same research projects have found that CBD’s average level has fallen from .028 to 0.15 percent.

What has happened to jack up the potency and lower the medical benefits of cannabis? Is it some abrupt shift in the evolution in the plant?

No. As I have heard public-relations people smirk after their company’s product gets a favorable story in a newspaper: “These things don’t happen by accident.”

The changes have happened because of selective breeding. Another name for this is “eugenics.” Marijuana growers are finding that more potent plants fetch more money from wholesalers. Among the leading wholesalers is Tardiv, Inc., of Boulder, Colorado, a startup in 2015 that now calls itself “the cannabis industry’s largest online wholesale marketplace.” (The acceleration of commodified weed can be grasped from the report of one market research firm Arcview that the cannabis “industry” generated $2.4 billion in sales in 2014, up 74% from 2013.) Tardiv, which keeps its profits a secret, advertises its mission as “To Make Wholesale Cannabis Trade Efficient, Easy & Secure.”

Secure from what?

Secure from being evaluated on its own demerits, for one thing. Big Marijuana is in its infancy compared to, say, Big Tobacco, Big Pharma, and Big Guns. Yet it is learning quickly from its elders.

Learning to turn liabilities into assets, for example: higher wholesale prices mean more cost to the consumer. But with this commodity, that’s not a problem. Higher bucks connote a higher high, not to mention the fantasy of elite consumption. And anyway, many smokers develop a tolerance for THC over time, and actually require ever-larger jolts. In this sense, marijuana is its own gateway drug.

Here some other adaptive skills that Big Marijuana has absorbed.

Its business structures serve to further camouflage the irreducible gaminess of its product. These ape the sleek structures of the Corporation Eternal: advertising, marketing, and research divisions; sophisticated advertising accounts; acquisitions (“Aurora Cannabis Acquires Larssen to Offer Turnkey Cannabis Cultivation Services Worldwide”); flow charts; conferences (the “Aspen High”); burnished websites; speakers bureaus.

All of these strategies are important. None, perhaps, is as important as the manipulation of language to (further) neutralize activist opposition on public-health grounds. Big Marijuana has scrubbed its jargon clean of any usage that might summon thoughts of the product’s potential menace to human well-being and sanity, and replaced that usage with the antiseptic jargon of Corpspeak: “We connect investors and entrepreneurs to the deals and information they need to make the most of this emerging market.” “Cannabis, meet capital.” “Quality Products that Pave the Way for Mainstream Acceptance.”

And get this, for appropriation of the gilt-edged idiom of politesse:

“Snoop Dogg is one of the most revered figures in music, entertainment and more recently, a business pioneer in the cannabis sector. Over a respected career that stretches 25 years, his repertoire has turned him into a cultural icon across mediums. Snoop and business partner Ted Chung recently launched online media platform MERRY JANE, the definitive cultural destination for news and original content.” https://www.canopygrowth.com/

 

A capitalist juggernaut has formed and is rolling. Armed with its vast arsenal of persuasion; outfitted in the fine-woven haberdashery of Success; anointed with further legitimacy-by-association bequeathed by “progressive” billionaires such as George Soros and former Facebook chairman Steve Parker; dripping second-hand stardust from celebrity investors such as Roseanne Barr, Whoopi Goldberg, Melissa Etheridge, the inevitable Willie Nelson, and others, Big Pharma seems poised to overrun the rusting Maginot Line of social checks and balances: federal and state governments, regulators, educators, medical doctors and psychiatrists. It seems guaranteed to take its place among the rest of the ethically impervious Bigs: a massive Goliath striding forward, its path clear of natural enemies.

And yet a resistance remains in place. Across the country, determined local activists have dug in against the onslaught. They are armed with the flimsy-seeming small-bore weapons of medical research, demographic statistics, personal testimonies, and legal savvy. Their most valuable weapon, in the end, may prove to be what William Faulkner called “man’s puny, inexhaustible voice.” They are determined to prevail.

In some ensuing blogs, we will meet some of these Davids, and we will see what they have in their slingshots.

A Digital Remedy–Or a Digital Intrusion?

If neurochemistry can be thought to have a cruel side, it is evidenced in anosognosia. This loathsome side-effect of severe mental illness accompanies about fifty percent of all cases. As the link explains, it renders its victims incapable of understanding that they are afflicted, and prompts them to strongly resist doctors’ efforts to medicate them and, in cases of active psychosis, commit them to hospital treatment.

My family is acquainted with anosognosia and its lethal power.

Kevin Powers

Our younger son Kevin almost certainly was a victim of this ride-along predator, and it cost him his life. He accepted psychiatric treatment and medications for most of the three years after he was diagnosed with schizophrenia, yet never acknowledged the disease itself, insisting that it was merely a “condition.” Near the end, after he had been re-diagnosed with schizoaffective disorder he renounced medication of any kind. He hid the pills that we continued to insist he take, and committed suicide just days before his twenty-first birthday.

Kevin’s older brother Dean, stricken a few years after his sibling’s death, has been more fortunate. An enlightened psychiatrist observed Dean’s own resistance to intervention, and turned it to my son’s advantage: In brief, “Report to a clinician for a monthly antipsychotic injection, or be legally hospitalized when the inevitable psychosis erupts.” Dean has taken this carrot/stick choice seriously, and has significantly improved from his psychotic depths.

