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July 10, 2019 - Freedomain Radio - Stefan Molyneux

03:14:43

The Destruction of America's Mental Health Care System

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	Hi everybody, this is Stefan Molyneux.
	I hope you're doing well.
	This presentation, The Destruction of America's Mental Health Care System and Its Consequences, is very powerful.
	I believe it's going to bear watching more than once.
	I'm really going to beg you to pay attention to this presentation and not multitask while I'm talking about this stuff.
	If you're just listening to the audio, I strongly urge you to check out the video for the graphs.
	And the diagrams and, of course, if you decide to dig deeper into any of the topics I've talked about here in the PDF linked below, linked in the notes to the show, are hundreds of detailed primary and secondary sources on all sides of the issue, which I think will serve as a valuable starting are hundreds of detailed primary and secondary sources on all sides of the issue, which I think will I think will serve as a valuable starting point for us to have this conversation together.
	I really, really hope this presentation is a worthy contribution to a conversation that is frankly long overdue.
	I've touched on my own experiences with immediate family members' mental health crises in my show in the past, just for those who don't know.
	My mother was institutionalized when I was in my early teens after she battled a wide variety of mental health ailments from depression, anxiety, paranoia, and so on.
	And she was not kept very long.
	She was then released into the general population and it did not work out very well.
	And the numbers of people who are impossible to manage if you're not a professional...
	that are dumped onto the community as part of a conscious process of dismantling.
	A very hard one.
	Mental health system is something which we, I really can't overemphasize just how destructive this has been to families, to communities, to the peace and security of people in society.
	So let's get in and talk about this.
	Now, the Western mental health care system was the result of centuries of effort to solve a fundamentally difficult problem.
	How to best care for addicts, the mentally disabled and the mentally ill.
	Although the system was, of course, far from perfect, it was much better than what came before or since.
	The critics of the mental health care system in the 20th century failed to appreciate the benefits of this system, especially compared to realistic alternatives.
	They exaggerated its failures for political and ideological reasons.
	Instead of being reformed and improved, the system of custodial care for the mentally ill was systematically undermined and ultimately destroyed.
	The result was a sort of free-range psychiatry.
	Instead of living in specialized care facilities, the mentally ill are often left to fend for themselves in the streets, or in jails, or in the homes of family members who are not equipped to properly care for them.
	It is a story that didn't have to happen.
	It resulted from specific ideological beliefs that were absolutely, not just unsupported by data, but frankly contradicted by data and a system of care which took centuries of trial and error to develop was destroyed in just a few short decades by people who had complete fantasies about what was possible in terms of cure look there's an unfortunate reality it is a tragic reality and it's very much under discussed
	Some, it's a small portion of the population, but it could be as high as 1%.
	They simply cannot function independently.
	They require full-time care and supervision and potentially medication to avoid causing substantial harm to themselves and to others.
	The consequences of failing to accept this basic truth have been devastating to the mentally ill and to society at large.
	So let's look at the hierarchy of care goals that is the ideal place to start.
	Now each stage in this process of caring for the mentally ill builds on successes of the ones that come below it and steps higher up in this pyramid become increasingly difficult to achieve and maintain.
	So the main purpose down at the bottom here that the bare minimum of care is that society is shielded from chaos and disorder and violence.
	Now, if that has been achieved, then the patient can hopefully be protected from exploitation and self-harm because if there are crazy people out there on the streets, they're easy to exploit, particularly if they're self-medicating through other forms of drugs or through alcohol.
	And, of course, they don't take care of themselves and so on.
	So hopefully you can achieve that.
	Now, if you can shield society from violence and chaos and you can help protect the patient from exploitation and self-harm, then hopefully the patient's symptoms are managed and some of them are even eliminated.
	Now if you can achieve that then perhaps there are underlying causes that can be addressed and the patient is cured and if that is achieved then potentially the patient can return to normal independent life integrated into the community.
	This is all very very difficult to achieve.
	Listen I am very good at helping people think clearly.
	I've had conversations with Thousands of people over the course of doing this public philosophy show over the years.
	I've got great reports.
	People are generally very helpful.
	It's very helpful to have conversations with someone who can help clear up clouds of contradiction and anti-empiricism, anti-rationality.
	I'm really good at it.
	I had no luck with my own mother.
	No luck.
	I mean, I can't even tell you how many thousands of hours I spent trying to talk my own mother into not being crazy.
	And it was impossible.
	It was not possible for reasons that we'll get into as we get into here.
	I mean, in my family tree, there are people who have been hospitalized or who've been suicidal, hospitalized for depression, and there are people who've gone through electroshock therapy.
	I mean, there's a reason why I'm really interested in philosophy, which is that the alternative to philosophy Often seems to be a crash, particularly if you're very smart.
	Like if you have a very fast car, you need to be a very, very good driver or you're going to crash for sure.
	And the amount of creativity and intelligence in my family tree is truly spectacular.
	But also the amount of dysfunction and craziness is there as well.
	So I think that it was very personal for me, having seen what a rejection of rationality can do to a human mind.
	Well, it's like if you grew up with an alcoholic, you don't want to ever touch alcohol again.
	So, Treatment, paradigms, what is possible.
	So care for the mentally ill, and please remember, I'm not an expert here.
	This is just data that I've gathered, my own opinions.
	I'm not trained, so please everybody just don't take this as any kind of advice on what anyone should ever do.
	These are just thoughts that I've gathered over the years.
	So care for the mentally ill falls into four broad categories.
	The first, you see here at the bottom left, is custodial care.
	So this is a safe environment with close professional supervision.
	Now, another part of the toolbox is what's called moral treatment.
	Now, this is the case that if the patient is rational enough to respond to rewards and punishments, the patient may benefit from religious or moral instruction and meaningful work.
	The third is medicine and surgeries.
	In this case, the goal, of course, of the ideal is that symptoms are brought under control via physical or pharmacological means.
	Because of course some people go crazy because they have a brain deterioration, they have a tumor, they have injury or something like that.
	So that's important as well.
	There's also sociological intervention.
	So this is with the goal of addressing underlying social factors which might exacerbate or provoke mental illness.
	Now, if you want to address addiction and mental illness in any kind of scalable or sustainable way, you have to use tools from all four treatment paradigms.
	There's no one-size-fits-all solution.
	Interventions which rely on a single strategy to hammer in every nail are no match for the inherent complexity of the problems that fall.
	Under the broad category of mental illness.
	Look, it's really clear about the reality of this that there is certainly evidence that some people are born with a significant genetic predisposition to mental illness.
	That combined with Environmental factors such as stress, abuse, sexual abuse, violence, chaos, abandonment, neglect and so on can cause a trigger wherein the dominoes of mental illness begin to fall.
	And that is very important.
	The fact that my mother grew up in Germany during the Second World War was not incidental to what happened to her later in life.
	It's kind of like smoking, right?
	So some people can smoke, like George Burns, smoked to be a hundred, lived to be a hundred, was fine, right?
	Other people, they have like five cigarettes and get lung cancer.
	You don't know your susceptibility, which is why you have to act in a moral manner, not use violence against children, not stress them out, not abuse them, not neglect them, because you don't know.
	There are boys with a particular gene And if they are physically violently abused, 100% of them become criminals.
	But if they're not, eh, you know.
	So you act in a moral manner because you don't know people's genetic susceptibility in the same way that you don't smoke because you don't know your genetic susceptibility to emphysema or lung cancer or whatever else might happen to you as a result of smoking.
	So some of it, there's genetic susceptibility, I believe.
	There are environmental factors that are important.
	To understand there are physical injuries and then there are bad mental habits, which we'll get into.
	I really want you to understand what it's like with people who are crazy.
	I mean, my mother, there would be a car backfiring on the street.
	She would believe that people were shooting at her.
	There was graffiti somewhere in the neighborhood.
	She would believe it was a message of threat for her to change her behavior.
	She slept with a knife under her pillow.
	She was extraordinarily volatile and violent.
	It's a tortured, tortured life.
	And there's worse.
	Here's an example, because this is real people in the real world with massive problems.
	In Washington, a homeless woman sleeps every night on the sidewalk surrounded by plastic bags filled with dirty clothes and blankets.
	According to her, she is not homeless, but is actually waiting for the movie star.
	A few blocks away, a man sleeps on a park bench because he believes he is conducting a long-term socio-economic study.
	Another man sleeps under a nearby bridge and claims that his identity was stolen by federal agents.
	In San Francisco, the mentally ill wander the streets, gesticulating and speaking random phrases.
	Others stop traffic and bang their heads against street poles or lie on the sidewalk hallucinating.
	A Texas man with a history of hearing voices and repeated suicide attempts stabbed his wife and two children to death, cut out their hearts, and put the organs in his pockets on his way to confess to police.
	While in prison, he later pulled out one of his own eyeballs and ate it.
	Mentally ill prison inmates have been known to attempt escape by smearing themselves with feces and trying to flush themselves down toilets.
	These are extraordinarily dysfunctional people who are often a risk to themselves and to others.
	And what do we do with them?
	This is what some people live with on a daily basis.
	Now we're going to flesh out some of the more details, some details about the more common forms of mental illness.
	Remember, I'm just a guy on the internet.
	Do not use this for any kind of diagnosis.
	Go to a professional, blah, blah, blah, right?
	So degrees of severity.
	The first thing to understand is this is just about every social phenomenon.
	There's a bell curve with respect to sanity.
	So in America, about 4% of Americans live with a serious mental illness that's abbreviated as SMI.
	And that is an illness or a dysfunction in the mind that substantially interferes with or limits one or more of their major life activities.
	Now the most common of these severe mental illnesses or serious mental illnesses are schizophrenia, bipolar disorder, or major depression.
	Now, of the Americans who have severe mental illness, about one in ten, which pulls out to about 0.5% of the population, make up the majority of the mentally ill who are homeless, who are imprisoned or institutionalized, right?
	So, you remember this Pareto principle.
	A small minority of the most severe cases are responsible for the majority of difficulty in care.
	Now, of course it's important to remember, there's a lot of people who suffer from mild versions of some of these symptoms from time to time.
	But these issues are distinguished by the extremities of the symptoms.
	So again, remember, following descriptions, just education, not sufficient for any non-professional to diagnose any kind of mental ailment or disease.
	So, Schizophrenia.
	This is a chronic and severe mental disorder characterized by delusions, hallucinations, poor executive function, flat affect, which is kind of an emotionless robotic tone, and agitated body movement.
	Symptoms usually begin late in adolescence or early in adulthood.
	Schizophrenia is highly heritable.
	Twin studies have suggested a strong underlying genetic cause, which has been supported by molecular genetic studies.
	Differences in violent tendencies among schizophrenia patients are correlated with brain imaging differences.
	Patients show a substantial gray matter deficit that gets worse as the disease progresses.
	The majority of potential biomarkers for schizophrenia are related to the body's inflammatory response and recent evidence supports the hypothesis.
	that schizophrenia symptoms are at least sometimes triggered by overactive pruning of brain synapses during adolescence, right?
	So you remember, we're born with all this crazy constellation of joint brain synapses, and one of the purpose of maturation of the brain, which happens in the early 20s for women and in the mid-20s for men, is to get rid of all of the useless ones, right, so to speak, right?
	And so if you go too far with the pruning, then you lose executive function, like the ability.
	Like you have like a third of a second to intercept an impulse and decide not to do something.
	Like if you ever want to just yell at someone or hit someone, the impulse arises.
	Executive function says, whoa, whoa, whoa, shut it down, shut it down, don't do that.
	The consequences are bad.
	The consequences are dire.
	You have a very short amount of time to be able to do that, and being able to restrain impulses is very important.
	Now some research has suggested that childhood trauma and parasitic infections may also play a role in the complex gene-environment interactions which underlie the disease.
	Bipolar disorder.
	Now, this is a mental disorder.
	This used to be called, I think, manic depressive disorder.
	A mental disorder characterized by unusual shifts in mood, energy, activity levels, and an inconsistent ability to carry out day-to-day tasks.
	It is widely recognized by alternating manic and depressive periods lasting up to several weeks.
	So in the manic period, you believe you're incredibly creative.
	You can do no wrong.
	Everything you do is brilliant.
	You don't really need any sleep.
	You're restless.
	Often it's lageria or sort of verbal diarrhea and so on.
	And then you crash to the point where sometimes you can't even get out of bed.
	And Now bipolar is also highly heritable and some of these specific genetic markers have been Identify it.
	Now, again, I focus very much on the environment, right?
	So if a child is raised peacefully, I believe that fewer of these genetic predispositions will be triggered.
	And also, if you have good mental habits, I believe that really helps.
	So, like, here's an analogy.
	Let's say you have a family history of heart disease, right?
	You have genetic predisposition towards heart disease.
	Now, if you, you know, work out religiously and watch your diet and stay at a reasonable weight and so on, That's going to help.
	Now, you might still die of heart disease, but you're doing everything you can to prevent it, and that's really, really important.
	If you have genetic predisposition to alcoholism, but you don't touch alcohol, Well, you probably can end up doing okay.
	You're certainly not, probably not going to die of cirrhosis of the liver.
	And this is why in the world when I talk about good mental health habits, when I talk about thinking rationally, when I talk about the value of self-knowledge and self-criticism and being honest about your past and the people in your life and virtue and ethics and all that, this is all To help people not go crazy.
	To help people not go crazy.
	And I believe that level of environmental influence is a very positive effect in the world.
	Now, brain-derived neurotrophic factor.
	Ah, okay, what is that?
	So, there's BDNF.
	It's a protein that causes certain types of nerve cells to survive and grow.
	It is primarily located in the central nervous system.
	It acts on brain cells and the eyes.
	In the peripheral nervous system, BDNF promotes the growth of sensory and motor neurons.
	BDNF supports the survival and growth of neurons along with the formation of new synapses.
