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Jun 14, 2023
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I agree with you completely. She wants her child to be cured (e.g. to no longer have a mental illness) and THAT is what is wrong with “the system”. Despite her husbands and her advanced degrees, despite their lawyers, despite their constant advocacy for their child, their love and devotion and despite the fact that her child writes precocious poetry, she still has a mentally ill child that the system “can’t fix”. To her mind nothing short of a cure will “help” her child. She is howling at the moon.

As a mother I can totally sympathize and of course it is human nature to want to blame someone or something. But this essay does nothing to help any flaws with the system. I think this mother feels it is unfair she has a child with a mental illness... and it is. But as another commenter pointed out she needs to accept this and re-arrange her expectations for her child, her family, herself, and “the system” she fights against. She will likely need this very system the rest of her life so hope she can find a way to work within it instead of against it.

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I thought it was oddly invasive to publish the child's poetry, and also obviously trying to show that the child is an artistic genius.

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Right?!?

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I suspected the mother “edited” it.

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Jun 14, 2023
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Yep. I guess it’s because these very important products are being produced by corporations motivated by profit, not the public good. Oh, wait, that pretty much describes every good and service we need to exist. Why the particular animus toward pharmaceutical companies?

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It is ridiculous to blame people for turning viciously on Big Pharma after they contributed so much to years of COVID debacles.

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Jun 14, 2023
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So what's your problem with them?

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"Fixing American mental healthcare" isn't the point, and probably can't be done without upsetting a lot of entrenched constituencies, constituencies that will fight tooth and nail to protect and expand their turf and which don't always necessarily line up neatly for Team R or Team D.

The point is virtue signaling and in-group signaling on social media, as well as designating the right sort of persons as out-group.

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"There was a gold rush with psych meds after Prozac hit, that money dried up, and now there’s precious little pharmaceutical industry interest in developing better medications."

Antipsychotic development is actually in the midst of a small renaissance right now given the development of muscarinic antipsychotics, the big recent news being the success of KarXT in its phase 3 trial which is poised to dramatically improve the standard of care. Muscarinic antipsychotics like KarXT and its relative drug in Phase 2 Emraclidine effectively treat psychosis with robust effect sizes (Cohen's d=0.6-0.7, better than all antipsychotics except clozapine and amisulpride) and no side effects of weight gain, sedation, tardive dyskinesia, akathisia, or anticholinergic effects. KarXT has only mild gastrointestinal side effects in <10% and Emraclidine probably will have almost none. Aside from muscarinics, Amisulpride, which is a very effective antipsychotic available in Europe, is being trialed in the US with a tweak that reduces its effect on QT interval. There are also a few others like Evenamide and Ulotaront going through the clinical trial loops, but their futures a little less certain.

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Damn, that is some of the best, most tantalizing, most hopeful news I've received in a long time. I'm going to commit the words "muscarinic antipsychotics" to memory and hope for a (relatively!) speedy entrance to the Canadian market, because the notion of meds that I can take which have no side effects of weight gain, sedation, akathisia (the sheer torment!) or tardive dyskinesia is something like a dream come true. Thanks for sharing this info.

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Wow, thanks for turning me on to this development. A serious prospect for a new class of APs is the best psych news I've heard in a long time. Thinking of so many folks who've burned through available modalities or are treatment-refractory getting another shot at getting well--not to mention QoL improvement for those burdened by side effects--puts a spring in my step.

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Really interesting point about how silly claims that this is a "particularly hard" moment in history for adolescents, it screams "I've never read about the past before 1965." I think so much of life is about expectations - and whenever I read a piece like this where the mom has clearly been communicating to her child that the world is doomed since before the kid can speak, and that there's no chance of salvation.

Makes me think of this song, which I love, although I loathe the attitude of melancholy that it expresses so well (and that I feel sometimes). When you're a kid you're not supposed to be told that you're born to a dying world.

https://youtu.be/sJaIrQ6pT2w

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For (especially) female teens and preteens, social media is a massive blow to mental health. In that sense society is much worse for teen mental health than it has been in the past.

