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May 23, 2003

You could call it an unintended consequence. The sad state of the treatment of the mentally ill in this country (largely due to the meddling of the ACLU and the politically-motivated brainless positions of organizations like the APA) leads to events like this one happening every day. Of course, it's only considered newsworthy when the irony is overwhelming.

Members of the nation's largest psychiatric association discovered San Francisco's mentally ill homeless problem up close this week, as they stepped out of their annual convention and were surprised -- some say shocked -- by the legions of people living on the street.

I'm shocked - shocked! - to hear of mental patients on the streets! I wonder who put them there?

The worst, however, came when an official of the American Psychiatric Association, a Baltimore doctor known for being an advocate for the indigent mentally ill, was assaulted by an apparently homeless man with a history of psychiatric problems.

Thus enters the irony. "Advocate for the indigent mentally ill"? What exactly does this doctor advocate? I'll wager that the short list of causes she advocates would include free needle exchanges, bigger cash welfare payouts, and taxpayer-funded "halfway" housing.

I'll further wager that her list doesn't include what would actually be best for some of these unfortunate people: institutionalization.

Knocked unconscious by the seemingly random attack near Union Square on Sunday morning, the doctor spent the week recovering at San Francisco General Hospital. Dr. Geetha Jayaram, an associate professor of psychiatry at Johns Hopkins University School of Medicine and the scientific program committee chairwoman of the psychiatric association, is expected to be released soon.

Released soon....

Police arrested Aaron Matthew Hull, 32, who has no local address and has a history of being detained for psychiatric evaluations, according to law enforcement sources. He was being held in the county jail on two felony counts of assault and battery and is scheduled to appear in court today to determine if he is competent to face charges.

Mr. Hull won't be released soon. Nor will he receive the help he really needs.

The irony of the attack was not lost on the association's members and other convention goers, many of whom said that they'd been noting the large numbers of homeless people on the streets ever since they arrived Saturday.

Read, "we know this sort of thing happens all the time, but it's not supposed to happen to us!"

"It's kind of shocking," said James McNulty, head of the National Alliance for the Mentally Ill. "I've been walking around the hotels and up the hill to Fisherman's Wharf. It was very disheartening."

The shocking thing is the limited way we as a society are permitted to handle the seriously mentally ill. Again, thanks mainly to the ACLU and the APA.

Long before the attack happened, the APA had planned a news conference Wednesday to publicize past and future threatened cuts to what the group's leaders called the nation's "crumbling mental health system." More than 27 million people with mental health problems are facing "personal health care disasters," they said, because of Medicaid and state funding cuts to mental health programs.

Said mental health programs often being little more than outpatient clinics for people who need more intense care.

"Imagine what it would be like to have heart disease and be told, 'Sorry, there is a budget crisis, we can't afford your beta blockers,' " McNulty said at the news conference. "Can you imagine the outcry?"

Well, most folks have this thing called "insurance."

McNulty, who lives in Omaha, said that he had "never seen greater contrast between degradation and great wealth. If you think things are bad in San Francisco now, wait until the cuts happen. And I'm not just talking like Chicken Little."

San Francisco's problems are many and have various causes. But the problem they have with homeless mentally ill people are of their own making. When you subsidize homelessness, you get more homeless people. Duh.

Jayaram had come to the convention, which drew about 19,000 participants, to speak, among other topics, about outreach to indigent mentally ill people in India.

At this point I have to wonder how much this conference cost everyone involved. I also have to wonder a) were the attendees talking about more taxpayer funding, and b) how much the attendees donate to charity every year?

Her husband, Jay Kumar, said his wife is "doing better but not 100 percent right yet."

If there's any one thing we can surmise from this tale, it is that Mr. Hull will likely never be "100 percent right." He certainly will not receive the care he needs by being paid by the city of San Francisco to live on the streets.


I am a "government minimalist" sort of almost-libertarian. I really don't see the compelling interest the government has in taking my dollars to distribute in the form of what are euphemistically referred to as "transfer payments" - i.e., social programs.

There is one set of cases, though, in which social spending is not only in our best interest, but is the right thing to do: programs to care for those who are unable to care for themselves.

Not unwilling. Unable.

Unable doesn't mean "well, I didn't bother to save for my retirement," it doesn't mean "I'm 16 and having my second baby so pay me," it most certainly and emphatically does not mean "buy me medical care even though I can afford a big-screen TVs and cable in my house."

Unable means mentally or physically incapable of providing for one's self. That really leaves only a few general categories of people: orphaned children, disabled veterans, and the seriously mentally ill, for instance.