	Patients diagnosed as bipolar have greatly reduced BDNF levels, especially during their depressive phases.
	So look, you have a personality, you have an identity, and there's almost no aspect of personality that is not affected by genetics.
	You're dealing with a person who has thoughts and opinions and control and usually control over what they do.
	But you're also dealing with a constellation of genetics, which is kind of why it's hard to talk people in and out of things.
	There are significant genetic roots to political beliefs, which is why sometimes trying to get someone to go from collectivism to individualism, from socialism to capitalism, is kind of like trying to verbally convince them to change their eye color or to change their height.
	That's why these conversations tend to be so frustrating and repetitive.
	But we are all of us sitting on a substructure of biology, of genetics, of these BDNF systems and so on.
	And it's just a reality.
	I mean, there's this famous stories of the, I think it's a 19th century story of the guy who got a railway spike to the head and went from being peaceful to highly aggressive.
	Some of it's moral.
	Some of it's, I believe, choice.
	Some of it can be affected.
	Some of it, of course, we're just sitting on a superstructure or substructure really of biology.
	An increased risk of bipolar disorder may also be connected to certain autoimmune diseases and to mitochondrial dysfunction.
	Now here, this is very interesting.
	So if you look down here on the bottom left, for those who are just listening in, I'm sorry.
	So here you can see a scan on the left shows a normal brain and a scan just on the right shows the brain of someone suffering from bipolar disorder.
	So patients show reduced cortical thickness compared to healthy controls along with enlarged lateral ventricles, cavities within the brain that contain Cerebro spinal fluid now for those of you who want to leap straight over the canyon to aha 100% genetic 100% biological Be careful be careful because look If you look at, say, a 40-year-old man who works out four times a week, right?
	He's going to have a certain BMI.
	He's going to have a body fat percentage.
	He's going to have the presence of a particular musculature.
	And if you look at a 40-year-old man who doesn't work out at all, well, he's going to be flabby.
	He's going to be flaccid.
	For some reason, they are neck-bearded.
	And so you're going to do a scan of this person's body.
	You're going to say, wow, their bodies are totally different.
	But you wouldn't say that that's genetic.
	I mean, I know that there's genetics involved in how much muscle you can accumulate.
	There are some people, genetically gifted, they can eat as much as they want, they don't gain weight, and they swell up like crazy, like, you know, lift-buffer icons of the gods when they work out a little bit.
	I've known people like that.
	They kind of lean, they work out, like Michelin Man holding in a sneeze of the gods.
	But if you do a scan of someone's body, one person's worked out for 20 years, one person's not worked out for 20 years, their body's gonna look totally different.
	But that's the result of choice, to a large degree.
	Well, I mean, in terms of development of muscle, right?
	So, looking at these scans, everybody wants to look at these scans and say, aha!
	Biological 100%, genetic 100%, outside our free will.
	Be careful, be careful, be careful.
	It's very early days with this kind of stuff, and we always want to err on the side A free will.
	We always want to err on the side of free will.
	Because the moment we start talking biology, genetics, and so on, people give up.
	And what if that becomes a self-fulfilling prophecy?
	Right?
	What if somebody says, or somebody hears, oh I've got a family history of heart disease, man.
	So to hell with it.
	I'm going to drink, I'm going to smoke, I'm going to eat badly, I'm not going to exercise because, you know, I've got a family history of heart disease, so what does it matter, right?
	Whereas his brother says, oh man, I've got a family history of heart disease, I'd better work out, I'd better make sure my cardiovascular health is very good, I'd better make sure I get checked out regularly, no smoking, no drinking, no eating badly.
	I mean, you want to err on the side of free will and control over these things as much as humanly possible.
	In other words, until there's a hundred percent proof.
	of genetics, I'm going to err on free will, moral responsibility, good mental health habits, rationality, philosophy, and so on.
	Right?
	This is why, I mean, I don't do calls with people.
	I say, Oh, would you like to be taller?
	Well, philosophy is your answer.
	You want to change your eye color or regrow hair, whatever.
	I mean, it's right.
	But if you want to be in a reason equals virtue equals happiness, if you want to have good mental health philosophy, for me, it's 100%.
	Philosophy, mental health, good habits, until proven otherwise.
	I'm just, I'm telling you that outright.
	Because the alternative of saying it's environment when it's not, is you're literally going to make people insane.
	Right?
	I understand that if it is open to choice, and people say it's 100% genetics, then people are just going to give up.
	And you're actually going to make people crazy.
	I don't want that in my conscience.
	I'm sure you don't want it on yours as well.
	Let's look at major depression.
	So this is a mood disorder characterized by persistent feelings of emptiness, endless fatigue, insomnia.
	Fatigue plus insomnia is Satan's gift to the planet, right?
	Because insomnia, let's say if you have insomnia because you're on the manic phase of a manic depression or you're just really excited by something or whether your kid getting up early on Christmas Day, oh I can't sleep, it's good, right?
	Because at least you can be productive, you get something done, but if you have insomnia plus godforsaken fatigue, you're literally like a brain-clouded zombie struggling your way through the day and the night.
	People who have major depression also have difficulty concentrating, they have poor appetite, and they can be a bit of a black hole for other people's moods as well.
	Major depression is moderately heritable, but has a weaker genetic influence than schizophrenia or bipolar.
	Prolonged depression and chronic stress are associated with reduced brain volume, especially of significant regions like the hippocampus.
	Childhood maltreatment is a significant risk factor for depression, and abuse also seems to reduce the effectiveness of treatments.
	Yeah, I mean, if you're treated like garbage, you tend to end up feeling like garbage.
	If you are treated as an empty vessel for your parents or teachers or priests' convenience, then you're going to grow up, I think, without this sense of an identity, without the sense of freedom and the value of your existence.
	If you're used like a tool, you end up feeling as empty as a tool.
	Certain genetic markers, such as an overexpression of G-A-T-A-1 may predispose some people to greater physiological sensitivity, distress, and depression by reducing the synaptic connections between two brain cells.
	And again, we've got some graphics here which look, perhaps, to some people like, oh, it's all genetics, right?
	But again, there's a choice.
	If you look at, imagine these as the muscle fibers of somebody on the left who'd worked out and somebody on the right who hadn't worked out regularly, you'd say, okay, well, it's not just genetics, right?
	It's a choice you make here.
	The neuron on the left shows the synaptic connections between neurons in a normal brain, that's on the left, while the image on the right shows connections from the brain of someone with an overexpression of GATA1, which is associated with major depression.
	Now, one of the, this is just personal anecdote time, so this is not science, it's a personal anecdote, but one of the things that I've seen crazy people do is they are desperate to put their ailments on a physical basis.
	Right?
	So for my mom, it was like, she says, Oh, I have these diseases, I have these illnesses, I have blah, blah, blah, blah, blah, I won't get into all the details.
	Because she really, really wanted there to be a physical, non moral explanation as to why she had the dysfunctions that she had.
	Now, some of it, of course, had to do with her environment growing up.
	Some of it had to do with her choices.
	Some of it, I actually believe, had to do with her physical beauty, which was considerable and gave her the capacity to manipulate and also gave her a strength and a power that, you know, when she hit 40, she literally didn't get out of bed for two weeks.
	I'd go to school.
	I'd come home.
	I'd make her tea.
	I'd leave the tea.
	I'd come home, go back to school, come back, put in a flush of tea.
	She just didn't get out of bed.
	I didn't really understand it at the time.
	It took me many years to figure out, oh, that's when she turned 40.
	Because, you know, that's the war, certainly post-war.
	And when she lost her beauty, as we all do, I mean, it was really, really harsh.
	And some of it was that she had committed great acts of evil against me and the violence and so on.
	I mean, she had, when I tried to get out of the house when I was, I don't know, three or four years old, I tried to flee the little apartment we were living in because my mom was so violent.
	She caught me and beat my head against a heavy door to the point where I just had to go limp because I was terrified.
	I was going to get a permanent brain injury or possibly even die.
	So there was great evil in the household.
	And I kind of understood this more when I played Macbeth in the theater, that when you do a great evil, It robs you of peace of mind.
	It robs you of security and serenity.
	And because she wasn't religious, she didn't even have a place where she could go and confess and be absolved.
	And I think that the guilt kind of ate her up as well.
	Now, this is a huge, huge issue.
	And it's got a bit of a long name.
	Anisognosia.
	So with major brain disorders, it's common for brain circuits responsible for self-awareness to become damaged.
	So this results in this condition called anosognosia, in which the patient has a lack of knowledge or insight about their disease.
	It is not to be confused with mere denial.
	So denial is when you kind of know something deep down, but you push back against it.
	This is like you could pass a lie detector test.
	You know, you're sitting in a bunny suit in the middle of the highway hallucinating that space aliens are trying to take your nipples to Aldebaran for experiments with a mouse utopia and you could pass a lie detector test as you genuinely don't have an insight about how far you've drifted from reality.
	Anasognosia can be easily recognized in patients with advanced Alzheimer's whose memory is impaired but they no longer remember what they've forgotten.
	Or with patients who have suffered a stroke who may be partially paralyzed and not even Realize that.
	You can say to these people, you know, move your right arm, and if they can't see it, they're, oh, I'm moving it, right, it really feels that way, but they're not.
	Now, a substantial proportion of patients who are diagnosed with schizophrenia or other severe mental disorders are unaware of their illness.
	But this is an old saying when I was a kid.
	I read it in Invasion of the Body Snatcher or something like that in a book I read when I was younger.
	It's a movie I think, more than one.
	But the idea was if you think you might be going crazy, you're not going crazy.
	Like if you think it, it's not happening.
	And I've heard some pushback on this, but this is kind of where things are.
	Because patients with anasthnosia do not think they have a problem or mistakenly believe they've been cured, they often resist medication or...
	Other forms of treatment.
	And they show a tendency to be more violent.
	So, the way that I process this in my head, so, I don't know, it's like six years ago, seven years ago, I was diagnosed with cancer.
	And, you know, I went through the usual ungodly treatments.
	It wasn't hugely effective.
	It didn't hugely change my hairstyle, but it certainly changed my levels of energy and all that.
	And I've got a clean bill of health.
	I think it was last year I passed my five years.
	I'm fine now.
	So I'm cured.
	Now, if somebody came up to me and said, Steph, you've got to go through chemo and radiation again.
	Be like, why?
	I'm fine.
	Why on earth would I want that?
	That was horrible.
	I wouldn't wish that on my worst enemy.
	And so if you, and I, but I am, like I literally am better.
	I've had the blood test, I've had the scan, I am fine.
	But if somebody said to me, sorry man, you gotta go back on chemo and radio, radiation therapy, I'd be like, not in your life.
	So if you're crazy, but you believe that you're better, or you believe that you're fine, go up to a healthy person and say, well you know, just in case you might have cancer, we're gonna put you on chemo and radiation therapy, but no thanks, right?
	And that's the way to sort of understand it.
	Now, of course, if somebody grabbed me and tried to put me into these treatment centers that I went to for cancer, I'd fight tooth and nail.
	I would consider that a violent assault upon me and an endangerment of my health.
	Somebody tied me down and was going to put radiation on me.
	Someone was going to tie me down and put the chemicals into me, the chemotherapy into me.
	I would view that as an assault upon me.
	I'd fight tooth and nail.
	So that's a way of understanding.
	If you genuinely believe that you're fine, a form of treatment would be considered incarceration and brutality and an assault.
	So brain scans show a marked difference between patients who have an awareness of their disease and those who don't.
	And again, you know, I've said this, I've told this story before, and I'm sorry to repeat for those.
	I'm always very, very self-conscious of repeating stories because, I mean, I really don't like it when people do it.
	But these are sort of collected stories that are important.
	So with my mom, I think I was about Maybe 18 or so and I took it to Pizza Hut and I said, look, look, I accept everything that you're saying, right?
	Like you have these ailments, they were injected into you and people are out to get, I accept all of that.
	Now that situation creates a lot of stress.
	Being persecuted in this way creates a lot of stress.
	So listen, there's a library right across the street.
	Let's walk across the street.
	Let's get a book on stress management so that you can deal with the stress of being persecuted in this manner.
	And I thought, okay, well, that's about as good as I can do.
	That's about as far I can go into crazy land without completely self-compromising.
	And she, I mean, she just went nuts, right?
	She, like, threw pitches of water at me and screamed and flipped over the plates and just went crazy because this was accepting everything but saying she still had some responsibility to Better her position.
	It gave her 1% responsibility, which at that point, you know, of course, I mean, if you've done evil against children, you start taking responsibility.
	That looms pretty hard in your review.
	Now, so the role of medication.
	Like a lot of these issues the role of medication is complex and controversial.
	I mean this could be an entire presentation by itself and you want to check out a book by Whitaker called Mad in America.
	I've had him on the show and I'll link to those shows below.
	There's some significant doubts like as the role of certain forms of quote mental health medication have increased so have the rates of mental health which is the exact opposite of what you would expect if they were actually efficacious.
	So I have enormous skepticism towards this but there is some data that shows there's effectiveness right?
	In particular, so look at psychotics, right?
	Truly delusional, other reality, waking dreams, you name it.
	Modern anti-psychotic medications seem to have a positive effect on patients in many cases.
	Although those with the most extreme illness still require long-term supervised residential care, a large number of patients can live independently if required to check in regularly with psychiatric staff.
	So these touch points allow patients to receive ongoing support and to ensure medication compliance.
	among other benefits.
	So the medications, of course, people will say when they're on these sort of mental health medicines that they have side effects and some of those side effects can be pretty negative and so they feel better and they don't like the side effects and then they stop taking and then they get worse but they don't know it because the disease hides them from themselves, right?
	So, medication compliance substantially reduces alcohol and drug abuse, self-harm and attempted suicide, public disturbances, physical harm to others, destruction of property, incarceration rates, and homelessness, right?