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Idk it seems like teens and preteens have been the venue for a ton of weird social phenomena from laughter and dancing epidemics to the Salem witch trials - it seems like that demographic is the first to crack under whatever maladaptive cultural paradigm is ruling at any moment. This isn't to discount the problems originating in social media use, but let's be honest it can't be as bad as losing one or two out of a hundred of the young people you know to war and pestilence.

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Shockingly, the evidence says that it is as bad. Social media is best compared with meth or heroin at this point.

https://jonathanhaidt.substack.com/p/social-media-mental-illness-epidemic

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For _some_ teens. There's a huge gap in well being between liberals and conservatives for instance so it appears that what you consume is at least as important as the medium itself

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The weird aspect is that poor mental health among young people heavily skews leftward. But if you look at the "misery index" stuff - things like suicides, overdoses, etc. - it's much higher in rural, conservative-leaning areas.

I'm not sure what this says. Liberals are more likely to have low-level/functional mental health issues, or to just pretend to have them for the sake of fitting in? Conservatives are more likely to suffer in silence until they just crack?

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What about the whole "Deaths of Despair" thing from a few years back? Average lifespan in the US actually _dropped_ and it was blamed on out of work blue collar workers who killed themselves via alcoholism and drug abuse--and occasionally a hangman's noose or shotgun.

My personal guess is that leftward leaning teens occupy a far more secure economic position. So why the anxiety?

"Greg is prone to depression, and after hospitalization for a serious episode in 2007, Greg learned CBT (Cognitive Behavioral Therapy). In CBT you learn to recognize when your ruminations and automatic thinking patterns exemplify one or more of about a dozen “cognitive distortions,” such as catastrophizing, black-and-white thinking, fortune telling, or emotional reasoning. Thinking in these ways causes depression, as well as being a symptom of depression. Breaking out of these painful distortions is a cure for depression.

"What Greg saw in 2013 were students justifying the suppression of speech and the punishment of dissent using the exact distortions that Greg had learned to free himself from. Students were saying that an unorthodox speaker on campus would cause severe harm to vulnerable students (catastrophizing); they were using their emotions as proof that a text should be removed from a syllabus (emotional reasoning). Greg hypothesized that if colleges supported the use of these cognitive distortions, rather than teaching students skills of critical thinking (which is basically what CBT is), then this could cause students to become depressed. Greg feared that colleges were performing reverse CBT. "

https://jonathanhaidt.substack.com/p/mental-health-liberal-girls

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Allow me to summarize my other post: sometimes depression and anxiety are completely normal. If you find out that you have a terminal cancer diagnosis you are supposed to feel terrible. If someone you love has a terminal cancer diagnosis or dies you are supposed to feel terrible. If you lose your job and the bank forecloses on your house and car you are supposed to feel terrible. Why wouldn't you?

For the working class denizens of manufacturing hubs that saw their jobs shipped overseas and consequently saw their standard of living plummet and their towns and cities empty out some mental distress would seem to be a natural consequence of adverse conditions in the real world. Why should college kids at elite institutions like Yale feel anxiety and depression though? Seemingly they should be on top of the world in terms of their future economic prospects.

And for the answer to that I suspect the answer lies in the article from Haidt that I linked.

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I think it's eminently possible that both sides in this thread are correct. It can very much be the case that things are far better now for kids/humans in a comfort/material/lack of exposure to death/disease/violence way, and ALSO true that they are way less mentally healthy because of it. People should not assume that the most comfortable and easiest of circumstances lead to the best mental health. Why would they? It's not what our brains evolved for. They evolved for surviving in groups in contexts where survival was not easy but took real physical work and problem solving and cooperation, EVERY DAY, just to have something to eat.

It is usually notable to almost anyone who visits an extremely impoverished third world (or whatever we're calling them nowadays) country, how the people actually seem visibly and clearly happier. They're smiling and laughing most of the time. Now, none of us ever want to purposely make ourselves uncomfortable or live in poverty or go back to more precarious times (we., most of us don't), yet facing major survival threats does not seem to cause depression. If you talk to people who've survived near death experiences, often times they feel actual exhilaration from the experience.

