Wanna see what some mental health providers are thinking right now?

[politicat]

67. So...

I'm taking about kids that are aggressive, drop out, have low intelligence an just get into trouble all the time.

Here's the thing with "aggressive, trouble-making dropouts." By the time they're 15 or 16 and have their reputation, they've usually spent a decade in crappy schools with inexperienced or burnt out teachers who have flattened their ability to invest and care out of self-defense. (Note that I'm talking urban-suburban; rural aggressive, trouble-making dropouts have their own set of issues.) It's not the teachers' fault -- teachers have it no better than we head-shrinkers. Those kids are generally not low-intelligence -- the most effective trouble-makers are often of high-normal intelligence. They ARE ignorant because learning is a skill they've never been taught. They often have underlying heavy metals toxicity (which affects impulsivity and long-term planning ability) from living in sub-standard housing. They often experienced early childhood malnutrition, which also contributes to impulsivity. Why should they care when nobody around them does? (If you haven't read it yet, please read Sudhir Venkatesh's Gang Leader for a Day. JT was brilliant and an example of how we waste young, agile minds.)

These kids live in a truly dysfunctional power structure -- they know that their parents/elders are exploited by a system that takes their labor and gives as little as possible in return, or without even the hope of being exploited. They see no reason to believe they'll have anything different, and few reasons to invest in a system that doesn't invest in them. They can't articulate it, but they know they're being screwed.

When people are powerless, they will assert any power possible. If that means causing trouble, that's the scrap they can take. Causing trouble doesn't HELP, but it's a solace for a little while. They feel better, at least temporarily. Intoxicants and sex follow the same pattern -- intoxication is insulation from the insults the world is hurling; sex is a temporary connection. In a world with little solace, you take what you can get.

The Boston State Hospital example (and most of the state hospitals) are an excellent example of what we shouldn't do -- and the smoking is a strong indicator of exactly what population we screwed over. About 80% of schizophrenics smoke heavily, because nicotine and the MAOIs in tobacco smoke work as neuro-regulators. They're medicating when they smoke. Tobacco is a somewhat better drug than the anti-psychotics in our medicine cabinet -- fewer immediate side effects, easier to obtain. (Cancer and emphysema are not concerns when the voices are loud.) Schizophrenia is brittle -- without meds, a schizophrenic has about a 1 in 10 chance of navigating the world. Out-patient care can work, but only with high-touch, regular and consistent assistance and advocacy. A social worker with a 500 client case load can't provide that.

As far as Congress goes... they're the other end of the power spectrum, and just as much at the mercy of money as my teen-age dropouts. Experts don't make campaign contributions. We've got a broken system in need of far more bribery and far less corruption.