	So the idea that, like somebody who's psychotic, if they're sort of out of custodial care, if they're not taking their meds, they're often taking something else, right?
	Which is not good.
	Alcohol and illicit drugs and so on.
	Now, medication can be moderately effective at controlling the symptoms of psychosis, especially violence.
	It seems to also substantially reduce the chance that a mentally ill person will themselves be the victim of violence, right?
	So, if you're psychotic and, let's say, you're taking illicit drugs, you have to go out and procure those illicit drugs.
	You may not be the wisest person to interact with criminals with, and there may be escalations based on that.
	Some medications have been criticized for masking symptoms without actually curing the underlying problem.
	In certain cases, medication may even make problems worse, especially if it is taken inconsistently or combined with alcohol or other drugs.
	Right?
	So, you know, let's just take a silly example.
	I mean, it's not silly to the people who are experiencing it, but compared to psychosis, it's less serious.
	Something like social anxiety.
	Social anxiety.
	Now, you may have social anxiety, and I've made this argument, I've had this argument before, not that I have any capacity to diagnose, of course, just to remind you, or you might just be surrounded by really nasty people.
	I mean, if you fell into a lion cage at the zoo, no one would say you just had a weird kind of cataphobia, right?
	You'd be like, oh my god, I'm in the lion cage, I've got to get out!
	And in the same way, it's only an irrational anxiety if you're not actually in danger.
	If you're kidnapped, you don't have claustrophobia as some irrational thing.
	If you're in an elevator, you're probably okay, but if you're kidnapped in the back of a... locked in the trunk of a car, you know, like Tragically Hip style, then it's not a phobia.
	You're actually in danger.
	And so, the environment might be Dangerous.
	The environment might be dysfunctional.
	Your environment might be abusive.
	You may be surrounded by abusive people, in which case, right, it's the old saying, it's not a mark of mental health to be well adjusted to profoundly disturbed circumstances.
	All right.
	How did we get here?
	Now, of course, way back in the day, mental illness was often considered to be just demonic possession, right?
	Because they didn't understand genetics, they didn't understand, like, Dr. Vincent Felici.
	I've interviewed him and I've got a whole presentation called The Bomb in the Brain, which, again, I'll link to below.
	So he interviewed people about their childhoods and he developed something called the adverse childhood experience score, which everybody should take and get people in your life to take it.
	It's not perfect in my view, but it's a great starting point.
	And he found that the more adverse childhood experiences you had, the worse was your overall health in the long run.
	It was dose dependent.
	In other words, the more adverse childhood experience you had, the more likely in a step-by-step way you were to have ischemic heart disease, to be susceptible to cancer, to Be promiscuous, to be a cigarette or drug abuser, to be an alcoholic, and so on.
	And severe child abuse took like 20 years off people's lives.
	I mean, on average, it was... I mean, it was brutal.
	It's one of the reasons why, knowing I had the childhood that I had, that I exercise, that I maintain a healthy weight, that I eat well, you know, all that kind of stuff, because I know the risks that have been associated, and it certainly could very well be the case that, you know, cancer was also my mom's gift to me as well.
	It was a very stressful childhood, I'll tell you that.
	So there was this argument way back in the day that if you had visions, well you were possessed by Satan, you were possessed by a devil or a malevolent spirit or something like that.
	And there would be these rituals and so on.
	And I believe that some of the practice, if you look at something like
	Confession in the Catholic Church where you kind of cough up your sins and your evils and you're given steps Through which you can absolve them or if you look at the 12-step program wherein you you take responsibility You apologize to people you try to make restitution for those you've harmed or wronged These are all good things to do and they're put into a framework sometimes self-help II sometimes Theological but it really does help people and one of the things that's happened of course is with the fall of religion We don't have the pressure valve of confession
	an absolution and restitution, right?
	If you've wronged someone then you owe them an apology and restitution, a promise never to do.
	We don't have a framework for doing that anymore and I think that's one of the reasons why mental health issues have built up more.
	We don't have, I mean, for the very wealthy you can afford therapy, right?
	I mean I did years of therapy when I was an entrepreneur, talk therapy.
	I did like three hours a week plus I did another 10 to 12 hours of journaling and Self-work and so on and I had the luxury in a sense to be able to do that I was able to leave work early twice a week to go and do that and so I was in a sense quite fortunate but many people aren't so just about everyone had access to the model of Confession and absolution, but you know how many people can can get that kind of release now?
	Right, so there was this problem.
	Now, before the development of specialized psychiatric institutions, people with mental illnesses were usually taken care of by their families.
	Now, let me tell you, I mean, you know this if you've had any exposure to this kind of stuff.
	It is Was it Deborah Winger's character in Shadowlands?
	It's a great movie with Anthony Hopkins.
	Saw it with my mom actually.
	She says in taking care of her destructive boyfriend like she's just worn out.
	It's exhausting.
	It is really freaking exhausting.
	Being up close and personal with somebody who's crazy on a daily basis.
	It sands down your will.
	It shaves down your spine.
	You become so reactive it's almost like you don't have a personality anymore.
	Like reclaiming an actual identity after growing up with a mentally ill mom was a really, really tough job, which is why I won't surrender it back to anyone.
	Anymore and and sort of standing in the sand blasting whirlwind Face and identity erasing craziness because my mom was not quiet about it she sit corner me and talk to me for hours about her crazy theories and ideas and I'm really trapped and Learning how to push back against that mentally I couldn't when I was young because she just got violent right but learning how to push back against that gave me a very sharpened sense of
	of detecting and pushing back against anti-rationality which I hopefully am using that musculature that was imposed upon me abusively as a child for good in the world as it stands but it is so tiring It is so tiring.
	It wears you out.
	And you can't even get good sleep because sometimes crazy people erupt in the middle of the night.
	And it's dangerous for your soul and reason.
	You can't date and it's really a very, very tough Because if somebody's physically ill, like, I don't know, they have some terminal illness or cancer or something like that, they're still there.
	You can have a conversation.
	They're not trying to impose any kind of insanity on you, because that craziness radiates from crazy people and tries to implant itself in other people by bringing the same chaos and disturbance and anti-rationality and no-win situations, right?
	Like with my mom, there was this constant pattern when I was younger, which was she would give me instructions for something that were confusing or contradictory or incomplete.
	And I couldn't possibly win with those instructions, because if I came back for clarification, what would she say?
	I already told you!
	Right?
	She'd get really angry that I'd come back for clarification when she'd already told me.
	But if I just try to puzzle things through and figure out what she wants, and if I get something wrong, it's like, well, why don't you listen?
	Right?
	So these impossible situations were all, and they make you crazy.
	Like, it's total gaslighting.
	It's total...
	No win situations.
	They destroy your sense of efficacy and what you're good at and can achieve is the foundation of your personality.
	So it kind of erases the base of who you are.
	And that's why therapy was so important.
	That's why I constantly talk to people who've been through abusive, destructive, or violent, or neglectful childhoods.
	Like, go to therapy because you'll have the capacity to have opinions and identity and understand the importance of your own internal processes.
	without constantly being on guard.
	Like, you know, I've had this pleasant experience where you're kind of sitting in a hammock or some really hyper relaxed state, just letting your mind wander.
	And I mean, that's kind of who you are.
	Tracking the migration of your mind is foundational to mapping who you are as a human being.
	Now imagine that you're sitting in your garden and you're just kind of mulling this stuff over and thinking about your life and what you want to do and achievements.
	You know the big zoom out big perspective stuff where we get our moral clarity and strength from.
	And then you hear a sound, you wake up and there's a giant grizzly bear like snuffling right next to you.
	Well, of course, immediately all of your internal musings and meanderings and wanderings vanish.
	And you're like, please don't rip off my scalp.
	Right?
	You fight a flight kicks in and your identity vanishes because you become a bear biped bald mammal trying to not die.
	And that is very important to understand for people.
	who have to deal with this kind of stuff.
	Right?
	So those with our families or those who were too difficult or violent for home-based care were entrusted to special wards within hospitals and poor houses.
	Others were imprisoned or left homeless.
	Quote, care in such circumstances consisted largely of isolation and restraint.
	We can't make them better, but at least we can keep them from doing violence in the community.
	And again, this is not the same as a sort of criminal intent, right?
	They're crazy, right?
	See, whether that craziness is genetic, whether that craziness results from bad mental health habits, whether that craziness is the festering, bubbling, lava scalding of a bad conscience spilling over into the soul with ill historical deeds, kind of doesn't matter.
	It kind of doesn't matter once they're crazy.
	Right, so once someone has, let's say, heart disease, whether it's genetic, whether it's environmental, whether it's the result of bad choices, well, they still have heart disease, right?
	And maybe they can serve as a warning to others if it was based on choice, like 70% of ailments are lifestyle related.
	In other words, they're around free will.
	But once they've gone crazy, it kind of doesn't matter why at that point, right?
	So asylums emerged from the idea that at least some mental illnesses could be cured by moral treatment.
	Moral treatment, now.
	This is a quote from the University of Pennsylvania School of Nursing's History of Psychiatric Hospitals.
	Here we go.
	The moral treatment of the insane was built on the assumption that those suffering from mental illness could find their way to recovery and an eventual cure if treated kindly and in ways that appealed to the parts of their minds that remained rational.
	It repudiated the use of harsh restraints and long periods of isolation that had been used to manage the most destructive behaviors of mentally ill individuals.
	It depended instead on specially constructed hospitals that provided quiet, secluded, and peaceful country settings, opportunities for meaningful work and recreation, a system of privileges and rewards for rational behaviors, and gentler kinds of restraints used for shorter periods.
	So... I mean, I think that's important.
	Will that automatically cure?
	Well, there is the mystery factor of free will.
	There is the mystery factor of choice in these situations.
	So, in contrast to family care or small-scale efforts by local communities, asylums enabled far greater levels of professional care.
	Patients could be isolated from risks and prevented from harming themselves or others.
	Staff could monitor changes in patients' condition and ensure compliance with treatment plans.
	You know, expecting the average person.
	I mean, I was a child and there were, of course, millions of other children dealing with this kind of craziness in their own immediate environment.
	You can't get away.
	You can't escape.
	You know, you marry a guy and he's crazy.
	At least you chose to be there.
	You have the legal right to leave.
	Your parent goes crazy.
	You're really stuck there.
	And it also, gotta tell you, honestly, my friends, it gives you a pretty freaking chilling perception of society's lack of empathy for this, right?
	I mean, there were hundreds of people in my childhood.
	I mean, I lived in three different countries, hundreds of people who knew that my mother was insane, and not one person ever did or said anything about it.
	In fact, I was blamed a lot of times, right?
	So in schools, I got this constant refrain.
	I still remember the teacher giving me the feedback on a test.
	If effort matched ability, you'd be an A+, right?
	Because everybody recognized I was very smart, but they couldn't figure out why I wasn't doing that well in school.
	Man, I did okay.
	I passed, you know, and I got A's certainly in English and other things that I had natural ability.
	But people were like, well, it's incomprehensible that given how smart you are, you're not getting straight A's across the board.
	I mean, you're just lazy.
	I mean, that was the constant refrain that I got.
	It's like, man, you try living with a crazy woman.
	You try getting homework done when she's screaming and throwing things around.
	Yeah, good luck.
	The rise of state hospitals.
	So over time procedures and training for work at asylums became more formalized and the modern psychiatric hospital evolved.
	Privately run hospitals in colonial America had special rooms for housing mentally ill patients as early as the 1750s.
	The first public funding for psychiatric hospitals began in Virginia in the 1770s, right?
	This is amazing when you think about it that The issue of dealing with mental illness, which goes back as far as human history does, we got hundreds and hundreds of years ago they are beginning to try and find a different way of doing it that's not just religious condemnation and so on.
	Trying to get to the etiology of the source of this, these issues and so on.
	And so when you start to fast forward Right, 200 years from the 1750s to the 1950s and you see how quickly and how destructively all of this was just wrecking ball raised to the ground, people turned loose in the streets.
	Well, we'll get to that and just go straight back to, I think, leftist ideology.
	So destructive.
	So throughout the middle of the 19th century, most US states built one or more state-run psychiatric hospitals.
	I mean, look at this place, you know, this is like something out of Downton Abbey.
	Was it?
	Were there problems?
	Of course there were problems in these places.
	And one of the basic problems is... I mean, for the psychiatrists and the doctors, you know, they're well paid and so on.
	But just think of the orderlies.
	Like, who wants to spend their life?
	Who wants to spend their life cleaning human excrement off the walls, being potentially attacked, having people throw food at you?
	And having to wrangle people who, many of whom aren't going to get better and believe that they're sane and that you're an evil person who's unjustly imprisoned them.
	That they all believe that they're Julian Assange and you're just some evil guy.
	And they believe that their medication is making them sick, not making them better.
	Like, who wants to spend their life dealing with that for low wages, right?
	I mean, it is just one of these problems of supply and demand.
	So, Interesting.
	There were early attempts at federalization, right?
	So there's always this hot potato between local governments and centralized governments, right?
	Between federal and state, between federal and provincial, whatever you want to call it, and provincial or state and county and so on.
	Everybody wants everyone else to pay their bills, right?
	This is government as a whole, right?
	And so a land-grant bill for indigent, insane persons was proposed in Congress in 1848.
	The bill attempted to establish federal asylums under a land-grant model similar to what was later used for universities.
	It passed in the spring of 1854.
	President Franklin Pierce rightly predicted that federal responsibility for mental illness would lead inexorably to responsibility for a wide range of other social problems and vetoed the bill.
	So, this basic corruption thing, right?
	The closer the government, the less likelihood there is of corruption.
	Because, I mean, if it's a county, it's a couple of towns or whatever, everybody knows everyone.