Rumination is what causes depression. Having so much comfort and ease that you could literally lay on the couch for months on end and do nothing, and still have plenty to eat and heat and a soft place to put your head, should you choose to, gives you tons of times to think about stupid stuff and focus on stupid problems. To spend all your time worrying about what your peers think or being envious of all the things you don't have or worrying about things that might happen in 10 or 50 years. That's what makes people depressed. Human brains are not designed to NOT worry and ruminate and problem solve. It's what we do. So maybe when we're in a context where there aren't any big problems, that hamster wheel just keeps spinning and you start to go crazy. And if you KNOW that your "problems" are actually rather shallow and pathetic, then you probably feel even worse, yet can't help yourself.

I think one of the reasons teens mental health is worse today is because none of them have jobs. They have no responsibilities, they don't do work that is necessary. For all of history til like 30 years ago, virtually all kids and teenagers had actual work to do, work that needed to be done, whether it was working on the farm or at an after school job. Now most of them don't have jobs, other than the "job" of trying to please their parents and teachers with good grades, which most of them know is a bullshit job. There's no real responsibility there, no providing value for others or accomplishing something that matters to anyone else. It's just pressure.

I also truly believe that the absolute best thing for the mental health of many of these kids would be being sent on a summer-long outward bound type difficult outdoor experience, or working on a farm, or something similar where they have to do stuff, physically hard stuff, every day to stay alive or earn their keep, rather than just sitting motionlessly for the vast majority of every day, thinking and scanning and ruminating.

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One of the best comments here. I would also posit that "community" is problem solving as a group and working together for some shared goal. For human beings that cooperation could well be an essential component to mental well being.

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Absolutely. Which is probably why kids who play team sports seem to have much better mental health (funny for me to say this because I always such an anti-athlete as a kid).

But we've basically created a generation who are like the bears at the zoo...they are in zero danger of starving or being killed by rivals/predators or any physical harm, and don't need to work to earn their meals. One might say they have it made. Yet instead they develop what looks like OCD, chew their own fur out, pace endlessly, refuse to mate...

Instead of difficult problem solving or hard work to survive in real life, we all watch it on screens instead. No one wants to watch a show about people just enjoying themselves in comfort. We want to see problems and adversity and adventures where the characters overcome them and survive (or don't).

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I don't think any of us can understand just how poor and rough life was before WWII and the postwar stability that allowed so many people to live in material comfort. The people who lived it are almost all gone now.

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I think for some subset of young people it’s hard on their mental health recognizing that they’re not going to enjoy the material comfort their parents and grandparents did. Their world is going to be a lot more hostile to human life and comfort than it has been and emergencies are imminent to which no one has any solutions.

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_Marginally_ more hostile. To the point that a majority of kids are dropping dead from infectious disease as was the case just a few years ago? Not even close.

I am not a big fan of internet memes but the "first world problems" stuff is helpful I think. Not only does it encourage people to realize that they're bitching about nothing but it does so by making people laugh. Some more of that might go a long way.

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I’m not talking about the way things are now. I’m talking about eco-anxiety on the level of extinction events once the ice is all melted in the near future or when the combination of topsoil depletion, freshwater scarcity, and extreme weather collapses our agricultural systems. They know warming has accelerated and will continue to accelerate. There are a lot of people out there who don’t expect to live out their natural lifespans. Which is a whole other conversation, but while it’s absolutely true that kids these days are better off than kids a century ago in many ways, the specter of climate change and it’s consequences is one major shift that was not at play at that time.

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IMHO if it wasn't climate change, it would have been something else which fueled the same anxieties.

I think people start with inclinations first (towards anger, towards nervousness, etc.) and then glom onto beliefs in their teen years that validate their feelings.

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But as deBoer points out those previous generations weren't anticipating the apocalypse, they were actually living through it. The Spanish Flu produced a massive number of deaths and it disproportionately targeted the young rather than the elderly as Covid did. Plus there was a World War in Europe that would end up eventually killing so many young men that it altered the course of history for the continent.