Abilify® (aripiprazole) 10mg

Now comes medical science (via the pharmaceutical industry) with a product designed to defeat anosognosia. The Food and Drug Administration has approved the digital modification of a popular oral medication, Abilify® (Aripiprazole, manufactured by Bristol-Myers Squibb). As explained in this  New York Times story, each pill will be equipped with a digitalized sensor that can transmit electronic data to doctors and family members, reporting whether and when the patient took the medication.

The device will surely be welcomed by parents who have exhausted themselves begging in vain for their children to accept professional intervention, and watched helplessly as their children have refused, and deteriorated into deep psychosis, and sometimes, as with Kevin, death.

My own instinct (naturally) is to celebrate this promising solution to a scourge that would be called “evil” if there were sentience behind it. Yet reason tells me that celebration is premature.

An obvious roadblock to the product’s success is that those who most need it may not take it. If anosognosia leads SMI sufferers to resist acknowledging their illness, why would it not lead them to reject a medication that treats a “nonexistent” illness? (It should be noted that the digitalized medication will also be marketed to older sufferers of various discomforts who tend to forget taking their meds.)

Another barrier is popular distrust–legitimate distrust, to an overwhelming extent–of Big Pharma itself. The distrust has been earned.

Bristol-Myers Squibb is a part of a massive industry that has recently been rated as the second-most hated in America. (The top pariah varies from website to website.  The far-flung electronic communications industry is often the No. 1 contender, or nolo contenderer.) Pharmaceutical companies raked in a composite global revenue of more than one trillion dollars in 2014. This ongoing bonanza has made them virtually impervious to the restraints of the law. In 2012, for instance, GlaxoSmithKline paid the U.S. Department of Justice three billion dollars in a false-claims settlement, the largest in the long and bloated history of penalties assessed Big Pharma. Bristol-Myers Squibb’s history of producing Abilify® has been tainted with lawsuits: the watchdog organization drugwatch reports that as of September, 365 actions were pending against the company. Most of them charged that Abilify’s® side-effects include compulsive tendencies toward gambling, eating, shopping and sex.

Big Pharma’s excesses are making headline news, and disrupting America’s social fabric, to this very day. The October 30 issue of the New Yorker carries a bold and searing investigative essay by the writer Patrick Radden Keefe. Keefe’s immersive journalism meticulously lays out the chain of greed, recklessness and “ruthless marketing” that led to our present opioid crisis. Keefe trains his sharp lens on the family of multi-generational philanthropists and drug entrepreneurs, the Sackler family, private owners of Purdue Pharma, which has built them a net worth of thirteen billion dollars, and which is responsible for the prescription painkiller OxyContin. OxyContin’s active ingredient, as most people now know (many of them through catastrophic experience) is oxycodone, a chemical similar to heroin.

Oxycodone

Keefe reports that “Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids.”

Chapter 15, “Antipsychotics,” in my book NO ONE CARES ABOUT CRAZY PEOPLE, covers the era of Big Pharma from the introduction of Thorazine in 1954 through our present time. The saga is one of proliferating medications, global expansion of companies, almost inconceivable profits, false claims, hidden or downplayed side-effects, and a corporate culture whose manifest amorality was damningly characterized by a former insider, quoted in the chapter, as fulfilling “the criteria for crime in U.S. law.”

Given the details that I have amassed, in this essay and in NO ONE CARES, covering the nearly 70 years of depredations that make up the worst of Big Pharma, it may seem surprising that I do not, out of hand, dismiss the introduction of digitalized Abilify. And the entire universe of antipsychotic pharmaceuticals along with it.

The reason I do not is at once simple and complex: many of them work. Or work for some patients, if not others. Or work in spite of their problematic side effects. Or work until they don’t work. Our vexed universe of care for the seriously mentally ill, even at its best, remains enshrouded in mystery, incomplete science, and human failing.

I believe that until the day that an infallible cure arrives, the advocates of intervention (including conditional support for new products such as digital Abilify, and strong support for laws that ease intervention’s barriers) must acknowledge that we take our stands in a world of risks. Some of the risks we advocate might result in more harm than good, or in harm, period.

But I also believe this: that the biggest risk of all is doing nothing. For this way lies madness.

A Father’s Cry From the Heart

Ray Weaver is a singer/songwriter whose daughter is afflicted. With his permission I am reposting his recent message on the private Facebook site CCAC. Never have I seen the many griefs and agonies of a parent expressed so compactly and so bursting with truth.

Ray’s words remind us, among many other things, that far too many Americans remain uneducated about the nature of serious mental illness. It is a genetic brain disease, beyond the control of the sufferer. Yet its effects can be stabilized by medications, therapy, and a loving environment.

Thank you, Ray, and peace to you and to her.

When you have a sick child, there is never a day off. Never. Every day. Waiting for the phone to ring. Trips to the hospital. Fear. Fear. Fear. Sadness. Regret. And yeah, anger. At them. At yourself. At the fucking world. My daughter tried to kill my own mother. Demons. She tried to stab them out to save mom-mom’s life. And so, my own family, my own sisters have washed their hands of her, and, because they cannot understand the sickness, the illness, they have turned their backs on me as well,

I understand. I am not angry.

I am just tired. So very, very tired.

My Interview With Molly O’Brien

While in Providence to give a talk to the powerful advocacy group,  the Mental Health Association of Rhode Island I stopped in for an interview with Molly O’Brien, a young and talented host for the innovative public-affairs webcast GoLocalProv. Here is the clip:

Read the full story here: http://www.golocalprov.com/live/pulitzer-prize-winning-journalist-powers-on-mental-health-in-america

Tyler West is Viciously Assaulted in Jail AGAIN!