	So if somebody's corrupt, if somebody's not doing their job, there could be social ostracism, there can be social feedback, you can, you know, vote someone else, someone else can vote someone else, someone else can run for office or whatever.
	So when you have really, really local government, there's much more feedback and control over corruption, pushback against corruption.
	The further you get away from the local population, the more easy it is for corrupt people to just do whatever they want.
	want, right?
	And of course also the less likelihood there is for anyone in particular, any individual, to mount a big challenge against the federal government, whereas they can easily do so against the local mayor or something like that.
	So there's always this, think of it like bubbles in the Mariana Trench, right?
	It takes an hour to drop a stone down, probably takes an equivalent amount of time for a bubble to come up from the bottom.
	Responsibility always wants to bubble up in the states, in layers of government, so that Problems can be hidden and corruption can flourish.
	So this is the veto message that President Franklin Pierce gave to Congress.
	Now this may sound like a foreign language akin to Klingon, but that's simply because the Constitution matters so little these days in America, but this is his veto message to Congress, and I quote, I readily and I trust feelingly acknowledge the duty incumbent on us all as men and citizens and as among the highest and holiest of our duties to provide for those who, in the mysterious order of providence, are subject to want and to disease of body or mind.
	I cannot find any authority in the Constitution for making the Federal Government the great almoner of public charity throughout the United States.
	To do so would, in my judgment, be contrary to the letter and spirit of the Constitution and subversive of the whole theory upon which the Union of these States is founded.
	Can you imagine such a thing being said today when the federal government runs all kinds of entitlement programs and is the great almanac of public charity throughout the United States?
	Plus, of course, it's not charity if it's coercive.
	Government funds are taken and redistributed at the point of a gun, so it's not charity if it's coercive.
	So President Pierce also anticipated that the establishment of federal asylums would undermine the sovereignty of the states.
	So the idea of course, well one of the original ideas of the federal government, was have it do what states can't do.
	Everything that the state can possibly do, the state should do, and the federal government should only do what the states can't do, like provide for national defense, often of foreign countries these days.
	So, he also said, with regards to this principle that's issued, he said, and I quote, I cannot but repeat what I have before expressed, that if the several states, many of which have already laid the foundation of munificent establishments of local beneficence,
	and nearly all of which are proceeding to establish them shall be led to suppose as should this bill become a law they will be that congress is to make provision for such objects the foundation the fountains of charity will be dried up at home and the several states instead of bestowing their own means on the social wants of their own people may themselves through the strong temptation which appeals to states as to individuals become humble supplicants for the bounty of the federal government reversing their true relations to this union, right?
	So back in the day, the primary government was local, was state, and the federal government was like a footnote or an afterthought.
	So he's basically saying if the federal government takes over this stuff, all that will happen is the local governments will stop funding it, the federal government will get too much power, and everyone will start kissing the ring of the federal government.
	And of course, the other thing too, is if the federal government established, if the big national government establishes a standard, Then competing experiments stop, right?
	How does progress occur?
	How does progress achieve?
	Progress is achieved through competition.
	And so if the federal government says, okay, here's the funding, here's what mental hospitals have to do, here's how it's all going to work, and so on, then everyone's just like, okay.
	But if you have states all experimenting, with the best way to treat the mentally ill then you know Kentucky may do something that Louisiana hasn't thought of that really works you can transfer that right so you stop competition and improvement and progress when you get more centralized government control now Let's look at the issue of overcrowding.
	Now, first of all, there are many different individual diseases in the broad categories of mental illness, addiction, or mental disability, each with their own complex causes.
	It's easy for even experts to be overwhelmed, of course, right?
	Now, patients with mental disorders are vulnerable to neglect or even abuse in any setting.
	Because of their centralized nature, the shortcomings of mental hospitals are easier to observe than in many other settings where mentally ill people live.
	So from the 1880s in America through the 1920s local governments around the country took the opportunity to offload the residents of local charity housing or regular hospitals onto state-funded mental hospitals, right?
	So everyone's got a budget and if you can kick an incurable highly expensive crazy person to a state hospital rather than running it in your local hospital you're more likely to do that and because these people are very very difficult to manage and to work with and this of course is before any Pharmaceutical solutions had arisen, and they had some pretty brutal, quote, solutions for mental health issues, which I will talk about in a few minutes.
	But because everyone was kicking their problem upstairs, or a lot of people were, you had this issue of overcrowding.
	So with state governments picking up the tab, there was a moral hazard incentive for families, charities, and municipalities to relieve themselves of the burden to care for a wide range of difficult cases, remember.
	It's a tiny minority of the cases that consume the vast majority of the resources.
	So this contributed, in the state hospitals, to overcrowding, and it increased the proportion of mental hospital residents who were merely old, sick, or poor, and not necessarily mentally ill.
	Now, funding was an issue, of course.
	In 1929, it lasted for 13 years, arguably until the Second World War.
	There was this massive catastrophic depression throughout the West, in particular in the United States, like 25% unemployment, and a massive expansion and explosion of socialized control of the economy through FDR.
	But, of course, during the Depression, because there was so much unemployment and malinvestment of resources socially, nationally, Government receipts went down hugely, right?
	People who aren't employed don't pay their taxes, don't pay taxes, right?
	So there were massive funding shortfalls throughout the Depression that's caused further overcrowding, right?
	Remember 1880s and 1920s people kicking all their major expensive big problems upstairs to the state institutions and then you get the Great Depression and you've got overpopulation and then you get a collapse in funding.
	Now also During World War II in America, a substantial proportion of hospital staff were drafted, right?
	Just yanked out, enslavement style, and put into the military.
	The debilitating staffing shortfalls resulted, of course, in widespread and acute neglect of patients, right?
	You've got overcrowding, you've got underfunding, and then a massive proportion of hospital staff are drafted.
	Conditions in psychiatric hospitals during this time were used to justify legislation that would ultimately destroy the state hospital system.
	Again, not perfect.
	And the thing is, too, like we look at something like the war, Second World War, and we look at, of course, all the massive geopolitical, the destruction, the Holocaust, you name it, right?
	But we don't see things like this, which is everything that was destroyed or undermined because people were yanked out of the economy and forced to fight.
	Now, this is also very interesting as well.
	This has occurred more recently with the IQ issue, although the IQ issue, like people with an IQ in the low 80s, around 83 or so, the army won't take them because you can't find anything productive for them to do.
	And in fact, when the army did take them, they were called McNamara's morons in Vietnam.
	When the army did take people of lower IQ, it's one of the reasons why Vietnam was such a disaster is you had troops that couldn't be trained, that couldn't make good decisions and thought it was funny to pretend to roll hand grenades into people's tents until they eventually made a mistake and blew people up.
	And, you know, people who couldn't do a call and answer, like shaving a haircut, two bits, call and answer and just shot people around.
	It just didn't work, right?
	But in this instance, in World War II, mental illness became a big issue in other ways.
	So, of course, they would draft a whole bunch of people and they would give them tests and they would interview them and so on, and a surprising number of enlistees were rejected.
	Why?
	For mental health reasons.
	Now, this began to give people a map of just how widespread mental disorders are or were at the time.
	Now, of course, some of these would be Jamie Farr and MASH dressing up as a woman to get out of the army.
	Some of these may be draft dodging, but some of them, because the majority of them I assume, were quite real.
	So the increase in rejection rates was due mostly to rising recruiting standards rather than an increase in the rate of mental illness, but the numbers made a lasting impression.
	And of course, war had become more complex as time goes forward.
	I mean, you give some medieval peasant a stick or a sword, it's one thing, right?
	But you've got to train people on how to run tanks or advanced missile systems or fly planes or calculate trajectories for shelling and so on.
	You kind of need smarter people in the army, and if you have to raise your standards so that you keep more smart people, then you're going to end up with more people being rejected for issues either to do with IQ or mental illness.
	Now this is interesting as well.
	Sorry, when I say that it's always like I'm aware, but does that mean the other thing isn't?
	No, it's all interesting, but here's something particularly fascinating.
	Thousands of conscientious objectors were assigned alternative duty in mental hospitals to attempt to make up for the starving shortfalls.
	Right, so if you really hate the war, then you can end up not fighting, but you could be assigned somewhere else.
	Now, I'm going to go out on a fairly stable limb here and I'm going to say that a lot of the people who were conscientious objectors were hard leftists, if not outright communists, right?
	Because they're like, why would I want to fight a capitalist imperialistic war against my fellow working-class brethren across the sea?
	Which, you know, I can understand that perspective to some degree, but they would be, I think for the most part, if not overwhelmingly, hard leftists, socialists, and communists, right?
	Now they have a particular perspective.
	Socialism, communism, hard leftists.
	It's almost 100% environmental.
	You've got a class consciousness that is based upon your relationship to the means of production.
	And so if someone's crazy, it's always the system.
	It can't be genetics, it can't be their own personal choices, it can't be a moral failing, it can't be whatever, right?
	Everything is environmental and if you change People's relationship to the means of production, you change their entire consciousness.
	That we're a blank slate written on entirely by economics.
	And so when a leftist, a hard leftist, a communist, a socialist, looks at a crazy person, they see not a very complex constellation of cause and effect, of genetics, of choice, of environment, of injury, of illness, of you name it, right?
	It's a very, very complex thing to deal with.
	What they do when they look at a crazy person is they say capitalism made them insane.
	And so all the crazy people around us have been tortured into madness by bourgeois ownership of the means of production.
	100%.
	It's simple, it's simplistic, it's ridiculous.
	Ridiculous, of course, right?
	Because there are lots of crazy people who own the means of production, too.
	But all of this complexity and all of this slow, developed evolution of how to deal with these very tough-to-solve problems It's like, boom!
	This is capitalist exploitation, it's all environmental, these people are victims of an exploitive and destructive economic system, and it's not their fault.
	And also, if you remember, if you've ever read the book by Ken Kesey, also author of the Electric Kool-Aid Acid Test, but Ken Kesey wrote a book in the 60s, I think it was the 60s, called One Flew Over the Cuckoo's Nest, later turned into a very famous movie with a very powerful and dynamic Danny DeVito
	actually I completely missed that sorry a very powerful and dynamic Jack Nicholson playing RPM great acronym Randall Patrick McMurphy and sorry Danny DeVito was in it with his last last tuft or two of hair and in it of course Randall Patrick McMurphy was just this
	you know very independent guy who rebelled against authority and was ground down in the pecking party run by this sociopathic fascist nurse called Nurse Ratched and And he eventually, because he rebelled too much and disagreed with the medication and restraints and control of the mental health care system, well, they ended up lobotomizing him.
	And then the Native guy got free.
	Anyway, it's one of these massive criticisms of the mental health care system that comes from, I don't know what Ken Kesey's politics were, but I'm going to assume left-ish.
	And so he would say, well, there's no reason for people to be here.
	They should just get free.
	And the entire mental health care system is used to harm and destroy and incarcerate dissidents or those who question the system.
	Now, of course, The reality was that that was actually occurring in the Soviet Union, but a lot of the psychiatric hospitals, where of course there were problems, still a government-run institution, but it was a lot of trial and error in society and people were doing the best they could in many ways.
	So when you get these conscientious objectors going into mental hospitals, what happens?
	start reporting about all of this.
	You know, one thing that is very true about people on the left is they tend to have good language skills, good reporting skills, and they're expert emotional manipulators, right?
	So they'll show someone being badly treated in particular ways.
	I mean, look at how they break down the borders in Europe by showing a drowned boy on a Turkish beach, even though his father is responsible for What caused him to drown, which was getting on an overcrowded boat because he wanted to get to Canada for dental care.
	Or they show to try and erase the borders in the south of the US.
	They show a father and a daughter who have drowned, at least it's claimed that they drowned in the water.
	I'm sure they did.
	And somehow this means you like so it's very emotionally manipulative.
	So when they when the leftists don't like something, they just start pumping out propaganda and emotionally manipulative stuff until people just give up the ghost and hand over their freedoms.
	So the conscientious objectors who got into these environments, they reported dirty and dangerous conditions.
	There were media exposés, official inquiries, and this further undermined any public confidence in the existing system.
	Now here are some other problems and shortcomings.
	There were some pretty primitive and barbaric if not downright brutal treatments.
	So many of the most popular treatments for mental illness during the early to mid 20th century strike modern critics as little more than the intentional infliction of brain damage in an attempt to manage or reduce symptoms.
	Although such treatments sometimes, quote, worked in the sense of eliminating certain aspects of mental illness, most people today recoil from the destructive side effects.
	So, Electro-convulsive therapy and in this situation electric currents were passed through the brain to cause seizures.
	Some versions of the treatment were performed without anesthesia and involved high amounts of current.
	Many patients suffered broken bones and memory loss.
	I actually know somebody in my family who went through this and I don't know that they were the same.
	There was another one, and again, if you don't know this, it's kind of shocking.
	I can see why people were pretty appalled.
	Insulin coma therapy.
	This was an extreme state of hypoglycemia that was induced in a patient via high-dose insulin injections, often leading to a brief coma.
	The procedure would typically be repeated many times, often resulting in long-term complications like obesity and severe brain damage.
	And, of course, the prefrontal lobotomy.
	So, in this Procedure.
	Two small holes are drilled in the top of the patient's skull and a surgeon would insert a sharp object to sever the connections between the frontal lobes and the rest of the brain.
	Many patients experience side effects such as seizures, personality changes, and lethargy.
	You hear the descriptions of these techniques and there were others and their side effects.
	Easy to see why people would say, my gosh, these, these are torture chambers.
	They need to be abolished.
	But look, this was before the invention of most modern psychiatric medications and hospital staff are regularly facing the prospect of patients who were violent, who were dangerous to themselves or to others.
	And I mean, if you could imagine, imagine this task, a difficult and often thankless task, Of managing hundreds of patients with extreme mental illness.