What people were dealing with then wasn't "The world is going to end in 50 years" so much as "The young man I was dating didn't make it to the trenches because right before he was due to ship off he died of a raging fever in the sick house, where I myself contracted the disease and barely survived."

There is no comparison.

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The climate doomerism is so overblown in in the wealthy world it's not even funny. It's going to be the Y2K bug all over again.

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The thing that drives me crazy is that both you and OP are clearly wrong.

Tens of millions of people will die and trillions of dollars of property will be destroyed. That is terrible. It is one of the worst preventable disasters of all time.

But there are billions of people and quadrillions of dollars of property. It is obviously not an existential threat. It just isn't.

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Note that these kids' parents grew up minutes away from global thermonuclear war, it seemed.

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In the US, sure, but my boss was born in 1960s China. He's wildly unimpressed with any complaining about the state of the world today of obvious reasons. (my boss of boss is from a similar time period, but in Pakistan instead. I can't win a "things were better before computers" argument with him either)

Always good to get other perspectives.

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my father lived in a tent next to the colorado river during the depression. my uncle burned it down trying to kill ants. if all your siblings lived you were lucky, two of his cousins went blind from scarlet fever. i could go on an on.

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My mom rarely gets worked up about things (she's almost 90) but if you want to get her foaming at the mouth, show her a news story about parents not vaccinating their kids against preventable diseases like measles and mumps. Her sister almost died of measles. Parents today have never even seen these illnesses--to them it's theoretical, where anybody old enough to have had mumps can't get their kids vaccinated fast enough.

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right. same principle as crime - if people have not seen it themselves they think it doesn't exist, and vote policies into place that create literal ruin

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I agree with you. And another reason I don't like the "things are so much worse today than before" is that it's usually not relevant. If something is bad now, it doesn't have to be worse than how things used to be in order for that thing to be bad.

Similar thing with social media and youth. Young persons' mental health may be severely challenged by social media. And maybe that is (at least arguably) worse than the challenges faced at any other time in history. But the uniqueness in our historical era is besides the point. If it's harmful, it's harmful regardless of whether the 1910s were worse.

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Thanks for this. My dad was institutionalized for a few weeks and while he raged like Ehrenfeld rages about the inhumanity of it all, all I saw were people doing their best to care for him.

Also wanted to say that your penultimate paragraph could, with only minor revisions, apply to educators…

(whispers) …and cops.

(ducks)

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Very true. A utopian world view that makes the perfect the enemy of the good and therefore seeks to tear everything down so that it can be rebuilt?

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"My dad was institutionalized for a few weeks and while he raged like Ehrenfeld rages about the inhumanity of it all, all I saw were people doing their best to care for him."

In fairness to your Dad, you didn't have to experience any of it, including the loss of autonomy, which can be hard to wrap your head around when it isn't being done to you personally. Someone else dealing with your Dad and hopefully taking care of him is a win-win for you. Getting taken care of while being kept involuntarily in a facility is a win-lose for your Dad.

I truly wish people would stop black-and-whiting inpatient care. Sometimes is it both very necessary *and* very unpleasant to the point of being traumatic. Two things can be true, everything involves tradeoffs, etc.

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Who is behind the anti-psychiatry movement? I see so many people denying that psychiatry helps anyone but I can't tell where they get this information. Or is it just vibes?

As a side note, I am one of those women who was diagnosed with ADHD several years ago and have been medicated ever since. Does is resolve all my issues? No but I lost several jobs in a row before my diagnosis and have been employed with good reviews ever since so clearly its helping. But people still casually say to me that Adderall is essentially meth all the time. I am wondering if I come off as a meth addict or something (I don't, I am a pretty normal middle-class mom) so they are getting this message somewhere.

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Medical grade methamphetamine is prescribed for ADHD in some cases, and it is generally reported as superior to Adderall/Ritalin/etc. The dosages are much smaller, purer, and taken orally, but there is truth to the notion that these medications are all similar in action and effect.

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I got prescribed adderall as a middle schooler.

I accidentally took a double dose once and stayed up for three nights straight and stopped eating.

So, I guess, kinda? Dosage depending?