Tyler West photo courtesy Kimmy West

I have posted several blogs about the unconscionable jailhouse ordeal of Tyler West, the 18-year-old mental-illness sufferer who has been held in the Muskegon (MI) County Jail since February (!) while awaiting trial on a felony charge of breaking and entering. (He committed this offense early this year, walking into a neighbor’s house and falling asleep on a sofa while in a psychotic state.) Last week Tyler was beaten up by a violent inmate in a cell. It was the second beating he has endured.

Tyler has suffered unthinkably: deprivation of his medications for periods, stints in solitary confinement for no discernable reasons, and the one previous beating by an inmate. I cannot recall a case in which so much punitive state power and so much negligence for well being has ever been visited upon an ill and essentially peaceful young man. His adoptive parents, Dan and Kimberlee West, have held themselves together with remarkable fortitude as they have pleaded again and again for humane treatment and public recognition of Tyler’s torment.

Tyler West photo courtesy Kimmy West

The futility of finding help for Tyler–legal or through mass-media sources–rivals his ordeal itself in surreality. Together with many of you who read this blog, I have alerted media outlets in Michigan and an NPR program dedicated to investigative reporting. I am–we are–met with silence.

Kimberlee West herself updates the story in the message below, which I reprint with permission from the Circle of Comfort and Assistance Community website.

Please read it, and the letter she sent to the Muskegon County sheriff, and follow your conscience.

Wish with all of my being, I had nothing to post. Unfortunately, that is not the case. Our son Tyler was assaulted again, last week in jail. Tomorrow I will email another letter to Sheriff Poulin. Also I will bring forensic psych report into jail medical and to CMH. It is overwhelming. It is hard to carry on, when it has been one fire after another for the last 3 years. So hard to work like this. Ty has had struggles, but, this is a completely different matter. Admire all of you, who have been doing this year after year. This may be a ridiculous question because I already know the answer. How do ya all do it!? Hope one day we will have real choices! We told the sheriff several months prior, “Ty can’t protect himself”. Please do not place him with violent offenders. They are NEVER proactive! They mentioned placing him in security. What does that mean? Isolation!? The last week it has been hard to have a real conversation with Ty. He seems scared. He will barely talk to us. He fears he will be a snitch. Then someone else will get him. We found out during his video visit. We also noticed he had lost weight. Just wanted to reach through that computer and hug him, never letting go. Daddys and Mommys, if your kids and adult children are with you physically, hug them like there is no tomorrow. It is precious to have them near you! Even if you have rough days. Prayers ya all! Ty has a target on his back. Below is the letter to the sheriff. Hope I get it right?

Hello Sheriff Poulin,

We appreciate your quick response last time we emailed.
This is to inform you as of 10-31-2017, Tyler Daniel West,#131395, continues to be in your care at the Muskegon County Jail. We are Dan & Kimberlee West we are his parents, guardians and advocates. Should anything else happen to our son we hold you responsible for the damage/ or loss of life. We seek, for Ty to be moved to the appropriate pod. He was assaulted last week. Tyler is not violent. He has black eye and his neck, snapped back. He does not know how to fight. The last week he has has had a flat affect. Currently he does not feel safe? He is now a target in this unit. He is not street smart.

Sheriff Poulin,

Ty was also, assaulted March 11, 2017. Ty has traumatic brain injury as he has sustained, several serious concussions. Tyler has Healthwest,(CMH) Dan Scanlan is his liason. Ty cannot protect himself, which means he is a danger to himself. Should he not be, in either a disabilities, medical/mental or handicap pod? His previous pod, he was safe. Tyler is autistic, and has a neurocognitive disability. He also has a Serious Mental Illness. He has intrusive auditory command hallucinations. Sensory integration disorder and ADHD. We will also send his recent Psychiatric report, from Dr. Harris. Tyler is only 18.
We thank you for your help and hope you have compassion to do the right thing for Ty.

Cheers,

Dan and Kimberlee West
6712 Northpoint Drive
Fruitport, Michigan 49415

An Insane Consequence, and a Monstrous Violation-in-Progress

Unless a national petition sponsored by an Arkansas social-justice group succeeds (see the bottom of this blog), the life of a hopelessly insane man will be extinguished by the Arkansas Department of Corrections on November 9, less than two weeks away at this writing.

Jack Greene was convicted of murder in 1991. Greene’s lifelong history of suffering abuse, organic brain damage, psychotic disorder, and intellectual impairment amount to traditional grounds for being spared the death penalty. That history cries out for psychiatric attention and, yes, perhaps lifelong confinement. But not death. Yet, as this essay by Jessica Brand of Injustice Today reveals, Greene’s legal representation has been spectacularly clueless and negligent. The jury in his capital murder trial never received evidence of the manifold damages to his brain.

Jack Greene is the embodiment of what can (and often does) happen when a state criminal-justice system loses its fundamental sense of justice. But he is also a maimed human being who does not deserve to die for the violence impelled by a deformed brain.

Please sign the petition below, and repost this–and help in the effort to ward off what Brand rightly calls “a stain on our country’s moral conscience.”

Commentary: “It Is So Loud Inside My Head”
The words of a mentally ill man the state of Arkansas hopes to execute on November 9th

via Injustice Today

Photo: Arkansas Department of Correction
Photo: Arkansas Department of Correction

It is so loud inside my head. It feels like electrical impulses are going through my head all the time. If you took that pen and tapped it on the table I can feel it all the way down my spinal column. It is so loud inside my head.”