Time doesn't allow for me to go into the role I think families should be playing in any of these types of situations, but suffice it to say that there are some few circumstances wherein a family is not an answer - the danger-to-themselves-and-others mentally ill, orphans with no family whatsoever, and so on. But all in all, the numbers of such situations are not huge.

I really don't have it in me to comment on the rest of the article. It's too sad.

Posted by Russ at 06:09 PM, May 23, 2003 in Idiots

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"Well, most folks have this thing called "insurance." On the other hand, if you don't take your beta blockers you only hurt yourself. If you don't take your antipsychotics you could be a danger to society. I really don't understand your comments. First, you imply that the best thing to do would be to institutionalize them. Then you inveigh against paying for drugs or treatment. How can you institutionalize them without paying for treatment? And since you say you ar ea small government libertarian, wouldn't it be better to have people out of asylums, and therefore more independent and less costly to the government, whenever possible? .

Posted by: ml at May 24, 2003 03:55 AM

You seem to have misunderstood. Institutionalization for the people who really need it, who really cannot take care of themselves and have no family to do so is a legitimate thing to spend tax dollars on. Indeed, one of the only legitimate things on which to spend our tax dollars.

What bothers me is that many of these people who really need to be institutionalized are not getting the help they need.

Posted by: Russ at May 24, 2003 12:28 PM

I loved your summary. You hit the nail on the headwhen you state that SF is attracting homelessness by offering so much "free" aid.

I had many of these psychiatrists on my local tours, who incidentally did not seem to be informed at all of its occurrence. They WERE shocked! I added, "I, too, have been attacked physically and repeatedly abused verbally. So has my mother and almost all work colleagues. But let's face it, ORDINARY people attacked? How BORING!!! It has to be a police chief, Chelsea Clinton or good heavens a PSYCHIATRIST to be of any importance at all!" One doctor, Robert Fisch of Israel, reasoned that "She must have done SOMETHING!" I told him, with that reasoning, he could join the SFPD, who blame victims all the tiem = as if we sucker taxpayers would provoke them, let alone invite them into our city with free money!!!!

I am livid about this, too. Let the trial on June 4th for Aaron Hull be worldwide news. The APA is indirectly on trial, for Hull has been repeatedly released in the past, to attack again, and this time, o golly gee, it was a DOCTOR of the mind. O Lord. Let us only pray it helps SF!

Posted by: Mary at May 31, 2003 10:28 PM

After running your narrative and interpretation of the attack on Dr. Jayaram on my ColoradoPsycho.com Web site, I have been frantically searching for any follow-up stories on the fate of Aaron Matthew Hull, but either there seems to be a cover-up, or even the APA is in deep denial. Reporters would rather spend their time and energy on something more sensationalistic, like the Laci Peterson murder case. The incident only serves to drive home the fact that there's something terribly wrong about how we deal with the mentally ill.

Posted by: Charles at June 13, 2003 01:13 AM

Funny to see some comments on this case, only because Mr. Hull and I grew up in the same neighborhood just outside of San Francisco.

He was fine as a kid but as he got older he started to develop some serious mental illness, compounded by people around him who convinced him that the way to solve these problems was to take illegal drugs. He didn't have health insurance when he needed it and once the spiral started, that was pretty much it.

He is not the only person from my old high school in Millbrae who has developed serious illness, both came from nice families, and both at one time had bright futures.

Since nowadays our policy to deal with people who are so seriously messed up is to let them roam the streets it is small wonder this happened. It is realy too bad since if there was some way to make sure this guy took his medication he'd at least be ok enough to go to a job everyday and not hurt anyone.

Ah but that would take some planning and some system or something and we all know how much better it is to let the business sector deal with this. They've done such a great job so far, heck, look at the results! Expensive treatment most people can't afford, and lots of homeless lunatics on the street!

But at least we can rest easy knowing the "government" isn't taking a few pennies more right???


Posted by: buzz at December 1, 2003 06:22 PM

Dear Russ,

I was just scanning the net and came across this article.I am happy to see your concern for the homeless mentally ill and also to the fact that you voiced it out.Even though this happened in 2003,it still holds much relevance to me.I am working for an NGO called The Banyan in Chennai,India.We have been working for this cause past 13 years.The plight of the homeless mentally ill is still in the back row and on nobody's agenda.The homeless mentally ill are seen more as a threat and not looked as a person who needs care and treatment after which he /she would live life just like any one of us.Ther is so much more to this issue and I really want to get in touch with you personally and take this conversation forward

Posted by: Poornima at February 28, 2006 02:34 AM