Hospitals & Asylums
State Mental
Institution Library Education (SMILE)
To amend Chapter 4 Saint Elizabeth’s Hospital by replacing
Subchapters I Establishment And Management; Pensions, Moneys, And
Appropriations and; Subchapter II Inmates; Burden Of Expenses Thereof;
Detention Of Insane; renumbering Subchapter III Mental Health System for the District
of Columbia to Article X, transfer §321-329 from Chapter 9 Hospitalization of the
Mentally Ill National Returned from Foreign Countries to Article 6 §189-194 of this Chapter, to conditionally
recognize the new occupants as Customs, to bring federal torture statute and
other general laws in compliance with the Convention against Torture (CAT), to change
the name of the Substance Abuse Mental Health Service Administration (SAMHSA)
to the Social Work Administration (SWA), to abolish civil commitments and
terminate the license of all private psychiatric hospitals, state mental
institutions and general hospital psychiatric wards, to ensure sado-masochism is defined in the Diagnostic
and Statistical Manual (DSM-V), and to transfer responsibility for the review of
mental illness to the licensed social workers of the Board of Mental Health with adequate
community shelter beds supervised by the SWA
Be the
Democratic and Republican (DR) mad house Dissolved, referred to the National
Alliance for the Mentally Ill
1st
Draft August 2004, 2nd May 2005 3rd 28 February 2007, 4th
30 July 2007, 5th 20&22 April 2009, 6th 16 March 2011
1.This Act may be titled the State
Mental Institution Library Education (SMILE) Act to express, in writing, the idea
that a free public library education is the ideal treatment for otherwise
unemployed people suffering from mental illness, the diagnosis of mental
illness or discrimination on the basis of alleged mentally illness. This
Act establishes in the federal government a Social Work Administration (SWA) to
supersede the Substance Abuse Mental Health Service Administration (SAMHSA). This
Act abolishes civil commitment, judge enforced medication and Psychiatric emergency
services (PES). This Act terminates the
licenses of all inpatient psychiatric hospitals, other than forensic. In the
interim 9-11 first responders and EMTs, mental health patients and
professionals, shall boycott all general hospitals with psychiatric wards. This
Act elects only licensed social workers to judge mental health courts, tort
claims, and refer patients to residential treatment.
2. St. Elizabeth’s Hospital, was founded by Dorothea
Dix in 1855 with a maximum capacity of 250. However by the 1940s, the
Hospital complex covered over 300 acres and housed 7,000 patients. It was the
first and only federal mental facility with a national scope. Politicians were
importing mentally ill people. In 1987, the National Institute of Mental
Health (NIMH) acting in behalf of the federal government transferred the
hospital operations to the District of Columbia, while retaining ownership of
the western campus. Under the regulation of the District of Columbia Council
the patient population steadily declined, and the Hospital now houses only 600
patients in 1992. In 2010 the Department
of Homeland Security assumed control of the property, wherefore the sixth draft
makes technical amendments, on the condition that Title 6 of USC and CFR be re-named “Customs”.
3. The World Health Organization Report on Mental Health
of November of 2001 estimates that mental illness and psychological disorders
stemming from substance abuse affect a combined total of 450 million people,
7.3%, of the 6,137,000,000 global population. The Surgeon General’s Report on Mental Health of 1999
stated that 55% of Americans suffered from mental illness at some time in their
life and 1 in 5 Americans experience a diagnosable mental disorder in any given
year, more than 5% serious. Suicide is the 3rd leading cause
of death among 15 -24 year olds. In 1997 30,535 people died from suicide in the
U.S. It was the 11th leading cause of death in 2000 for all
age groups. The highest suicide rates are found in white men over the age
of 85.
Twelve-month prevalence and severity of DSM-IV disorders,
2003
|
Total |
Serious |
Moderate
|
Mild |
|
|
|
%
|
%
|
% |
% |
|
I.