Those are Jack Greene’s words. He is the 62-year-old man that the state of Arkansas hopes to execute on November 9th for the 1991 killing of Sidney Burnett. Greene suffers from crippling psychiatric deficits, a possible intellectual disability, and a mental illness so severe that there are questions about his competency. He received such grossly inadequate representation at trial that the jury that sentenced him to death never heard of his devastating mental illness — a refrain all too familiar in capital cases. The state is aware of the glaring problems in Greene’s case, but it still hopes to execute him next month.

Greene, for example, regularly stuffs his ears and nose with paper “to alleviateperceived (but delusional) injuries.” Sometimes he intentionally causes his nose to bleed, and guards discover his face covered with blood. He eats out of his sink; his toilet is his desk. He thinks his central nervous system is totally destroyed, caused by, in his words,

[t]he prolong and repeated injuries on me . . . by staff of the Ark. Dept. of Corrections with the deliberate permanent destruction of such vital bodily functioning organs that’s caused injuries so severe and traumaticly [sic] inflicted to my brain, head, left inner ear, etc. . . . for all of which is so painfully torturing and inhumane I can no longer humanly function properly and live with.

He believes that his ex-attorney, the prison warden, a nurse, and a prison guard have conspired together (in that “chronological order”) to destroy “these vital functioning organs,” and that they are also preventing him from being extradited to North Carolina, where he could receive adequate medical care. He thinks his looming execution is part of this conspiracy.

Doctors believe Greene has organic brain damage. He has had a serious head injury in the past, and neuropsychological testing reveals damage to his frontal lobes. Several experts who have examined him have diagnosed him with a psychotic disorder, and his current lawyers are certain he is not competent to be executed. He also might be intellectually disabled, a status that, like incompetence, would render him categorically ineligible for the death penalty.

Then there is the trauma and the familial mental illness visible in many of Greene’s relatives. Greene’s father killed himself when Greene was an infant. His mother would later overdose on pain pills, and his brother later shot himself. Greene’s grandfather physically abused him and his siblings, sometimes rubbing salt in the wounds he caused. Greene lived in a house with no running water, electricity, or plumbing. At eleven, his grandfather handed him over to a notorious state-run training school for boys. While there, Greene was sexually and physically abused.

The evidence described above is the type that often causes juries to spare someone’s life, according to the findings of the Capital Jury Project. But at Greene’s sentencing trial, his attorney did not put on a mental-health expert and he presented no other mental-health evidence, although the signs of his illness were readily apparent. Instead, to convince the jury to spare Greene’s life, his lawyer presented a measly 46 pages of testimony, 33 of which were read from a cold, emotionless, transcript from a prior proceeding.

What happened next is equally disturbing. During post-conviction proceedings, an expert found that Greene might be intellectually disabled but stated that he needed to do additional testing to confirm. Greene, insistent that his lawyers were conspiring to torture him, asked the district court to withdraw the claim. He accused the Federal Defender’s Office of “making [him] out to be some kind of incompetent retard to get their office appointed to [his] case and try and cover up crimes of inhumane injuries maim and torture.” The judge found Greene competent to abandon this potentially life-saving claim and withdrew it. No court has ever heard it.

Perhaps the most shocking thing in Mr. Greene’s case is that, with a little more than two weeks until the scheduled execution, he has yet to receive a hearing to determine whether he is competent for execution under U.S. Supreme Court precedent that bars the execution of persons who lack a rational understanding of the punishment they are to receive. Arkansas’s unusual statute gives the Director of the Department of Correction sole discretion in making competency determinations. This means that the same person who is in charge of carrying out Mr. Greene’s execution also gets to determine –without a fair and independent court hearing — if he is competent for execution.

If the state has its way, Jack Greene will join a group of four other men executed by Arkansas in 2017, a group that to a man suffered from the most debilitating illnesses and trauma and received the worst lawyers. Ledell Lee, who might have been intellectually disabled, had lawyers who tried to withdraw from his case, citing a “gross [ethical] conflict,” a drunk lawyer, a mentally ill lawyer, but never, until it was too late, a competent lawyer. Marcel Wayne Williams had a mother who pimped him out for sex at ten and who tortured him by pouring boiling water on him and covering him with tar; Kenneth Williams may well have been intellectually disabled; and Jack Jones suffered from extreme physical abuse, was brutally raped by strangers, and suffered from bipolar disorder. Juries never heard these stories because of ineffective lawyering.

What is happening in Arkansas is a stain on our country’s moral conscience. Under the Eighth Amendment, the death penalty is supposed to be reserved for the worst of the worst, society’s most culpable. The prosecutors’ continued push for death in the face of severe illness and trauma, never heard about by juries, flouts that constitutional promise. And each time a court allows a state to carry out the harshest of punishments on the most impaired and least represented, it mocks the promise of justice. Will a court finally recognize this reality and intervene? Or will Greene become another tragedy in a system that is completely and utterly broken?

Take Action

Please watch the video below to learn more about Mr. Greene and share his story with friends.

Click here to sign the petition to grant mercy to Jack Greene initiated by the Arkansas Coalition to Abolish the Death Penalty.

The (Continuing) Education of a White Writer Regarding Black Americans and Mental Illness

This post is for two of the best women I know, the New York actor and activist Madeline McCray and her close friend Terrie M. Williams, the author of BLACK PAIN: IT JUST LOOKS LIKE WE’RE NOT HURTING.  

Terrie Williams and Madeline McCray

Madeline and Terrie, you tried to put me wise to the special challenges of African-Americans who suffer from mental illness. You reached out to me as I began research on NO ONE CARES ABOUT CRAZY PEOPLE.