	And I think of the guy plucked out his own eyeball and aided people who are violent.
	I remember when I visited my mother.
	It's not violent.
	This was just extreme anxiety when I visited my mother.
	When she was institutionalized, I have no idea how this came about.
	I played table tennis with a woman there while I was waiting for my mother to come and she lost and she just like folded and sobbed and like just the loss was, you know, again, I'm like 11 or 12, 12 I think, something like that.
	So that's a lot of work.
	It's a lot of work.
	It's a lot of patience and physically it's a lot of danger too.
	These people can become violent at the drop of a hat.
	Some of them right now, of course, not all, not all, but at all.
	So here's the thing.
	So when you're looking at these kinds of people, they're just going to try anything.
	They're going to experiment with anything.
	And some of these treatments did appear to help.
	Some patients, you know, I think that the electroconvulsive therapy was sometimes used for extreme depression, where the talk therapy doesn't seem to work, diet change, exercise, and so they just, it was like a reset, and sometimes it seemed to work.
	And of course, in the future, it may be that the
	very strong medications that are sometimes used for mental health issues at the moment I mean from the very strong anti-psychotics to the milder ones for depression and so on they may be just considered as barbaric as we consider these now in the future because you know from a philosophical standpoint society from a philosophical standpoint society as it stands is kind of an asylum right I mean we we have
	We have crazy institutions, we have crazy education, we have indoctrination, we have the massive transfer of resources through the coercive power of the government.
	Children are born into massive debt because of unfunded liabilities and because of national debt and so on.
	We have a crazy system.
	As it stands, and it's saner in many ways than a lot of the systems in the past, but we have a crazy, crazy system at the moment, and children are dumped in daycares, they are often raised by single parents or single moms who have a great deal of difficulty.
	providing the safety security and stability that the children need and uh... but we have this crazy crazy system at the moment and of course uh... we have uh... entire neighborhoods uh... falling apart and people cocooning and isolating themselves partly as a result of diversity partly as a result of stuff we'll talk about Here, so we kind of have a crazy system as it stands and we need a lot of reform in what it is that we do.
	I mean, it's not like burn it to the ground and start again because we've got a lot of good stuff.
	Freedom of speech, for instance, is a pretty good thing, a very good thing, an essential thing.
	But we have a lot of crazy and immoral elements to our society.
	And just saying, well, the only problem is crazy people is not the answer.
	You know, it's easy to just dump all the insanity that society has as a whole into the crazy people and say, well, we don't need to change.
	They're the ones who need to change.
	It's like, well, maybe some of the insanity is a response to a crazy environment.
	And again, I'm not going full leftist environment about it all, but it's easy to just say, well, the dysfunctional people are crazy and our system is perfect.
	And that's not true at all.
	So, Let's talk about the federalization of mental health.
	And I'm calling this part a tale of hubris, of vanity, of, I would say, narcissism, of ideology, and of a rejection of data.
	What did these people do?
	Oh, it's taken thousands of years to develop the system that we have.
	We're just going to kick it out real quick.
	It's just ideology.
	We're going to over-promise, we're going to under-deliver, we're going to set up a system that goes directly against the data.
	Well, it's like marriage.
	Marriage was, in the West, in Europe, in North America, was an institution that had evolved to take care of children over tens of thousands of years.
	People were just like, marriage is a prison!
	We're going to end it!
	Charity was incredibly complicated, remains incredibly complicated.
	It's very, very hard.
	to help people in this world.
	And the only people who think it's easy are people who've never actually tried to help anyone in their lives.
	Very hard to help people, because you want to help people, but you don't want to enable their bad decisions.
	You want to give money to people who are destitute, but you don't want to pay people to become destitute.
	It's really complicated to help people.
	And the idea is like, well, we're just going to have the government take trillions of dollars from one group and give it to another group.
	And that's going to be, it's just, it's mad hubris that goes against all of the depth and complexity of the challenges that we face.
	So let's get into it.
	Let's talk about Robert Felix, architect of the National Mental Health Act and the first director of the National Institute of Mental Health or NIMH.
	So he believed that mental illness could be prevented by early detection and social intervention.
	So what did he say?
	Here's a quote from the dude.
	He said, if we are ever to reduce the volume of mental disease and raise the level of mental health in this country, we must go out and find the people who need help.
	And that means in their local communities.
	As physicians, we know that the environment plays a significant role in the recovery of any patient.
	How much more so in the recovery of the mentally ill.
	The established pattern of federal-state cooperation in general health programs, as well as in the campaigns against venereal disease and tuberculosis, could be applied in an attack upon mental disease.
	Mental illness is incredibly complicated.
	It's incredibly complicated.
	It's not just, oh, you have a urinary tract infection.
	Take these antibiotics and you'll be fine.
	It's not that way at all.
	At all.
	It's incredibly complicated.
	And he says, as physicians, we know that the environment plays a significant role in recovery of any patient.
	How much more so in the recovery of the mentally ill?
	Where's the data for that?
	Where's the data that proves that?
	There's no data that proves that.
	In fact, the data proves the opposite in many ways.
	In a 1946 congressional testimony, Felix said, and I quote, by the establishment of more outpatient clinics, care would be made easily accessible to members of the community at a stage where assistance can be most beneficial, thereby in many cases preventing the onset of more serious and deep-seated symptoms.
	There's this thing called the Dunning-Kruger effect, very, very important, where if you don't understand something, it all seems simple.
	If you don't really understand something, if you've not worked with it, Had this guy been a long-term director of a mental health facility?
	No.
	These guys bungeed in and out of these mental health facilities of these institutions and so on.
	He didn't bring in employees and interview them and say, Oh, you've been working with these people for 30 years.
	What can you tell me about how they could get better?
	He doesn't bring the data.
	He doesn't bring the studies.
	And he brings this stuff to Congress.
	Oh, we just have to do this and wave this magic wand and everyone's going to get better.
	And Congress has no idea.
	This guy is a professional.
	He's very confident.
	He knows what he's talking about and so on.
	And of course, Congress wants more power.
	They don't ask him any particular tough questions.
	I mean, mental illness is not the same as STDs.
	And here's the other thing, too.
	This is right after the Second World War.
	I mean, how many children had mental health issues because their fathers had been yanked off to fight and their mothers had been stressed out waiting for that Saving Private Ryan visit about the death of their father?
	How many men had post-traumatic stress disorder as a result of endless battles and privation overseas?
	I mean, just look at the Bataan Death March, for heaven's sakes.
	The people who survived that had some serious issues Look at the PDSD scene in Mrs. Miniver, a movie about the Second World War.
	Oh, all we have to do is this and we'll just put people in the community and they'll be fine.
	I mean, there's no data for that.
	There's a reason why these people ended up at institutions.
	Now, I'm not saying it couldn't have been improved.
	Of course it could.
	I mean, just privatize the whole thing.
	I mean, that's how things would be improved.
	But this idea, well, you know, we're just going to do this and everything's going to be better.
	And it's just like STDs.
	It's really, really frustrating when you, especially how badly all of this came out.
	This guy'd hardly ever set foot in a mental hospital.
	And later, when the disasters unfolded, it's like, yeah, you know, mistakes were made and right.
	So this Robert Felix failed to understand that there was a profound difference between mere social maladjustment and severe mental illnesses like schizophrenia.
	When his proposals weren't lacking In specifics, they often amounted to the suggestion that those at risk of mental illness receive life coaching.
	You can do it.
	Think positive.
	I mean, this is all... You don't try and talk someone out of having a tumor.
	And some of the stuff, again, even if it's choice and bad mental health habits and lifestyle related and so on, by the time they're crazy, you can't just talk them out of it.
	If someone has lung cancer because they chose to smoke, it doesn't mean you can talk them out of having lung cancer.
	So Felix said, essential to the effective operation of a preventive mental health program are first, a population which knows what to do and is prepared to act at the first sign of trouble, and next, services that can give the requested help.
	They must know why they should seek advice when they plan for retirement, when they consider having a relative live with them, when they prepare a child for hospitalization.
	All these situations can lead to emotional problems if people are not prepared to cope with them adequately.
	There's no specifics to any of this.
	It's just magic.
	Essential to the effective operation of a preventive mental health program, a first of population which knows what to do and is prepared to act at the first sign of trouble.
	Well, wait a minute.
	If the experts in the mental health asylums, or the mentally ill asylums, if the experts don't know how to fix it, how is Aunt Jenny, the baker, supposed to know how to fix it?
	Knows what to do.
	The population as a whole knows what to do.
	If the experts don't know what to do to fix these issues, how on earth is the general population supposed to know what to do?
	It's magic.
	And oh, of course, you know, with the professionalization of psychiatric care, it was considered a very, very bad thing, you see, for non-experts to diagnose.
	It's bad for non-experts to diagnose.
	But now you see this guy says well you know everyone should just be able to diagnose and get the help that's needed to solve the problem.
	Now can you imagine if there was some plague in the land and I said I went to Congress and I said well the important thing you see is for people to recognize when somebody is ill and then get them the help that they need.
	I mean, this is, it's just, it's stupid stuff that people say and maybe it sounds profound to me.
	It's like going to some investors and say, you know, my goal, you see, my goal is to have a business that provides essential services to customers and makes a good profit.
	Yeah.
	Can you, can you flesh that out a little bit?
	Any, any specifics, any, any actual facts?
	It's terrible.
	So, in other words, in Felix's plan, all of society was to become one big psychiatric hospital and everybody needed to become an expert on mental illness and health, including the mentally ill themselves.
	Such unrealistic expectations were widespread at the time and did not make for good policy, to put it mildly.
	We'll see how that plays out.
	Now, the state hospitals in this plan, in this situation, were intentionally undermined.
	Now, in many cases, opposition to state hospitals was ideologically Motivated.
	So rather than attempting to implement admittedly necessary reforms, many key players sought to just end the system outright.
	And again, a lot of this is lefty stuff, which says, well, people are crazy because of capitalism and we shouldn't blame them for that.
	In his 1962 testimony before the Senate Appropriations Committee, aha, everybody always tells the truth when there's billions of dollars to be had.
	The National Institute for Mental Health director, same guy, Robert Felix, said, and I quote, if the communities will enter into cooperation with the federal government and the private foundations and agencies with the right goodwill, public mental hospitals as we know them today can disappear in 25 years!
	And you see how crazy and absurd this all is?
	Mental illness has been a central factor in defining characteristic of human society as far back as recorded history goes.
	So this problem, this challenge that has plagued human society for tens of thousands of years, this guy just puffs up his chest and says, well, I can end it in 25 years.
	Just give me enough money.
	And, and, and of course, people in Congress, do they say, well, where, where's the data?
	Like you're standing here saying that you can basically eliminate mental health issues or at least public mental hospitals in 25 years.
	Where's the data that supports such an outlandish proposition?
	A claim?
	How?
	Are you such a stone genius that everyone who's struggled with these issues for thousands of years just got it completely wrong but you can just magically make it right?
	I mean, I don't even know what to say.
	It's mad.
	Enemies of state hospitals went so far as to claim that institutionalization was actually the cause of mental illness and claimed that the mentally ill could get better if only society would set them free and let them live as they choose.
	Right.
	Right.
	Were some people unjustly put into mental institutions?
	Absolutely.
	Absolutely.
	Some people are unjustly put into prisons.
	It doesn't mean you turf all the criminals loose in society.
	Well, I guess unless you're a leftist mayor in New York or Chicago or wherever, right?
	But no, I mean, it literally is like saying, well, the only reason that people have cancer is because they're undergoing chemo and radiation therapy.
	And so we'll just kick them out and their cancer will disappear.
	So critics of state hospitals decided to replace them with outpatient clinics called Community Mental Health Centers, or CMHCs.
	Instead of treating patients in hospitals, mental illness would be dealt with in the community.
	In relation to state hospitals, CMHCs were designed to be a separate and even directly competing system.
	So according to Ralph Nader's 1974 study group report on the implementation, of these community mental health centers by the National Institute of Mental Health.
	And I quote, NIMH feebly communicated the original intent of the program to state and local officials, failed to coordinate the location of the centers with other social welfare efforts, made little attempt to train people for community work, did not engage consumers in the planning or operation of centers, and made only the most perfunctory evaluation of the program's performance.
	Furthermore, CMHC regulations describe no plans, mechanisms, nor procedures to guide centers in determining their relationship to state hospitals, no methods to divert potential state hospital admissions to community mental health centers, and no procedures whereby patients released from state hospitals could be rehabilitated and assisted back into the community.
	It's a scam.
	It's a vain, glorious, manipulative scam, in my opinion.
	And the brutality of just taking people from state hospitals, in a sense, or taking people who otherwise would have ended up in state hospitals, dumping them in local neighborhoods with ill-trained, undirected people.
	I mean, come on.
	I mean, come on.
	This is, I mean, this is absolutely ridiculous and incredibly dangerous.
	And as it turned out to be, we'll see.
	Now this institutional knowledge is very very important so as you saw this is back in the mid eighteenth century right so actually mid mid uh... yeah mid eighteenth century so you've got a couple hundred years of accumulated knowledge and wisdom on how to deal with this stuff it's not perfect of course I mean I understand that but the you know if you don't live in a perfect house what would you just detonate it and and live under the trees?
	I mean come on, you improve, you fix, you tweak You don't just detonate the whole thing.
	As federally funded CMHCs haphazardly replaced state mental health infrastructure, institutional knowledge that had accumulated over more than a century was lost.
	Emerging state and local level experiments without patient psychiatric services were bypassed and undermined.
	Now remember, the state hospitals always wanted to get people into the communities.
	I mean, because that would be a cure, that would be success, and it would lower their budgetary requirements, but
	all of this knowledge is lost in the same way like they used to be these friendly societies the turn of the last century where people had life insurance they could get access to high quality health care for an entire year for one day's wages and all of that accumulated knowledge and wisdom and community was all destroyed was all destroyed with increasingly socialized health care like all of the hard won stuff you know it takes forever to build a house of cards it takes one toe
	To kick it down.