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Sure, I had a roommate who started grad school and would take it for days/nights on end and not sleep then take an Ambian to sleep. Whereas I take as directed and fall asleep naturally every night.

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Any stimulant at a high enough dose will keep you up and kill your appetite, including caffeine, nicotine, etc. So unless the claim is "all stimulants are basically to meth" the similarity in effect doesn't tell you much about harms and hazards, which is what the comparison is trying to impute.

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I don't know about an anti-psychiatry "movement", but in my case, it's that some of the most insufferable, navel-gazing, perpetually-aggrieved and annoying people I know (and I'll be honest, they're all women), are also the ones who insist that EVERYONE needs therapy and are ready to diagnose everyone else with mental problems and declare they just need therapy. So yeah, it's a turn off. Everyone has a diagnosis, everyone needs therapy, and yet the people who advocate for it the most are also the ones with the same never-ending problems that they're constantly talking about. It's an epidemic on social media. These are the same people who are constantly posting inspirational quotes about how worthy they are and how they believe in themselves and who are always cutting off people and burning bridges in their quest to remove "toxicity" from their lives.

If you don't know what I'm talking about, count yourself lucky. It's like half of what I see posted by my peers.

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All too often, these women have cats.

And humans ask why I prefer to remain feral.

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The #psychiatrykills hashtag on Instagram has a lot of frankly anti-semitic complaints about Jewish doctors. Those memes are the worst.

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I’ve noticed that upper middle class (and those who aspire to present as such) cannot seem to accept that their kids are not gifted in some way and any obstacles to those “gifts” manifesting have to be labeled away as some condition that can be treated (drugs for some, keto diets for others, etc) and everyone MUST accommodate their kid’s “neuro-divergence” while simultaneously upholding their very special giftedness.

I’m not weighing in on whether the conditions over diagnosed or under diagnosed, just that they sometimes seem to be linked with a kid’s ordinariness and the parent’s inability to accept it.

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Totally. I cringed the way she labeled her her daughter in the article as "twice exceptional". Because she's smart AND has emotional problems. Well at least she isn't ordinary!

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"But people still casually say to me that Adderall is essentially meth all the time."

Hopefully you know those people are essentially wrong and this pharmaceutical "insight" is, well, not insightful. I don't know where it originated but "ADHD meds are just like meth" is an irresistible meme to a certain type of mindset.

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Like with everything else....no simple answers. I think the suffers at the same time from OVER medication and UNDER medication. Certain meds are handed out like candy when therapy or even exercise could help...but that's labor intensive and time consuming...

THEN, when someone CLEARLY needs meds or even an institution, we act like it's somehow cruel to fix them.

Stop worrying about people's FEELINGS and worry more about the true issue that particular person has......and that's the biggest problem, especially with mental health....there is NO cookie cutter method that works for everyone.

In other words, medicine is hard, psychiatric medicine is harder.

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She is exactly the type of parent that lets their child use social media and then complains about the massive and inevitable psychic damage.

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People cannot handle nuance. Lithium gave my mom ten good years. That is ten she wouldn’t have otherwise, and I was able to have a Mom during the most formative years of my life.

Later, her prefrontal cortex succumbed to the illness and today she is not functioning well. She has dementia and thyroid issues, likely from her meds. I’m sure many people would say “this is all the meds fault, she should have had a better life.” What they don’t see is that I had ten years of my mom that I wouldn’t otherwise.

The meds have side effects that are terrible. They shorten our lifespan. I’m on them myself. The only reason they are prescribed is because the illness is worse than these side effects. This is true for many illnesses.

The absolutely worst part of anti psychiatry is that it feeds into the paranoia of many of the illnesses that require medicine. I’ve fallen prey to it myself and lost several years to absolutely illness.

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If you want to kill yourself for psychiatry, go ahead. But, don’t insist that your mom should have done the same. No one is obligated to kill themselves for someone else. And, if you really loved your mom, you’d want her to live a long and healthy life, even if you had no relationship with her.

Personally, I suspect you’re already brain-damaged from the drugs and from the noxious influence of genocidal quacks. I can’t see how anyone, Mad or not, would knowingly write such a monstrous comment.