You provided me with sources. You tried to educate me. I promised you that I would look deeply into this topic in my book. But in the end, I did not look deeply enough.

Recognition of this truth arrived, appropriately enough, on Mental Health Day, October 10. It arrived in the form of a young woman in Cleveland, an African-American service-staff employee at the Intercontinental Hotel. It arrived just minutes after I’d finished addressing an exemplary civic group on—well, on the topic of education. Education about mental illness. How important this kind of education is.

(from left) David E. Weiss, board chairman; Honoree Fleming; Ron Powers; Elizabeth Newman, president and CEO at The Centers for Families and Children Benefit Luncheon 2017.

It took a three-minute conversation with this soft-spoken young woman to make me realize that my own education has been incomplete.

This is a rich irony—or a well-deserved comeuppance, depending on your point of view. I wrote NO ONE CARES essentially as an effort at education. After schizophrenia invaded my family and attacked both my sons, triggering the suicide of one of them, my wife and I realized that we’d become citizens of a “sub-nation”: the largely opaque nation of the afflicted and their families. Years later, when I recovered my willpower, I decided to write the book as an attempt to widen public understanding (and my own) about the nature and the reach of serious mental illness. That, and to illuminate the gross deficiencies in the American systems of mental health-care, criminal justice, and political willpower in addressing the problem.

As I’d hoped, writing the book educated me—but incompletely, as I now understand.

It is not as though the book ignores the particular ordeal of mentally ill black Americans. At least the public symptoms of that ordeal. It covers the epidemic of fatal shootings, by police, of unarmed and psychotic black men on the street. It portrays the overcrowding of the nation’s jails by juveniles, mostly black, who have been charged with crimes but not yet tried; and the violence visited on them by wardens and guards.

All of this is important. Yet in merely evoking these familiar abuses, I failed to cross an elusive border: the border that defines the daily realities of a sub-nation within a sub-nation. The lives of African-Americans struggling with mental illness amounts to unknown territory—unknown, at least, to most white Americans, of which I am one.

Ron Powers – keynote speaker at The Centers for Families and Children Annual Benefit Luncheon

I was ushered across that border in Cleveland on Mental Health Day.

My guide, the young service staff member, approached me just minutes after I had finished speaking at the annual luncheon of the Centers for Families and Children at the Intercontinental. (I am withholding her name. It’s a sad possibility that in these hair-trigger times, her employment could be jeopardized by the very fact that she spoke up to me about a racially charged public issue.)

Woodlawn Avenue, East Cleveland

The Centers deserves a moment of illumination here. It is a sterling civic institution. A nonprofit with an annual budget of $55 million, it reaches out to the poor, the hungry, the under-educated, the sick, and the troubled—some twenty-five thousand clients—in a city striving to overcome chronic post-industrial poverty entrenched racial tensions. The racial stress is burned into the city’s history along lines of segregation in its housing patterns: most of its black and poor population is concentrated in the near East Side, and most of its white population farther west. Cleveland’s incidents of fatal police gunplay in recent years, highlighted by the shooting of the 12-year-old Tamir Rice in 2014, have deepened black Cleveland’s distrust, bordering on paranoia, toward the mostly white police department.

David E. Weiss

Amidst these overwhelming challenges of poverty and racial unease, the Centers for Families and Children persists as a national model of enlightened civic service and hope. Its board chairman, the lawyer and businessman David E. Weiss, ranks among the most socially engaged civic leaders in the country. Its new director, Elizabeth Newman, has re-ignited its six hundred volunteers with her own passionate sense of mission: to help people find job opportunities and early-education conduits for their children, provide food for hungry families, dispatch pharmacists to households to help manage nutrition and medications, find treatment for substance abuse, and summon emergency services in crisis situations.

And to co-ordinate intervention and help in the crises of the mentally ill. Elizabeth Newman explained this cornerstone service to me in detail:

Elizabeth Newman

“The Centers is equipped to support people with serious mental illness, this skill set actually sets us apart in the community. We routinely assist people living with schizophrenia. We have psychiatrists on staff, in addition to relationships with the local/regional hospital systems and emergency rooms. In terms of onset of psychosis, we are outpatient providers but work in partnership with inpatient providers, so it really depends on the level of severity.  Another agency in town runs the mobile crisis unit, but we receive referrals and connections to clients directly from that unit.”

Which brings me (in my round-about way) to the topic of this blog.

Ron Powers

As mentioned, I had completed my remarks and was standing amidst the departing luncheon attendees when she emerged from the mix of people. She wore the brown uniform of the hotel’s service corps, and her manner was hesitant; yet it was clear that she had something she wanted to say.

What she said was, “Thank you for speaking about schizophrenia.”

I sensed the urgency behind this polite comment and asked her: “Is there a history in your family?”

She hesitated for a moment, as if trying to decide whether she could trust me with an answer, and then:

“My mother. And my brother.”

There is no way to prepare for a response like this, no matter how much you expect it, no matter how often it comes. One rule of thumb is to avoid “condolences.”

I asked her the only questions that seem fitting, and necessary:

“Are they getting treatment? Are they on medications?”

She smiled just a little before answering; and the smile should have told me everything I needed to know. But she spelled it out anyway.

“Black folks don’t like to get treatment. Black folks see it as a white man’s disease.”

While I was digesting this, she added: “Black men don’t like to talk about mental illness. They see it as a sign of weakness.”

And then, as if recognizing the need to explain the obvious to a blockhead (accurate, I suppose, in this instance): “So, no. They aren’t getting any treatment.”