Any Mental Disorder |
26.2 |
22 |
35.5 |
37 |
|
One disorder |
14.4
|
9.7
|
31.1
|
52.4
|
|
Two disorders |
5.9
|
25.6
|
42
|
26
|
|
Three or more disorders |
5.9
|
48.9
|
39.9
|
10.1
|
|
II.
Any anxiety disorder |
18.2 |
22.5 |
33 |
44.4 |
|
Panic disorder |
2.7
|
45.1
|
27.5
|
27.4
|
|
Agoraphobia without panic |
0.8
|
37.3
|
33.3
|
29.5
|
|
Specific phobia |
8.7
|
21.5
|
29.6
|
48.8
|
|
Social phobia |
6.8
|
29.9
|
38.4
|
31.6
|
|
Generalized anxiety disorder |
2.7
|
29
|
46
|
25
|
|
Post-traumatic stress disorder |
3.6
|
36.6
|
32.6
|
30.3
|
|
Obsessive-compulsive disorder |
1.1
|
41.6
|
26.1
|
32.4
|
|
Separation anxiety disorder |
0.9
|
43.3
|
24.8
|
31.9
|
|
III.
Any mood disorder |
9.5 |
44.8 |
40.2 |
15.1 |
|
Major depressive disorder |
6.7
|
30.1
|
50.2
|
19.7
|
|
Dysthymia |
1.5
|
49.7
|
32.1
|
18.2
|
|
Bipolar I-II disorders |
2.6
|
82.9
|
17.1
|
0
|
|
III.
Any impulse‑control disorder |
8.9 |
33 |
51.5 |
15.5 |
|
Oppositional-defiant disorder |
1
|
49.6
|
40.3
|
10.1
|
|
Conduct disorder |
1
|
40.5
|
25
|
34.5
|
|
Attention-deficit/hyperactivity
disorder |
4.1
|
41.3
|
35.2
|
23.5
|
|
Intermittent explosive disorder |
2.6
|
23.6
|
74.6
|
1.8
|
|
IV.
Any substance disorder |
3.8 |
27.3 |
26.1 |
9.9 |
|
Alcohol abuse |
3.1
|
26.3
|
26.6
|
10.4
|
|
Alcohol dependence |
1.3
|
28.3
|
37
|
13.9
|
|
Drug abuse |
1.4
|
36.4
|
20.1
|
10.8
|
|
Drug dependence |
0.4
|
57.3
|
22.8
|
7.5
|
4. The most prevalent mental
diseases are; a. “major depressive disorder” affecting 9.9 million people or 5%
of the U.S. population every year; b “Bi-polar disorder” affecting 2.3 million
U.S. adults or 1.2 % of the U.S. population; c. “Schizophrenia” affecting 2.2
million U.S. adults about 1.1% of the U.S. population; d. “Anxiety disorders”
affecting 19.1 million U.S. adults; e. “panic disorder” is an anxiety disorder
that affects 2.4 million U.S. adults, f. “Generalized Anxiety Disorder” is an
anxiety disorder affecting 4.0 million or 2.8% of the populace, g. “Social
Phobia” affecting 5.3 million or 2.8% of the populace. h. “agoraphobia
and specific phobia” affects 5 million people. i. “Attention Deficit
Hyperactivity Disorder” is a disorder that affects 4.6% of school age
juveniles. j. “Alzheimer’s disease” affects an estimated 4 million senior
citizens. k. According to US Army reports the suicide rate for American
soldiers serving in Iraq is 17.3 per 100,000, nearly five time the rate for the
Gulf War and 11% higher than for Vietnam. Over 19% of OIF veterans and
almost 12% of OEF veterans reported some mental health concerns (e.g., PTSD,
depression, and anxiety). Nearly 10% of OIF veterans and 5% of OEF
veterans reported symptoms of PTSD. Even when using a strict definition
of anxiety, depression, and PTSD, they found that 8% of those surveyed reported
anxiety, 8% reported depression, and 13% acknowledged PTSD-type symptoms.