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Jun 14, 2023
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Except, those AREN’T the only choices. Society could become more accepting of Mad people, including those who are caregivers. More support could be provided to Mad people. There could be MANY fewer consequences for educating the public about domestic violence toward Mad and disabled people. Any woman who would “choose” to sacrifice herself for her “family” when she DOES NOT have to isn’t mature enough to have a family.

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Yes, I should accept my mothers madness that tells her god wants he to kill me and herself, great plan. Sincerely, fuck you.

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Not sure if you're baiting here or what, I can only say this:

If I was that mom, I would, without a doubt, choose a much shorter life it meant I could have mental and emotional clarity for a decade. Doubly so with my child in the equation. If what Beatrix says is true, and the illness is indeed worse than the drug side effects, then I would say her words are nowhere near monstrous. They are human.

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1. The option does not seem to have been a “long and healthy life” vs dementia. The option was 10 good years and a shortened life or severe mental illness and (possibly) a longer life.

2. Every parent would have made the same choice.

3. People are sometimes obliged to kill themselves for someone else.

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Bullshit! John Forbes Nash quit medication, lived well, and functioned well enough as a parent and spouse. So did Joanne Greenberg. In a healthy family, a good life FOR EVERYONE is possible without psychiatry.

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I'm not sure your brain is working correctly. This is just so patently absurd that I have to resort to an ad hominem attack because there are no merits to your point that one could even consider debating. I'm just sorry for Beatrix that her already tough life gets additionally fucked with by people like you. Shame on you.

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It’s not “absurd”. Many people experience Madness and live well without psychiatry. And, of those who remain in treatment, none come anywhere close to a regular life unless they also have what Nash and Greenberg had: a home, a spouse, a career, their liberty. That’s a fact. If it “fucks” with someone’s “feelings” (i.e. prejudices and insecurities), I don’t give a flying fuck!

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You don’t seem to understand that it’s clearly not one size fits all. She has concluded for herself what the right approach to her disease is. It’s crazy arrogance to think you know better for her.

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Maybe I'm just old-fashioned, but as far as I'm concerned, the only "monstrous comment" here is the one that starts, "If you really loved your mom..."

How dare you!

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Thomas, you don’t even need to love a person to acknowledge their right to life. That just takes basic humanity, which Beatrix seems to be losing in her quest to become the “perfect patient”.

Would YOU love a person who wanted you to die prematurely for any reason, let alone a shitty one like, “You need to drug your volition away because it’s inconvenient for me!”? I doubt it.

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If my mom did not take lithium she would have died homeless 20 years ago, dumbass.

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So, I used to be 100% for investment in more mental health care facilities and involuntary commitment laws, but then the pandemic and it and many other examples of institutional abuse of power showed their hand. Unfortunately I am no longer fully supportive of having a system where authorities can label someone as mentally unfit and force them into involuntary treatment. If you are a clear-headed individual failing to adopt the current political-media narrative, the power and clones of that narrative will brand you as "crazy".

Sorry, but until and unless we take back the country from the corrupt ruling class and radicals, I am not in favor of giving any more exploitable power to government officials. Too bad for the sick.

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Nope. I am not ok with that. I think though if we just have more drug treatment and anti-camping laws where the penalty for breaking them after a few times is jail time or the alternative of drug treatment. Also need to bring back criminal laws and prosecution for illegal drug possession.

The homeless are primarily substance abuse people. It is about 60%. 20% are real mental health problems. The remaining 20% are economic hardship cases.

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Read it again. Targeted toward fixing the problem of homelessness that YOU brought up.

Targeting the homeless and substance abuse. Mental health is subjective. There are some that consider you quite off based on what you write. Do you really want them to have the power to force you into an asylum because you don't comply with certain ideological thinking?

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That is just crazy talk. I think you might be suffering from mental health issues. We need to commit you to treatment.

I consume more left-wing media... lot's more. I do that to prevent gravitating toward "news" that just feeds my confirmation bias. I want to be challenged for what I think I know. The good news is that I get more conservative view confirmation from reading the NYT than I get from watching Fox... which I don't since they fired Tucker.