And there it was: a key to the inner realities of a sub-sub-nation. The culturally learned set of attitudes that makes it all the harder for doctors and psychiatrists to intervene in the mental-illness crises of African-Americans. African-American men in particular, who routinely suffer violations of their self-respect, their safety, their very humanity, at the hands (and guns) of those who view them as inherently alien, dangerous, unworthy of inclusion in society.

Which, when you think about it, is exactly the same way that many people view the mentally ill in general.

 

I left the Intercontinental Hotel in Cleveland as the educated educator. I thought of my friends Madeline McCray and Terrie Williams, and about the exasperation they must have felt at my failure to cross that border. Felt silently, without rebuke, in the way many African-Americans experience the myopia of their white friends.

Back home, I sought to verify the viewpoint of the young service-worker at the Intercontinental in Cleveland. Below are some samples of what I came up with. There are more, many more, as a Google search of “African Americans mental illness” will show.

–That African Americans are 20 percent more likely to experience serious mental health problems than the general population, owing in part to the exceptional stress they experience just living their lives. The problems include major depression, attention deficit hyperactivity disorder, recourse to suicide, and post-traumatic stress disorder (this last because African Americans are especially likely to be victims of violent crime).

–That many black Americans misunderstand what a mental health condition is and don’t talk about it. Many thus believe that a mental health condition is a personal weakness punishment from God.

–That stigma—which knows no color lines—triggers especial reluctance among African Americans to discuss mental health issues and seek treatment.

–That a pervasive deficit of information—education—causes many African Americans to have trouble recognizing the symptoms of mental illness and to underestimating its dangers. Some may think of depression as “the blues” “or something to snap out of.”

(The above examples are taken from https://www.nami.org/Find-Support/Diverse-Communities/African-Americans)

–That black Americans’ distrust of doctors has some factual justification: Blacks are “over-diagnosed with schizophrenia, frequently misunderstood by their psychiatrists, and largely disenfranchised,” in the opinion of William B. Lawson, the distinguished African-American professor and chair of psychiatry at the Howard University College of Medicine. (https://www.medscape.com/viewarticle/768391#vp_2)

 

A Closing Thought

This has been far from an easy blog entry for me to write. No one likes to own up to failures of understanding, especially in the fraught arena of of racial relations. As with NO ONE CARES ABOUT CRAZY PEOPLE itself, I at first resisted writing it at all. Then I decided I had to write it because it was the truth. I hope that it is read with an understanding that writers are often fallible—just like ordinary people.

________

The full recording of the interview with Elizabeth Newman and Ron Powers is available here: http://www.ideastream.org/programs/sound-of-ideas/finding-the-cure-for-aids-book-no-one-cares-about-crazy-people.

Additional coverage of the Luncheon in The Plain Dealer, the daily newspaper for Cleveland: http://www.cleveland.com/healthfit/index.ssf/2017/10/putting_a_renewed_focus_on_men.html

Is the Tide Starting to Turn in the Battle for Mental Healthcare Reform?

“This is not the end. It is not even the beginning of the end. but it is, perhaps, the end of the beginning.”

These were Winston Churchill’s words to the British people after General Montgomery’s forces turned back the formidable German army under General Rommel at Alamein in November 1942.

Readers of this blog know that I see our present struggle to eradicate the terrible abuses of mentally ill people in terms of a war: a war against entrenched ignorance, apathy, denial, and abject cruelty within the institutions that exist to protect all citizens, especially the most helpless. Too many caregivers, jail wardens, and state governments (among others) remain clueless or unwilling to reform the atrocities that they perpetuate.

And yet hope endures. It is important to amplify and celebrate any example of enlightened hope overcoming dark chaos.

Here are three stories, linked below, that offer hope.

The first covers the efforts of lawyers in Illinois, representing a total of 12,000 mentally ill patients, demanding from a federal judge that Illinois face up to its “state of emergency” in Illinois prisons and move to eradicate poor psychiatric care amounting to “cruel and unusual punishment.” https://goo.gl/yaSvtq

The second addresses a barbaric practice that is near the top of my personal list for drastic action, solitary confinement. Written by the executive director of the Colorado department of corrections, it explains why the state recently ended the practice of long-term solitary confinement for prisoners. Colorado now limits stays in solitary to fifteen days. In my opinion, that is fifteen days too long; but it is a significant improvement over the state’s average length of two and a half years “and sometimes for decades.” https://goo.gl/c6SqTf

 

Elizabeth Newman, President and CEO of The Centers for Families and Children

The third focuses on the Centers for Families and Children in Cleveland, a nonprofit group that has existed for years but has accelerated dramatically in its outreach under its young new executive director, Elizabeth Newman. I visited the Centers on Tuesday to give a talk at their annual luncheon. My typic skepticism burned away as I experienced the Centers’ zeal, the intelligence, and the broad scope of outreach, exemplified by the remarkable Ms. Newman. I will return to the topic of the Centers in an upcoming blog. https://goo.gl/Jczmsk

For now, let us celebrate what may be the end of the beginning.

 

In the (Sad) Scheme of Things, This May Count for Progress

Mental healthcare reformers (and many jail officials) have complained for years that our jails and prisons have become defacto hospitals for the mentally ill, however grossly inadequate. The Illinois Youth Center in Joliette, once used for incarceration, has recognized this baleful truth and is transforming itself into a . . . mental hospital for inmates.

Note that they are still referred to as “inmates.” But any little turn toward enlightenment helps.