The National Vietnam Veterans Survey (1990) found that 15% of veterans surveyed
could be diagnosed with PTSD at the time of the survey, but that as many as 30%
of veterans eventually developed PTSD at some point following their combat
experience.
5. During 1999 there were 1.7
million admissions to inpatient psychiatric treatment. 424,450 were involuntary
commitments. Although the number of resident patients has gone down the
overall number of admissions has increased. In 1963, when the Community
Mental Health Center Construction Act was passed, the median stay
in a psychiatric hospital was 17 days and mean 20 days. In 1975
the median stay was 6.7 days and the mean 11 days. Since the 1950’s
public funding policy has been to close state mental institutions in support of
community based care. The number of patient care episodes has both
greatly increased and become increasingly directed to less than 24-hour
treatment facilities. In 1955 there were 1.7 million care episodes
of which 77% were treated in 24-hour care facilities. By 1971 there were
4.1 million cases of which 58% were treated in less than 24 hours, by 1998 11
million care episodes were treated only 24% of the time in 24-hour treatment
centers. The numbers show that de-institutionalization policies
between 1970 and 1998 have been successful in reducing the supply of totally
government funded psychiatric beds by a total of 376,704. State and county mental institutions having reduced their number of
inpatient beds from 413,066 in 1970 to 63,525 in 1998. Likewise VA
medical center psychiatric beds went down from 50,688 in 1970 to 13,301 in
1998. To compensate private psychiatric hospitals, non-federal general hospital
and residential centers for emotionally disturbed children that are funded 68%
by private clients’ HMO have increased 51,348 beds. Between 1970 and 1998
Private psychiatric hospitals have increased in patient population from 14,295
to 33,635, Non-federal general hospital psychiatric wards have increased from
22,394 to 54,266, residential treatment centers for emotionally disturbed
children increased from 15,129 to 33,483. The total number inpatient beds
of all “mental institutions” declined from 515,572 in 1970 to 198,195 in
1998. The objective is to increase the number of residential treatment
beds and reduce the number inpatient beds.
6. The diagnosis and treatment of
mental illness is performed by 40,000 psychiatrists and over 1 million mental
health professionals. Mental illness is the second leading cause of
disability, costing disability insurance an estimated $24 billion, medical
insurance $65 billion annually with expenditures by mental health organizations
growing from $3.3 billion in 1969, to $38.5 billion in 1998 and 2002
declining to slightly more than $34 billion. Psychiatric medication has
become an accepted method for treating mental illness since the
deinstitutionalization movement began in the 1950s. Psychiatric drugs are
however the leading cause of fatal drug overdose, and
Cogentin is needed to cure the extra-pyramidal side effects of antipsychotic
drugs. Psychotherapy is a general term
for a way of treating mental and emotional disorders by talking about the
condition and related issues with a mental health professional. It’s also known
as talk therapy, counseling, psychosocial therapy or, simply, therapy.
Through psychotherapy sessions, one may learn about the causes of the condition
to better understand it, learn how to identify and
change behaviors or thoughts that adversely affect your life, explore
relationships and experiences, find better ways to cope and solve problems and
learn to set realistic goals for life.
7. In 2000 at the Conference on the
Report of the Surgeon General Ohio Director of Mental Health Mike Hogan PhD
promised to, “close all state mental institutions and private psychiatric
hospitals to provide unimpeded access to community mental health.” On
June 18, 2001 President Bush signed E.O. 13217 Community Based Alternatives
for Individuals with Disabilities to (1) commit the United States to
community based alternatives for individuals with disabilities (2) community
programs foster independence (3) unjustified isolation or segregation through
institutionalization is prohibited (4) states must take responsibility to place
people with mental disabilities in community settings (5) states must ensure
that all Americans have the right to live close to their families and friends,
to live independently, to engage in productive employment and to participate in
community life. WHO recommends that in the future, “governments take
responsibility for providing treatment for mental disorders within primary
care; ensuring that psychotropic drugs are available; replacing large custodial
mental hospitals with community care facilities backed by general hospital
psychiatric beds and home care support.”