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Has it occurred to you that government exploits its power not to oppress, but to keep the larger population safe? Failing to "adopt the current political-media narrative" may mean you are just an asshole, or that you are so deluded that you think you have a perfect right to stand in the middle of the street shouting at the clouds--traffic and communters be damned.

People who didn't buy into the "political-media" narratives around COVID and precautions such as masking made it a lot harder for the general population to avoid getting infected. And there are people who don't believe the government has any right to make them take their TB meds...apparently this woman does not buy into the "political narrative" that she should not spread TB all over the county: https://www.knkx.org/south-sound/2023-03-02/arrest-warrant-issued-for-tacoma-woman-who-refuses-tb-treatment.

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I could not have paid you enough to write this and thus qualify what I wrote.

Masks did not help prevent the spread. The mRNA "vaccines" did not stop the spread. Social distancing did not stop the spread. Stay at home did not stop the spread. The only thing that seemed to work to stop the spread was natural immunity combined with being healthy and fit.

The "keep the population safe" excuse is the tool that the authoritarians use to control the sheeple that are prone to easily fear death.

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Fully agree here. The thing that really made me angry: videos and pics that would surface of some politician or otherwise famous person dining at the French Laundry or getting down with their posse at some private club or event maskless.

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It made everyone angry, and half noted the blatant hypocrisy and thus could easily draw the conclusion that the ruling class was lying and abusing power. Newsom's kids attended private school as he mandated the shutdown of the public schools. More hypocrisy.

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Yet most of the offenders were reelected.

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In some ways, my "journey" (if you want to call it that) has been in the opposite direction, from being knee-jerk opposed to involuntary treatment to being more willing to endorse it.

But I do agree that there are important costs and tradeoffs if we make it easier to involuntarily commit people. Even if the committers are simply people trying to do right by others and not "[members of the] corrupt ruling class and radicals," they can and will do some things wrong.

So far, the pendulum seems to be pretty far (probably too much) in the direction of "less involuntary commitment" than "more involuntary commitment." So my focus on the tradeoffs is maybe overwrought. But tradeoffs there are.

And for some commenters here: No, I'm not "okay" with people harming themselves or others or with people suffering when involuntary commitment might be the solution. That's why I'm more willing to endorse involuntary commitment.

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While I know you're on record as a critic of the discourse around "stigma," it is difficult to imagine that we can endlessly stigmatize the places that serve the mentally ill without some of that stigma rubbing off on the clients served by those institutions.

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Ehrenfield's essay radiates with the deep wound of a parent who can't fix what ails their child, but it also smacks of the childishness of elites. The Discourse is really a series of endless tantrums right now, always demanding someone else to find a solution, to square the circle, to cut the Gordian knot, and to do so without any nasty trade-offs. We are living in a culture where being perpetually disappointed and aggrieved is a founding virtue, when actual virtue requires generosity, resiliency and patience, the three qualities in shortest supply right now. I know people who are in the trenches as social workers and therapists and they, by and large, deserve our support and gratitude, which should translate into better working conditions and reasonable expectations. Any adult in the room can see this, but our elites are too busy railing at the fact that a utopia is not a click away on their phone to get busy improving this imperfect world.

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The denial of trade offs is partly why I don't casually discuss issues anymore. I mentioned in a conversation something like "divorce is bad and negatively effects children" and people kneejerk "ohh so you think divorce should be illegal and women should just be STUCK WITH ABUSIVE HUSBANDS FOREVER???" back at me. It's just all so tiresome.

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It's a kind of magical thinking. All good things go together, and all bad things go together. So how can there be tradeoffs?

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wait till you add the stat that 1/3 of people who divorce regret ending their marriage

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The goal is to get attention...if you're viral enough, maybe the answer will magically appear.

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Love this thank you. Not everything is our fault but it is our responsibility

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Almost this entire post could be written about the practice of medicine at large. Any given day you can find a NYT article about the failings of doctors to treat women/minorities/long covid/breast cancer/name your favorite sub group, and very few articles about the ravages corporate consolidation and private equity have done to the access of care. And virtually no articles recognizing that doctors are human, largely care about the well being of their patients, and are steadily improving outcomes for heart disease, cancer, etc.