Facility for mentally ill inmates to open in Joliet

via Chicago Tribune

Illinois Department of Corrections officials Thursday showed off what will soon be the state’s largest residential facility for mentally ill inmates.

The former Illinois Youth Center prison in Joliet has been transformed into a mental health treatment unit for male inmates with severe mental illness. The facility will be the largest of its kind in Illinois and will begin accepting inmates by year’s end. The renovation project cost $17 million, officials said.

Read the full story here: http://www.chicagotribune.com/suburbs/daily-southtown/news/ct-sta-joliet-residential-center-st-0919-20170918-story.html

 

How to Kill “the Monster in Our National Basement”—a Proposal

In my previous blog, I called for the abolishment of solitary confinement—“the monster in our national basement”–throughout America’s jails and prisons. I left the question open as to how this might be accomplished.

Detention Centres, Solitary Confinement. Credit publik15 via Flickr http://bit.ly/2v2Yf8F

I see one route, and one route only, toward this essential and long-overdue reform: enactment of a federal law that categorically bans solitary confinement in all federal, state, and local prisons, jails, and detention centers. The law would establish strong felony charges (I would stop short of solitary confinement) for wardens and guards who violate it.

The congressional bill calling for total abolishment should be bipartisan, and should be buttressed by as many signatories as possible.

The law should have a name, of course. I propose the Dorothea Dix Humanity Toward Prisoners Act.

I will enlarge on this remedy and its possible champions later in this essay.

It is true that recent years have seen several initiatives to curtail solitary confinement, which currently encages 80,000 to 100,000 American prisoners and inmates on a given day. They are well intentioned half-measures, and they are doomed to meaninglessness and failure. Half-measures will never be enough to eradicate this evil.

Dix-Dorothea-LOC
Dorothea Dix
Among the most publicized has been then-President Obama’s executive order in January 2016 to ban solitary for juveniles in federal prisons. The facts, however, virtually neutralize the order’s headline appeal. How many juveniles reside in the federal penal system? Fewer than thirty, according to a survey conducted by the Marshall Project, a nonprofit organization that monitors criminal justice. This is in contrast to the system’s total population of 197,000). https://www.themarshallproject.org/2016/01/27/there-are-practically-no-juveniles-in-federal-prison-here-s-why#.lRlqKK4Kv

Nearly all juvenile offenders are sent to state prisons, or to local jails. Most of these are pre-trial detainees, trapped behind bars as they await trials that may be weeks, months, or years in the future.

USGS Rikers Island
Rikers Island By U.S. Geological Survey, conversion to PNG by uploader (Herr Satz). [Public domain], via Wikimedia Commons
A scandalous eighty-five percent of adolescents at the dreadful Rikers Island in New York—from a population that often approaches ten thousand daily—are pretrial detainees, most of whom simply cannot afford to pay bail for charges of petty crimes. Although this form of detention has been frequently challenged on constitutional grounds, it persists, with these young captives enjoying the same rights as convicted prisoners: the right to be separated indefinitely from their families; the right to be beaten and slashed by guards and fellow inmates; the right to kill themselves; and, of course, the right to solitary confinement and descent into madness (if they are not mad already, as twenty percent of the Rikers population typically is).

Kalief Browder. Credit Zach Gross

The single most notorious and crushing example of this, which I treat on pp. 150-151 of NO ONE CARES ABOUT CRAZY PEOPLE, is the post-incarceration suicide of Kalief Browder, a promising young African-American man falsely accused of a crime and then packed off to Rikers for three years, two of which he spent in solitary, before being released. Browder was the subject of two piercing essays by Jennifer Gonnerman in the New Yorker, linked below:

http://www.newyorker.com/news/news-desk/kalief-browder-1993-2015

http://www.newyorker.com/news/news-desk/kalief-browder-learned-how-to-commit-suicide-on-rikers

 

Few jails in America, or in history, are as dangerous to their inmates as Rikers. When guards manage to intervene in a suicide attempt, for instance, they often follow up by beating the inmate until his blood and urine flow. (To give credit where it is due, Mayor DeBlasio announced in 2014 that he had a plan to close Rikers. The plan would take ten years to implement. That’s nice. Maybe then he can start helping out on Guantanamo.) Across America, and with varying degrees of official brutality, the young, the mentally ill, and the un-tried are largely at the mercy of inept, negligent, or actively repressive wardens and jailers. As I wrote in my previous blog: “[O]ur state prisons—1,330,000 inmates strong—and our archipelago of county and local jails—with 630,000 behind bars at any given time, most of these young and unconvicted and awaiting trial—function under no such restrictions.”

Endemic in the United States, solitary confinement appears indifferent to a region’s general political values. It is the Monster Who Will Not Die—at least not until a stake is driven through its heart. Half-measures do not contemplate the stake. The federal government must.

 

California prides itself as being among the most progressive of states; yet it has ranked among the most promiscuous in the matter of bulldozing prisoners off for long stretches in “the Hole.” In the state’s charmingly named Pelican Bay State Prison alone, more than 500 prisoners had been held in solitary for more than 10 years, 78 of whom for more than 20. In all, the state held 9,870 prisoners in isolation in December 2012, when inmates, following the longest inmate hunger strike in California history to protest the practice, filed a prisoners’ lawsuit, Ashker vs. Governor. https://ccrjustice.org/sites/default/files/attach/2015/08/2015-09-01-Ashker-settlement-summary.pdf Supported by the Center for Constitutional Rights, the suit was settled in the prisoners’ favor—pretty much—in 2015. Settlement terms resulted in the trimming down to 3,471 solitary prisoners as of August 2016, a 65 percent reduction. It greatly reduced the number of long-term solitary captives as well.