	And this loss is... I mean, think of, like now, there have been three, four, maybe five generations of people who've never had a job.
	Like their family, their communities, almost completely dependent upon the welfare state.
	So now what?
	Right?
	They don't have anyone who knows how to get a job or keep a job or deal with difficult bosses or difficult customers.
	All of that knowledge, gone.
	I mean, it's absolutely brutal.
	The Community Mental Health Act was signed by President Kennedy on October 31st, 1963, less than a month before his assassination.
	Despite big promises about the program, it was never designed to address the reality of mental illness in a scalable and sustainable way.
	And, of course, its implementation was botched from the very beginning.
	Now the Kennedys, I mean I don't know obviously what was going on in JFK's mind, but Kennedy had a sister, Rosemary, and she'd been born with a fairly mild intellectual disability and then became somewhat difficult to manage in her teenage
	years and joseph kennedy senior right his dad was afraid that rosemary's behavior would embarrass the family so he just had her lobotomized and she ended up rotting away in an institution and her father never reportedly never visited her again so i don't know if this has anything to do with oh well these state institutions are bad i mean they lobotomized
	His sister was lobotomized and then she was stuck away in these institutions elder Fitzgerald style or I guess Tennessee Williams sister style.
	Now here's another quote.
	Other federal programs had the effect of further emptying the state institutions.
	Medicare provided funds for the elderly to be treated in nursing homes rather than hospitals.
	In 1972, social security was modified so that payments could be made to individuals not living in a hospital to encourage people to live independently.
	Medicaid was also designed to encourage states to move people out of hospitals and into smaller facilities.
	States could only be reimbursed for expenses if individuals were living in a facility with 16 or fewer beds.
	And all of this was largely in defiance of the actual science.
	So there was no scientific evidence that existed at the time to support this idea that community treatment was better than psychiatric hospitalization.
	In fact, the published research already showed that the plan to prevent mental illness with CMHCs was unlikely to work.
	So here's some data.
	In 1951, over a decade before the passage of the Community Mental Health Act, The Cambridge Somerville Youth Study used interventions very similar to those contemplated for CMHCs and found that, and I quote, there seems to be no significant difference between experiment and control boys in the frequency of their appearance before the Crime Prevention Bureau, before the courts, or in the number of commitments to correctional institutions.
	If anything, the experimental boys come off somewhat worse.
	Right?
	So there was a control group of people who stayed in the institutions, there was a control group of people who were supposed to get this community treatment, and the boys who got this community treatment, which is basically no treatment, I think, they came off somewhat worse.
	So there were negative outcomes.
	This is more than 10 years before, right?
	Policymakers assumed, with the encouragement of CMHC advocates, that most mental patients would have homes or families to return to upon release.
	But the National Institute for Mental Health's own data already indicated that many discharged patients would have no alternative but to end up in the streets.
	I mean this is, this is, I mean it's crazy.
	There's a reason why the people ended up in institutions.
	It's either because they didn't have someone to care for them or the people who care for them were too old or too frail or too broke or too poor or too stressed or too tired or too busy to do it.
	So just dumping people out and into the community, like, it's not fair.
	People have made life decisions on the basis of having a place to put crazy relatives and just saying, oh, well, they're coming back to your home.
	Oh, and your taxes aren't going down, by the way, either.
	I mean, how are you supposed to have a career when you've got a crazy person at home?
	How are you supposed to get educated?
	How are you supposed to have a life?
	It's crazy.
	A 1958 study of 504 admissions assessed whether a sizable proportion of psychiatric hospital admissions might be treated equally well in outpatient clinics and found that inpatient care was overwhelmingly needed.
	inpatient care was overwhelmingly needed.
	Contemporary reports showed that nearly half of discharged schizophrenia patients failed to take medication and that most had to be readmitted to full-time care. .
	Again, part of mental illness, a substantial proportion of mental illness is not knowing that you're crazy, but genuinely believing that the irrational, anti-irrational, hallucinatory thoughts that you have are genuinely real and true and factual, and you hallucinatory thoughts that you have are genuinely real and true and factual, and you believe in your hallucinations as certainly as you believe that
	Even while the bill was still in committee, experts raised serious doubts about CMHC's ability to deal with severe mental illness.
	Thank you.
	Because they're basically saying, look, we can't fix them in the state institutions.
	We can't fix them when they're put involuntarily into these institutions where we have experts, where we have medication, where we have treatment.
	We can't cure them.
	So let's dump them back with their families and they'll be fine.
	It's incredibly abusive and destructive to the people who are mentally ill, to the family members who are going to end up having their lives shredded and destroyed trying to manage what professionals can't fix.
	People who are now at risk of crime and predation in the neighborhood.
	It's... You know, it goes to me all the way back to this... Destruction.
	It's just destruction.
	You know, the mentally ill have been used before as bioweapons.
	So if you look at Cuba under Castro, he emptied out the asylums and the prisons and dumped everyone in Florida, which I guess goes some way to explaining Florida politics, but you can use crazy people as a bioweapon.
	And this idea, like a lot of the hard leftists really want to destroy the republic, they really want to destroy the remnants of the free market, they want to sow chaos and destruction and they want to undermine the institutions and what better way to do that than to empty out the asylums and put people in the community without a treatment plan, without any authority, without trained people, without... you're just destroying communities!
	I mean, if you were a hard leftist, if you were a socialist or a communist, and you wanted to really harm American society, as they say they want to, it's hard to imagine how you could have done a better job than this.
	So, acting in bad faith.
	Proponents of federally funded CMHCs pressed on despite the substantial evidence against their proposals.
	They also misled decision-makers.
	In order to get the bill passed, Robert Felix told Congress in 1963 that the initial funding for CMHC staffing would be mere, quote, seed money that would stimulate funding from local sources.
	But advocates of the bill had already privately planned that the federal staffing subsidies should be permanent.
	Oh yeah, we just need a little bit of money and we'll get it locally just to get us up and running.
	And it's like privately, nope, we're going to keep this money forever.
	So it's a massive fraud.
	It's a massive fraud.
	We tried to do that with investors.
	You get significant problems.
	Architects of the CMHC program cynically calculated that once the bill was passed, quote, temporary, funding provisions could easily be made permanent, and that initial limitations on the scope of the program could be removed.
	Once their political base was big enough, NIMH would be fully entrenched into the administrative state, and their power would be secure.
	A key proponent of the program later admitted, quote, a federally financially assisted system of approximately 2,000 centers would provide NIMH with the same type of political power that the postal system possessed.
	A center located in every congressman's district would increase the patronage power of Congress and enhance the political viability of the NIMH as the coordinating agency of this new system.
	Because there's nothing as permanent as a temporary government program.
	Well, at least until the whole system crashes and collapses.
	Up here in Canada, income tax is just a temporary measure put in in World War I. You know, just a temporary measure.
	A couple of percentage points on the super-rich.
	Don't worry, just temporary.
	So, it's bureaucratic empire building and it's using people's hope for a cure to exploit their resources.
	It's monstrous.
	I believe these people are crazier and worse than a lot of the people they were pretending to manage.
	So, National Institute of Mental Health Leadership believed that mental illness was caused by factors such as poverty or a lack of creative outlets.
	So again, this is back to this Marxist, socialist idea that the only dysfunction arises from economic factors.
	And that cures lay in socio-environmental factors like improved education and expanded cultural opportunities.
	Community health professionals believe that mental illness could be prevented and cured through, quote, prevention of social inequity, end quote.
	These sociological approaches didn't work.
	Of course they didn't work.
	Of course they didn't work.
	Even if we say that poorer people have higher rates of diabetes.
	We don't then give them money alone and assume that that cures their diabetes.
	We don't just move them to a nicer neighborhood and say, well, even if these things do have causes, by the time they're in your system and they're in your brain, fixing the... You don't cure someone's lung cancer with anti-smoking programs.
	So even if all of this was the case, which it's not, the strong genetic risk factors for some of these mental illnesses, even if they were right, the fix is still wrong.
	Maybe you can prevent it down the road.
	But what they should have done, if they really believed in their own theory and weren't just trying to, in my view, destabilize the West, what they should have done is said, well, we know how to prevent mental illness, so we're going to go fix it.
	Unfortunately, for the people already mentally ill, there's no data that it's easy to fix, but we can at least prevent it down the road, right?
	So, despite the accumulating evidence from failed attempts to treat mental illness through social engineering, the Presidential Commission on Mental Health continued to recommend in 1978 that, and I quote, the national effort to reduce societal stresses produced by racism, poverty, sexism, ageism, and urban blight must be strengthened as an important strategy for primary prevention of mental illness.
	See how far back all of this stuff goes?
	The isms racism, poverty, sexism, ageism, If we can just get rid of racism, everybody's going to be mentally healthy.
	CMHC is engaged in basic social welfare activities instead of directly helping the mentally ill.
	What did they do?
	They assisted local residents with tasks such as moving or finding employment.
	They organized community meetings and socials.
	They held workshops about family planning and published community newsletters.
	One center led a protest in favor of a new traffic light.
	Another, CMHC, lobbied the city government about the positioning of a crosswalk.
	Centers for Homes, too, quote, a range of activities which can include a coffee bar, films, people's theater, workshops and discussion groups, and many other activities.
	Now, of course, all of this is on the taxpayer's dime and none of it has anything to do with treating or preventing severe mental illness.
	But you see, it's a lot more fun to show a movie and have a protest than it is to deal with somebody who's psychotic or has schizophrenia or is bipolar.
	That is difficult to deal with.
	But making signs and chanting stupid slogans, well that's just a lot more fun.
	Why would you want to get involved in the other stuff which is not as much fun, right?
	Now, here's the thing too.
	For a variety of complex reasons, mental illnesses are not always equally distributed among the various ethnicities and races that make up the complex tapestry of the modern West.
	And so, you know, there was this flourishing of the black community that occurred in the post-war period.
	One of the things that happened when the asylums were emptied was a lot of these people went to go and live with their families and this had something to do with a negative effect on the black community, right?
	So you've got some guy who wants to go out and start a business and then basically you know crazy Uncle Ralph comes home and you're now caring for the mentally ill instead of running a business or starting a school or Becoming a pillar of your community, right?
	So it has a disproportionate effect on crushing the aspirations and opportunities of all communities and somewhat disproportionately in the black community as well.
	It's terrible, terrible stuff.
	So these CMHC programs were, quote, initiated with the vague goal of promoting a more positive self-image within the area population, right?
	So again, Nothing measurable, nothing solid, nothing where you're held accountable.
	You can't manage what you can't measure.
	Now, let's look at some of this political bias.
	So in the 1950s and 1960s, Americans overwhelmingly, by a ratio of 9 to 1, opposed allowing admitted communists to teach in high schools and colleges.
	By contrast, the majority of psychiatrists and virtually all psychoanalysts felt that communists should be allowed to teach.
	During the 1964 presidential election, hundreds of psychiatrists indulged their political biases to diagnose Republican candidate Barry Goldwater With mental illnesses ranging from narcissism and paranoia to megalomania and even schizophrenia.
	Of course, the same thing has happened with Trump.
	Now, Goldwater was later awarded $75,000 in damages in his suit against Fact Magazine and its editor, right?
	Now, it's not easy, if you're a public figure, to win damages for this kind of abuse.
	But he did, and that was a good deal of money now, it was a really good deal of money back in the day.
	And but here's the thing, right?
	So people still think negatively of Goldwater, but you should read his his platform.
	I mean he was he was an interesting guy and could have done some great good for the country in many ways.
	But of course by the time all of this smear has occurred, it's the same thing with Joseph McCarthy.
	Joseph McCarthy was endlessly smeared as a paranoid crazy guy who was fascistic and monstrous and paranoid.
	And he won a suit against the newspaper for this kind of libel.
	But it doesn't matter.
	By the time these lies spread around the world, by the time the public perception is shaped, let's say that a couple of years down the road you win some judgment, doesn't matter.
	Damage is done, right?
	So here's the fact.
	1,189 psychiatrists say Goldwater is psychologically unfit to be president.
	So, I don't believe they ever said that about a Democrat.
	And if you look down here at the graph, let's look down here at the graph, right?
	This is psychiatrists and psychoanalysts.
	Conservative to liberal bias, right?
	And so, you know, post-Second World War period for psychiatrists, it was, you know, 50-50, conservative to liberals, and then by 1964, the conservatives are down below 25%, the liberals are all over the place, right?
	If you look at psychoanalysts, If you look at the conservatives, they almost never got a toehold.
	The highest was maybe 20% in 1952.
	By 1964, there were almost no conservatives among the psychoanalysts and lots of liberals.
	I don't know.
	Hard to say whether there's influence of Judaism or something else.
	It's hard to know, but this is not evenly distributed.
	And of course, these are all the people who say, well, diversity is really, really important.
	But if you're a conservative, we won't have anything to do with you.
	And anyway, it's Right?
	So there is a lot of political bias towards leftism in the psychiatric and psychoanalytical community.
	Now, part of this, of course, is the communists and the socialists.
	This is an old story called the long walk through the institutions where they said, we're going to take over just about every public institution and subvert it for the ends of socialism and communism.
	And pretty hard to argue that they weren't successful in these two fields of psychiatry and among psychoanalysts.
	So, communist agitation.
	Right?
	There's this old rule that every institution not specifically anti-left becomes progressively leftist over time.
	That's the case here.
	Well, very quickly.
	So these community mental health center activity, activities somewhat limited to the just being ineffectual or benign or feel-good or showing movies and having coffee clutches, these centers regularly engaged in power struggles and turf wars with other federal, with other federal, state, and local entities, such as universities, hospitals, and departments of welfare.