8. Dr. Hogan was appointed head of
the New Freedom Commission on Mental Health in
April 2002 as a commitment to eliminate inequality for Americans with
disabilities. The Freedom Commission found. Stigma remains a significant
problem. A diagnosis of mental illness is often accompanied with fear and
hostility by the general public not to mention a person’s own friends and
family. Stigma decreases the willingness of people with mental illness to
seek or pay for services. People with mental illness
need choice and availability of acceptable treatment options or they are
unlikely to engage in treatment or to participate in appropriate and timely
interventions. Thus giving access to a range of effective community based
treatment options is critical to achieving their full community participation.
Despite the potential millions of people with severe mental illness lack
housing to meet their needs. Participation by people with mental illness
in service planning should be a priority and policy makers should increase
opportunities for participation.
9. Unlike
other medical specialties the quality of care for Americans with mental
health problems remains as poor today as it was several years ago. This
comes after decades of political improvement. Patients on antidepressant
medication are about as likely to receive appropriate care today as they were
in 1999. Similarly, patients hospitalized for mental illness are only
marginally likely to receive appropriate follow-up care according to the
National Committee for Quality Assurance in 2006. Even more alarming, Joseph Parks of the Missouri Department of Mental
Health reports that people with serious mental illness die at age 51, on
average, compared with 76 for Americans overall. Their odds of dying from
the following causes, compared with the general population. 3.4 times more likely to die of heart disease. 3.4 times more likely to die of diabetes. 3.8 times more likely to die of accidents. 5 times more likely to die of respiratory ailments. 6.6 times more likely to die of pneumonia or influenza.
Adults with serious mental illness treated in public systems die about 25 years
earlier than Americans overall, a gap that's widened since the early '90s when
major mental disorders cut life spans by 10 to 15 years.
10. Torts are infractions of law
from whence a substantial right to just compensation for actual or statutory
damages is derived. Torture is the cruel and wanton infliction of pain
and physical or mental suffering on an individual in legal custody.
Institutional psychiatry has a long history of physical as well as mental
abuse. The stigma and discrimination of a diagnosis of mental illness can
haunt people for the rest of their lives, however many formerly mentally ill
people have gone on to lead successful lives and many have taken the time to
report and litigate the cruel and unusual treatment they received and many
receive SSDI on the rational basis of their diagnosis of mental disability.
In general, it is a struggle to keep the day-to-day operations of the
psychiatric institution at a first-degree misdemeanor level for involuntary
treatment. Felonies occur frequently. When former
patrons hire psychiatrists to civilly commit their dependents.
When private hospitals falsely arrest people and sell their persona to CMS,
state and local government. When there are adverse reactions to enforced
medication. When patients are physically or mentally abused or killed by
staff or other patients. When patients are denied
medical treatment. When patients are denied access to their
own home or community shelters. When torturous
biological experiments or court orders cause insanity or physical illness or
death. Under 24USC(9)§326 (1&2) a psychiatric hospital must release
a patient in 48 hours from making a request or begin judicial process in five
days. No patient held without criminal
charge, who verbalizes their preference for community alternatives, whether or
not they can afford them, should be denied release. Timely torts
regarding release create an enforceable Mental Institution Relative Release
Order Request (MIRROR). Should the MIRROR be broken,
community re-investment of the hospital shall be enforced under 24USC(4)III§225.
Sanders, Tony J. Chapter 4:
State Mental Institution Library Education (SMILE). 6th
Draft. 120 pgs. Hospitals
& Asylums. 16 March 2011. www.title24uscode.org/SMILE.doc
Test Questions www.title24uscode.org/smiletest.doc