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The New Yorker has actually done some solid work on private equity's devastation of American healthcare.

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Ooof this is hard. Everything becomes so much harder when it comes to your child. And it becomes orders of magnitude harder still when you know, deep down, that you're partly to blame. Every parent has experienced this.

Reading between the lines about the divorce and family situation makes me feel infinitely bad for the kid. Of course there are other factors as well, but I'll just state it: yes, some of the kid's problems likely come from the parents. Jane hand-waves this away, but I think she knows the truth, and it kills her. So she lashes out.

Her and her husband's pedigrees proved useless. So do the double blind studies she relies on. So does everything else she reads about that is supposed to fix the problem for her. I honestly don't blame her for lashing out. Myself, and many people here would probably do the same.

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Her description of her boyfriend's "unique and beautiful" relationship with her daughter jumped out at me.

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"So she lashes out."

Just because she wants to doesn't mean that a private company should allow themselves to be the vehicle for that.

In a previous time an editor might have stepped in and said "We can take a pass on this one."

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Definitely. Though getting parents to act appropriately when it comes to their kids, especially in tough situations, is probably a bigger ask than fixing the mental health system.

And I dunno if you have kids, but I've found there to be a shockingly large amount of "the system is failing me and my perfect family" type articles if you start looking for them.

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Agreed. This writer is in a grieving process, with all its unfortunate but pedestrian recriminations and anger. That doesn't mean it should be published.

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I read the linked article and I can't help but think that part of this kid's problem may be that her parents systematically undermine and second guess every.single.intervention that has been tried. Her dad is a neurologist and her mother is an attorney and so of COURSE they know better than any of the mental health providers that are trying to help their kid.

My heart goes out to parents whose kids are suffering like this, and to the kids, who after all are kids and while they may be seriously mentally ill, they are still kids and so things like hospitals and separation from family are terrifying in a way that they are to almost any child. Maybe I am being unfair, but the author seems to be saying "we've dismissed all of the options offered to us, and nobody will help our child." It is also hard to understand what mental condition would be so severe in a 10 year old that they are repeatedly told by providers that they can't meet the child's needs. The author said she's not violent-she's a danger to herself but not others. So are the providers being honest--is the problem the kid, or that they can't help the kid given how her parents are operating?

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Yes. The problem is with the child. Around 10 the brain develops into the ability to do abstract reasoning. Most severe brain disorders not resulting from injury arrive in adolescence or young adulthood.

We have a kid who had severe, chronic anxiety and depression, that was severely disabling. The slightest thing would set him off and he'd be under the table in a full blown tantrum. It took four months to get him to a psychiatrist and we were willing to pay out of pocket. Anti-depressants worked. There are still issues with anxiety and he needs a low-key, low stress lifestyle. He's brilliant but works at a pizza place and is happy. That's what's important. He's happy and functioning.

The good thing about the onset at ten, it clearly wasn't "he's a teenager" or "he's using drugs". We were able to help him learn to deal with it and see it as just the way it is, this is what you need to do.

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It's good to hear that your son is doing well. It's easy to sit here and judge based on what the mother has written, but it must be really difficult to help kids who are clearly suffering from a complicated mental illness, but who have no agency in how their condition is treated. As a parent, you were making the decisions for your son and looking out for him. I wonder if these parents are helping or hindering their daughter with their decisions--I mean, it's possible that they think they are advocating for her, but their decisions are blocking her from receiving treatment that can help her.

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I doubt they're blocking her treatment. They're scared, desperate and angry. They've got more resources than most and still can't get it fixed. There may very well be no cure, just accommodation. You never know whether you're doing the right thing or not, you just do your best.

I think what Freddie is reacting to is another article about how our mental health care is no good and worthless, even for people with the resources to pay. By implication, it bolsters the claims of those who don't want to make any improvements.

We have some people who say, there is no such thing as mental illness or it's environmental failings. We have other people who say mentally ill people are just fine and we need to accept them as they are.

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yes that child does not stand a chance with crazytown parents like that

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