	Staff supported and led, quote, groups that work towards obtaining improved services for the members of the community and influencing institutional change in the service-providing agencies, end quote.
	What's that?
	Well, it's political lobbying for leftist causes all paid for by taxpayers.
	CMHC's engaged in explicitly political activities under the guise of preventing mental illness, including protests and marches, community organizing, rent strikes, voter registration, administrative consulting for local activist groups, and other left-wing activism.
	So, these community mental health centers became enormous left-wing patronage networks funded by the taxpayer.
	So, of course, what is told to the taxpayer is, oh, they're It's a humane and effective strategy for treating and preventing mental illness.
	But what were they in reality?
	Well in reality they were bases of power that left-wing agitators used to hire their friends to promote their ideals of communist infiltration and revolution and to lobby the government for even more funds so that they could expand the whole corrupt organized operation, and the fact that this was used at the expense of the community in terms of dumping crazy people into it, and at the expense of the crazy people, well, all is permitted that furthers the revolution, right comrades?
	So CMHCs encouraged their communities to think in terms of revolution.
	Centers dissolved into chaos on multiple occasions as patients and staff alike violently seized and occupied facilities, sometimes for days or weeks.
	At a time.
	Isn't it great that we have to deal with all these problems that were around probably before you and I were born?
	So.
	Dismantling the mental health care system.
	So while the National Institute for Mental Health was busy politically entrenching itself, and CMHC subsidized left-wing activism, the mental health infrastructure of America was being systematically dismantled.
	Deinstitutionalization was the widespread and intentional release of most mentally ill and disabled patients from institutional settings into the community.
	It began with relatively easy cases like mild disability and moderate mental illness and ultimately progressed to virtually all patients.
	Deinstitutionalization was caused by a perfect storm of factors.
	So, there were legitimate complaints about neglect and overcrowding, inhumane treatments and the misuse of diagnosis to punish social misfits.
	All valid concerns not to be dealt with by dumping crazy people into the community as a whole.
	Now, part of this deinstitutionalization was also triggered or gained some legitimacy because of the invention of these new antipsychotic medications.
	Such as chloropomazine.
	This is 1953.
	Imiprimamine in 1955.
	And this spurred optimism that it was like insulin for diabetes.
	A cure was finally at hand and this could all be solved.
	There was of course class action lawsuits by patients and guardians alleging mistreatment and again remember some of this mistreatment came out of the underfunding of the Great Depression.
	It came out of the counties kicking their most difficult to treat patients upstairs and it came out of the resulting overcrowding of state institutions and of course understaffing as a result of drafting in the Second World War.
	So there were states that shifted their financial burdens to the federal government, naturally, and changing legal norms which asserted a civil right of the mentally ill to refuse treatment and to remain in their, quote, chosen, end quote, state.
	And of course there was this false assumption that if people are dumped out of the state institutions that, you know, they're going to be perfectly well treated, in fact maybe even better treated By the community mental health centers, but they were too busy fomenting communist revolution to actually deal with people who were intractable and nobody knew how to particularly fix and you could only manage some of the destructive natures, right?
	And this idea that something as complex as mental illness, again, just like tuberculosis, well, you don't need a whole bunch of TB clinics, the staple of 19th and early 20th century novel tragedies, right?
	You don't need this because TB or smallpox or other things, polio.
	Well, you've got a cure, you've got a prevention, you've got an inoculation, you've got whatever fixes it all.
	So we don't really need these things anymore.
	Now we've got these miracle new drugs.
	It's going to fix mental illness.
	And of course, there's this huge hunger for a biological explanation from immoral people.
	So, as I said before, my mother, who did great evil, desperately wanted a biological explanation as to what happened with her life.
	Again, it's complex, right?
	She had a traumatic childhood, there were lots of issues and, you know, maybe she had some problem with her... I don't know, right?
	But the hunger for... it's just biological.
	Now, of course, if somebody does have a biological problem and you morally blame them, like let some guy goes and punches a cat, right?
	And it turns out he's got a brain tumor.
	Well, it would be wrong, very wrong, to ascribe or to judge someone morally for the effects of something like a brain tumor or some sort of brain disease or brain injury or brain damage.
	That's monstrously unfair to morally judge someone for something that's completely outside of their control.
	And there are those situations, I believe, in the area of mental health, of course, right?
	It's like when people get, what do they call them, senior moments, where they get cognitively somewhat, when they experience or manifest cognitive deficits when they get older, they forget their keys, their whatever, right?
	Where do they park their car?
	I mean, you wouldn't just spank them because they're being inattentive.
	I mean, for some reason it's fine when children have cognitive deficits due to being children that you spank them, which is completely wrong, but you wouldn't blame someone who had cognitive decline in old age, or you wouldn't blame someone morally for forgetting your birthday if they have Alzheimer's or something, you wouldn't, right?
	So there are the biological explanations that need to be understood.
	But in the same way that there are legitimately people who need money because they've had bad luck, right?
	There are other people who just have made bad decisions who want to hide and camouflage in the legitimately needy.
	And there are people who you would not want to morally judge for their failures because their failures have significant biological or genetic roots.
	Absolutely.
	And our sympathy, our sympathy for those people is used by other people to camouflage and gain access to resources in the same way that the asylum system into the West is very often abused by people in fact the vast majority was that ninety seven percent of people who were claiming asylum in Italy were found to be they weren't asylees.
	So you have this oh well we really care for these people and then other people just come swarming in And try and pretend that they are those people so that they can get access to the same resources.
	And separating the wheat from the chaff, so to speak, is really, really complicated.
	So there's this great hunger for biological explanations so people can just say, well, I mean, not my fault.
	It's just a biological thing.
	I didn't do anything wrong.
	I don't have to apologize to anyone.
	I don't have to make restitution.
	I don't have to admit fault.
	I don't have to admit that I did something evil.
	I don't have to admit that I beat children.
	So we have to understand that there's this great hunger for this.
	And so if you're an abusive parent, like let's say you basically mentally or physically torture your child into going crazy.
	Well, you're going to have a great hunger for the biological explanations.
	Well, you know, it's just a chemical imbalance in the brain.
	You just got to take this medication because you don't want to admit that you tortured your child into dysfunction.
	Of course not.
	You don't want to make amends.
	You don't want to apologize.
	You don't want that to come out.
	You want to play the victim?
	Oh, you know, like some mysterious ailment struck my child and, you know, I want sympathy and we're gonna get him help and, you know, it's got a medical issue.
	There's a great hunger for that.
	Because the alternative of admitting moral fault and improving is pretty unpalatable for nasty people.
	And not all, not all of it, I understand, it's complex.
	But anytime you have sympathy for a group, right?
	The people who come across the border.
	Oh, if you bring children in the South of America, right?
	Southern border.
	Oh, if you bring kids, you get, okay, so they just bring a bunch of kids.
	Oh, yeah, these are my kids.
	A lot of them aren't their kids, right?
	Whenever bad, nasty, exploitive, manipulative people, whenever they perceive a great wellspring of sympathy in society, they camouflage themselves to be the legitimate recipients of that sympathy when they're not.
	And this manipulation is a constant, constant factor.
	in human life.
	So there were a lot of pressures on the system.
	A lot of pressures on the system.
	So from its passage in 1965, Medicaid explicitly excluded funding for mental health institutions which encouraged states to empty their mental hospitals in favor of programs paid for or reimbursed by the federal government, right?
	So, the federal government is funding these community mental health centers and you're not getting funding for your state institution and you, you know, you believe all the propaganda and you, of course, you have a huge financial incentive to do so, then you say, oh, well, we're going to take all of our patients that we're paying a huge amount of money to manage, we're just going to drop them in these community mental health centers which are paid for by the feds and we're going to save a fortune.
	Again, these problems go back to, I mean I hate to say like the distortion of incentives because it sounds really cold and huge numbers of people suffered enormously under this system and situation.
	Terrible incentives produce terrible outcomes.
	Human beings do respond to incentives.
	And if you're basically charging people to care well for mental patients and you are subsidizing them, dumping them in the streets, well guess what?
	The existence of federal funding for mental health created a problem of the commons that had not previously existed.
	So individual states could quote cheat by shifting their state expenditures for mental health onto the federal government.
	Now this go back to may seem like a while ago we started.
	President Pierce had vetoed this a hundred years before.
	This is how people end up on the streets.
	As state hospitals hemorrhaged patients, nursing homes and assisted living facilities stepped in to fill some of the void and cash in on all those Medicaid funds.
	Standards of care in nursing homes were often lower than in mental hospitals, as shown by increases in death rates of the patients who were transferred there.
	Many former patients fell through the cracks and became homeless.
	Nursing homes intentionally misdiagnosed mentally ill patients to keep their Medicaid funds flowing.
	To remain eligible for funding, they had to keep their proportion of mental patients below 50%, at least on paper.
	So the way you just reclassify them, right?
	That's important.
	Now this release, I'm gonna go slightly out on a limb here but you know forgive me if you'll just follow me for a minute or so.
	So this subversion, this release of crazy people into the society is infiltration of leftists into the psychiatric and psychoanalytic professions.
	It's not Out of bounds.
	So here, January 10th, 1963, Congressman Albert S. Hurlong Jr.
	of Florida read a list of the, quote, 45 communist goals to take over America into the congressional record.
	The list was derived from a great researcher, Cleon Skousen's book, The Naked Communist, and here's one related to what we're talking about, and I quote, this is from the congressional record.
	Treat all behavioral problems as psychiatric disorders which no one but psychiatrists can understand or treat.
	Dominate the psychiatric profession and use mental health laws as a means of gaining coercive control.
	Discredit the family as an institution.
	Encourage promiscuity and easy divorce.
	Emphasize the need to raise children away from the negative influence of parents.
	Seems to have worked.
	Now, throughout the 1960s and 1970s, a series of federal and Supreme Court decisions undermined the moral, legal, and financial legitimacy of the mental health care system.
	The standards for involuntary commitment change from needs treatment to danger to self or others.
	It's a very, very big difference.
	Danger to self or others, really tough to establish.
	Needs treatment is, they're kind of crazy.
	In practice, this often means that mentally ill individuals must have committed a crime or attempted suicide before they can be admitted, right?
	You need evidence.
	Mental patients were granted a, quote, right to treatment, meaning that psychiatric facilities had to actively administer treatments and could not merely hold patients in supervised care.
	Asylums could no longer simply be a safe haven for the mentally ill.
	In practice, many patients who were difficult or expensive to treat were simply discharged, right?
	So, let's say somebody's, let's say, I dated a girl whose father was put into a such and such home for incurables, right?
	Back when you could actually call things for what they were.
	So, it's more expensive to give someone continual treatment than it is to just say, look, you're crazy, we're going to give you a comfortable place with a nice garden and you're probably never going to get better.
	Like Sid Barrett from Pink Floyd, right?
	I think he was the founder of Pink Floyd, the subject of the great songs, Shine On You Crazy, Diamond Pot, One Through Pie or whatever it is.
	Well, he went crazy and was incurable, lived with his mom.
	I don't know if it was drugs or something else, but a lot of drugs.
	And he died recently and couldn't be cured, couldn't be fixed.
	And so those people, I mean, you can provide a safe haven for them, I suppose, but it's more expensive to treat them.
	But when you have a right to treatment, it means that the more expensive and more chronic long-term problem patients, you can discharge them.
	Institutions became required to use the quote least restrictive alternative when treating people with mental illnesses.
	This meant that a patient could not be institutionalized if medication or outpatient services could even plausibly or possibly help them.
	And see these new legal precedents were based on two foundational assumptions that empirically and factually are frequently false.
	And it's kind of important when you get this stuff wrong.
	So the assumption is that people with severe mental illnesses, number one, know that they are ill.
	And number two, want treatment and help.
	So if you know that you're ill and you want treatment and help, then there's no need to treat you against your will, right?
	Like when I wanted, I didn't want, but I was willing to accept chemo and radiation.
	I know some people say it's bad, but I'm just going to go with majority opinion on this.
	So nobody had to force me to be treated.
	I knew I was ill, I knew I had cancer.
	You can see the scar here, a big giant lump on my salivary gland.
	And I wanted the treatment because I wanted to not get sick again.
	I wanted to live.
	So nobody had to force me.
	But as we talked about earlier, one of the things that happens in many cases of severe mental illness is the person no longer believes that they're ill.
	They don't believe they're ill and they believe that any kind of treatment is bad for them.
	It's making them worse, right?
	It's false.
	And this is what happens when you have some crazy ideology rather than you just dealing with the facts of the matter, the facts of the situation.
	Because if you start looking at the data, you realize there aren't any easy fixes, and you can't just rip off the taxpayer and lie to Congress in order to fund your economy revolution.
	It's a little harsh, but it's true.
	Now, the government also set minimum staff-to-patient ratios.
	And what does that mean?
	Well, it means you have to obviously have, you know, I don't know what it was, three patients, five patients for every staff, right?
	So as you increase the number of patients, you have to hire more staff.
	So when you said this, again, this is like Obamacare said, it doesn't apply to people who are part-time, right?
	Obamacare mandates don't apply to people who are part-time.
	So, you know, a lot of people just got shifted to part-time, right?
	They just change things, right?
	Oh, we're going to raise the minimum wage.
	Okay, we'll just hire fewer people and we'll automate, right?
	You get those big giant tablets, ordering screens in McDonald's, right?
	And then those jobs ain't going to come back, right?
	So it's just law of unintended consequences.
	So if they're going to set high staff to patient ratios, just get rid of patients rather than hiring more staff.
	You make a lot more money that way.
	It's terrible.
	And CMHCs did drop the ball, frankly.
	So in the 1970s, community mental health centers were supposed to be caring for patients being discharged by state hospitals, but they weren't.
	Only a tiny minority of CMHC patients came from state hospitals, even though the hospitals were discharging massive numbers of patients.