 

Prison officials had long justified solitary by pointing out the high percentage of gang members in their system. Gang-bangers’ influence was considered toxic, and dangerous, within the general prison population.

California’s enforced curtailing of “the Hole” is admirable, even pivotal, as far as it goes. The specter of gang members in the general population has not yet produced chaos: prison administrators have been obliged to seek other remedies, and they have worked. And for the hard-nosed among us, who believe that jailbirds deserve everything they get, here is a hard-nosed fact that may sway them: wiping out solitary confinement saves taxpayers’ money.

California Governor Jerry Brown’s 2016-2017 state budget stipulates a reduction of $28 million as a direct result of the jail and prison housing conversions.

As the nonprofit national watchdog group Solitary Watch has reported, citing the state’s Department of Corrections figures:

“The cost reductions are unsurprising given the long-reported high cost of isolating individuals in California’s prisons. In 2010-11. . .it cost $70,641 annually to hold prisoners in the SHU [Security Housing Unit]. . .In contrast, [spent] an average of $58,324 on general population prisoners.”

Solitary Watch continued: “As our fact sheet on the issue of cost points out, solitary confinement routinely costs more. One estimate put the average difference at as much as $50,000 a year, per-individual.” http://solitarywatch.com/2016/01/08/california-expects-to-save-28-million-by-reducing-solitary-confinement/

All of this is admirable; a promising, if woefully belated, start to the fulfillment of Dorothea Dix’s noble dream.

And yet, it remains just that: a start. A good intention. A half-measure, given the history of what too often happens to good intentions. As 2015 ended, 5,378  men and 199 women in remained in various forms of solitary in California. That is 5,577 solitary inmates too many.

Leahy2009
Patrick Leahy By Senate Judiciary Committee (http://judiciary.senate.gov/about/images/Leahy.jpg) [Public domain], via Wikimedia Commons
The most promising—well, half-measure—was introduced last October.  Five Democratic senators brought out a bill called the Solitary Reform Act (S. 3432), which would restrict solitary confinement for all federal prisoners, not just teenagers. The co-sponsors were Senators Dick Durbin of Illinois, Christopher Coons of Delaware, Patrick Leahy of Vermont, Cory Booker of New Jersey, and Al Franken of Minnesota.

 

Once again: this proposal is enlightened as far as it goes, and in all likelihood reflects the senators’ understanding of the art of the possible, and its limitations. The legislation would free about ten thousand solitary inmates in federal prisons, roughly 6 percent of the total Yet it would not touch the oppression of the 70,000 people encaged in state prisons and county jails.

I believe that federal law must go much farther—all the way to the death of the monster in our national basement.

I believe that federal law must encompass not just federal prisons, but the very constitutionality of solitary confinement.

113th Congress Official Photo of Rep. Tim Murphy
Timothy F. Murphy By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
I believe its sponsors should be bipartisan. Surely they must not exclude the Republican Congressman Tim Murphy of Pennsylvania, a trained child psychologist, who emerged last year as his party’s almost solitary champion of the mentally ill and their interests with his breakthrough CARES Act, which was incorporated into President Obama’s Affordable Care Act. The Republican Senate majority whip John Cornyn, a doctrinaire conservative on many issues, has supported reform, and Louisiana Senator Bill Cassidy, a medical doctor.

 

Joe Kennedy, Official Portrait, 113th Congress
Joe Kennedy III via Wikimedia Commons
Potential Democratic sponsors in addition to the five mentioned above might begin with the young Representative Joe Kennedy III of Massachusetts, who leapt into the headlines and television soundbites last March with his riveting and eloquent rebuke to Rep. Paul Ryan, who had called the (doomed) Republican replacement bill to Obamacare “an act of mercy.” “This is not an act of mercy, Kennedy snapped, after rattling off several tenets of the scripture. “It’s an act of malice.” Kennedy’s family, of course, has a long history of involvement in health care and mental-health care issues, and the Kennedy name on such a bill would give it great symbolic power.

Marcykaptur
Marcy Kaptur By Online Guide to House Members and Senators (Online Guide to House Members and Senators) [Public domain], via Wikimedia Commons
Finally—for purposes of this short list, anyway—I have admired the progressive zeal and compassion of the longtime Ohio Democrat, Rep. Marcy Kaptur, who has been honored as a Legislator of the Year by the National Mental Health Association for her efforts in defending Medicaid funds for the mentally ill and for expanding insurance parity for such sufferers, and for initiatives to safeguard young people entering the juvenile justice system.

Any and all of these legislators would enhance the prospects of an eventual dispatching of the monster in our national basement.

I believe that such a law is especially urgent in these days of civic turmoil, street terror, collapse of faith in our institutions, widespread ignorance of or contempt for national traditions; even the irreducible dignity of our fellow human beings. Abolishing solitary confinement would do more than end an enduring national scourge. It would enshrine in history the crusade of the frail woman who concluded her timeless “Memorial” to the Massachusetts legislature back in 1843:

Gentlemen, I commit to you this sacred cause. Your action upon this subject will affect the present and future condition of hundreds and of thousands. In this legislation, as in all things, may you exercise that “wisdom which is the breath of the power of God.”

The full text of Dorothea Dix’s Memorial, with a brief explanatory, is here:

https://usa.usembassy.de/etexts/democrac/15.htm

I will continue my discussion on solitary confinement when I return from a brief vacation. Please feel free to repost this.