	I remember when this all happened in Toronto, too.
	Most of the issues being dealt with by the CMHCs were minor mental health problems like societal maladjustment or neuroses.
	A substantial proportion of CMHC patients weren't diagnosed with any mental disorders at all.
	These, quote, patients were mostly people with life problems rather than acute mental illness or substance abuse, as had been originally promised.
	I'm down.
	Many CMHCs engaged in fraud, abuse of trust and misuse of federal funds.
	A popular and seldom punished scam during this time was to claim funding to build a CMHC and then do something else with the funds or sell the facility to a private company at a profit.
	Oversight and enforcement of regulations continues to be a challenge today.
	So, this community-based psychiatry paradigm, it was kind of like an attempt to replicate the services of a psychiatric hospital, but somehow translate it into the scale of an entire community.
	It's really expensive, and it just plain doesn't work.
	I mean, most of the outpatient clinics didn't even bother to try and deal with the hard cases.
	And millions of society's most vulnerable people have been left to fend for themselves or they've been dumped into the uncertain and stressful care of family members who are overwhelmed and at a loss and they're not being funded.
	Right?
	You've got some crazy person moving into your house.
	It's more expensive.
	You can't work probably.
	Nobody's funding that for you.
	Everybody else is making a ton of money in this scam.
	All the bureaucrats and the people there, but you're just being I mean, it's still a problem.
	There's a scam where you say, oh, I'm going to build a community mental health center.
	And you get a bunch of funds, and then you actually just build a motel and sell it to a developer, and there's no community mental health center in the community.
	But people believe that there is.
	So the state hospitals say, oh, you're from this neighborhood.
	Well, there's a community mental health center there.
	And they show up at a motel believing that they're being encircled by bats like rocks around Saturn and there's no help for them.
	Now, there was, of course, recognition that some significant damage was being done.
	So, in an attempt to re-establish some state authority for mental health, the Reagan administration switched to block-granting CMHC funds to state governments.
	But, of course, the damage was already done, the bureaucracy was in, the fix was in.
	State control, authority, and responsibility for treating the mental ill was fully undermined and dispersed.
	By 1981, there were 11 major federal departments and agencies administering 135 programs that had something to do with mental illness or disability with little, if any, coordination between them.
	Again, fiefdoms and power and money and prestige and no or little actual help for crazy people who need support and money.
	Nursing homes and board and care facilities are a frankly piss poor substitute for state mental hospitals.
	Now they're geographically dispersed and subject to virtually no oversight and so they have many of the same patient care problems as the mental hospitals did but with no real help of fixing them, right?
	So this is what happens when you gather together the mentally ill into a centralized facility then the problems are easy to see and obvious but when you scatter them into the community they become Much harder to see and there aren't reporters running around with photos and exposés and so on, so scatter, disperse and hide.
	The privatization of profits and public expense has exacerbated corruption of state governments.
	Owners and managers of private nursing homes and board and care facilities spend lavishly on lobbying at the state level to keep Medicaid and other money flowing their way.
	And now we can look at the bare numbers of the entire system's collapse.
	The system of mental health care that had been painfully developed over centuries collapsed in a few short years.
	This graph from 1934 to 2000 The top lighter gray is all mental hospitals, the darker gray below is state, county and city mental hospitals and as you can see the rate was cooking in aggregate 550 a little north of 600 per 100,000 and then starting in the 1950s it collapses to virtually nothing by the 1990s.
	The average length of stay in psychiatric hospitals declined From six months in the early 1960s to only 15 days by the early 1990s, the number of psychiatric hospital beds per capita is down 90% from 400 per 100,000 to fewer than 40 per 100,000.
	Where did all of the discharged psychiatric patients go?
	They didn't all get better?
	They weren't all magically cured by psychotropics?
	I mean a lot of them don't even know that they're ill.
	A lot of them believe that the cure is a poison.
	Where did they go?
	There is an answer.
	And the answer is about as bad as you can imagine.
	We'll get to that in a moment.
	So this is capacity for care.
	This is as of 2014.
	So the US now trails other developed countries in the number of available psychiatric care beds per 100,000 people.
	So the red bar, sort of right in the middle of this chart, is the OECD, the Organization for Economic Cooperation and Development member average.
	And way down there on the bottom, the black arrow points out the U.S.
	near the bottom of the list.
	Now, Japan and other low-crime countries like Belgium and Switzerland and the Netherlands are near the top of the list.
	Hmm, isn't that interesting?
	So Japan has a great deal of psychiatric beds and very low crime.
	Belgium, the Netherlands, Switzerland, very high availability of psychiatric beds and very low crime rates.
	That's very interesting.
	There is, in fact, a strong inverse correlation between a country's available psychiatric beds and its incarceration rates.
	So, the greater a country's capacity to care, to genuinely care for its mentally ill, the fewer prisons it needs.
	Well, until immigration changes that.
	Let's look at duration of care.
	The US also trails other developed countries in the average length of stay in psychiatric hospitals.
	Note again how the US trails lower crime countries like Japan.
	If you look over there on the right, Japan is very high and Israel, Greece, Korea and so on, lower crime countries.
	Now this is not one-to-one, there are a number of other factors regarding crime and I've got the truth about crime as a presentation here but this is a very important correlation.
	So Reinstitutionalization.
	This is very important.
	So, let's look at this graph in just a little bit more detail.
	So, the top bar, the straight line, the solid line, is aggregated institutionalization.
	Right, so that's mental hospitals plus the prison and jail rate.
	So this is mind-blowing when you sort of understand this, and I'm sure you get it.
	So if you look at the prison and jail rate, that's the one at the very bottom.
	It's quite low and relatively stable until people get kicked out of mental institutions.
	Get basically thrown out onto the street, fingers crossed, come back and see me sometime, and what happens?
	As the mental hospital rate institutionalization declines, there's a crossover.
	There's a bit of a delay, and then what happens is the prison population goes up enormously.
	And so you can see on the top right of the graph the aggregated institutionalization rate is back where it was slightly higher than in 1934.
	And this is per hundred thousand, so...
	It's not population-related.
	So all that's happened is you've taken people out of institutions where they were being cared for for their mental illnesses, put them out onto the street where they generally often end up back, institutionalized but not, in a country club setting where they can get the appropriate therapy and and care and medication and peace and quiet.
	Nope.
	You've taken them out of the mental institutions and you put them into prison.
	It's all that's happened.
	And once you understand this chart you understand why this is such an important issue.
	It was just a transfer.
	And how brutal a transfer it was.
	And imagine how many prisoners are driven crazy by being incarcerated with people who have severe mental illnesses.
	As deinstitutionalization accelerated and former psychiatric patients were discharged into their communities en masse, what happened?
	Well, homelessness, crime and drug abuse surged.
	Now, people didn't really understand the root cause of this increasing chaos.
	And so what happened was you got this tough on crime stuff.
	So many Americans said, well, crime is exploding.
	Crime is going through the roof.
	Let's throw people, as opposed to saying, well, let's review these crap community mental health care centers and let's get back to what actually worked.
	You can see what worked when the institutionalization rate was high in the state hospitals, the incarceration rate was low.
	So people said, well, we've got to just throw a bunch of people in prison because crime is going through the roof.
	Right?
	So this heavily dashed line, U.S.
	psychiatric institutionalized rate, institutionalization rate, we saw just a few slides ago, it starts in the 1930s, as you can see between 500 and 600 per 100,000, falls to around 50 per 100,000 by the year 2000.
	The lightly dashed line, total U.S.
	around 50 per 100,000 by the year 2000.
	The likely dashed line, total U.S. incarceration rate, starts in the 1930s around 200 per 100,000, rises to over 800 per 100,000, The solid line on top, this total aggregated institutionalization rate, institutionalization rate, all psychiatric hospitals, prisons and jails combined.
	So it's a mirror image.
	It's a mirror image.
	Now, of course, a lot of the, I imagine, a lot of the psychiatric Hospitals, which house some of the more severely mentally ill people, but probably gender segregated, in which case people aren't out there having lots of babies and inflicting mental health chaos on the next generation, harming people, scaring people, hurting people, spreading dysfunction and chaos in the community. hurting people, spreading dysfunction and chaos in the community.
	This is brutal, actually.
	And of course the war on drugs too.
	If you let a lot of people who are mentally ill, you kick them out of their secure environment, they're out on the streets, there's going to be a demand for self-medication, there's going to be a demand for drugs, there's going to be a demand for alcohol, there's going to be increased dysfunction, prostitution, theft.
	Theft!
	Right?
	So I mean, you can sell things that you steal at only about 10% of their value.
	So if you have a $400 a day drug habit, you have to steal $4,000 worth of stuff just to pay for your drug habit.
	Or you'll become a prostitute.
	Which fuels massive profits to organized crime in general.
	So just look at this.
	This is appalling and horrifying.
	People who are mentally ill are not evil.
	They're not criminals.
	But if you take them out of the environment that worked for them, Because you have weird leftist indoctrinated bullcrap ideas about the cause of mental ailments.
	Turn them loose on the street.
	This is a weapon against the stability of the society you live in.
	This is taking people exquisitely vulnerable, often dangerous, releasing them into the general population where they commit horrendous crimes a lot of times.
	Self-harm, harm to others, and think of the destruction of neighborhood property values.
	Think of crazy people having kids and dropping them in school where those kids then may end up bullying other kids.
	Just think about the wall that is broken between the mentally ill and the general population.
	Cutting a hole in this wall, removing this wall, this barrier between the crazy and the sane.
	It doesn't make the crazy people sane, but it sure can make the sane people crazy.
	This is a weapon.
	If this had been inflicted by a foreign government, it would be considered an act of war.
	So let's look at this relationship.
	Institutionalization versus crime.
	So the top dotted line starts on the top, is the homicide rate per 10 million persons.
	This is from 1934 again to 2000.
	And the solid line is this aggregated institutionalization rate.
	This is the combination of mental incarceration, so to speak, and prisons and jails.
	And as you can see, of course, as the aggregated institutionalization rate falls in the mid-60s, the homicide rate explodes.
	And then as the aggregated institutionalization rate begins to rise in the panic of the late 70s and the early 80s, you know, when New York City was a dystopian nightmare inhabited by Snake Plissken and guys with machetes for arms, then the homicide rate began to fall.
	And this is, right, so the decrease in aggregated institutionalization rate corresponds almost perfectly to the crime wave of the late 1960s that lasted until the early 1990s.
	So as psychiatric populations were discharged into the general population, the crime rates went through the roof.
	And then the crime rates only began to fall again when the mentally ill began to be re-institutionalized, again not in hospitals but in jails and prisons.
	So this data, if you understand, the crime wave of the late 20th century is comprehensible, right?
	Because it also gives us insight into the origins of the war on drugs.
	So before deinstitutionalization, many addicts were institutionalized to one degree or another, but by the early 1970s, a lot of them were on the streets.
	And so, when they're on the streets, you get demand for drugs, you get crime waves to pay for these drugs.
	The combination of rising homelessness, epidemic crime rates, and increasingly public addiction problems, you know, prompted this public outcry to do something!
	Now, unfortunately, as is often the case, it wasn't like the mental health professionals said, whoops, we made a terrible mistake!
	No, the do something was A massive war on drugs rather than giving the addicts or the mentally ill the help that they desperately needed, really needed, and they used to get.
	I mean, it's appalling stuff.
	This is appalling stuff.
	Now, I understand.
	I understand people are going to say, and it's a fair question, Correlation does not imply causation.
	So, how can we be sure that it was the discharged psychiatric patients that were actually causing this crime wave or largely responsible for this crime wave?
	Can we prove that there is a clear relationship?
	The one that's shown on this graph between institutionalization and homicide, can we prove that this relationship is more than a coincidence?
	I'm glad you asked.
	Yeah.
	They're mentally ill, on average.
	I can't judge individuals.
	They do commit more crime, right?
	So yeah, maybe the correlation isn't causation, but this proves causality.
	Again, sources to all of this below, you can check it out.
	Individuals with schizophrenia or bipolar disorder are three to six times more likely than average to commit violent crimes.
	Now, again, we were talking, remember, about the Pareto Principle that a small minority of people in society cause massive amounts of chaos, expense, and often violence.
	A longitudinal study which followed 11,000 subjects for 26 years found that men with both schizophrenia and alcoholism were 25 times more likely than average to commit a violent crime.
	Now, schizophrenia plus alcoholism, in the past the schizophrenics would be within the confines of a mental hospital and therefore they would not have access to alcohol which would reduce their violence even within the mental hospital.
	You put them out on the street, schizophrenia plus alcoholism 25 times more likely than average to commit a violent crime.
	In another study covering a 22-year period, the presence of a major mental disorder increased the odds of criminal conviction by nine times for men and by 23 times for women.
	I'm going to give this again.
	This is really, really important.
	The presence of a major mental disorder increased the odds of criminal conviction nine times for men and 23 times for women.
	It's not 9%, it's not 23%, it's 900% and 2300% increase.
	Do you see what I mean when I say that the mentally ill, when released into society, are a kind of weapon?
	And I have great sympathy.
	Somebody suffering from schizophrenia and alcoholism, I mean, that is not a fun life.
	I have great, great sympathy.
	for such suffering.
	Absolutely.
	It's not evil.
	It's not a moral issue.
	But if you remember way back to that sort of pyramid of how you help society, the first thing you have to do is restrain the chaos and the violence that the mentally ill can exact within society.
	Most murders of children are committed by people with psychoses, and of course a lot of them, the majority of them are women.
	The strong inverse relationship between the number of people in prison and the number in psychiatric hospitals was noted as early as 1939.
	These results were replicated with U.S.
	data in 1991.
	Now, in a free market situation, in a free situation, people are really freaking out about this kind of stuff, there would be an immediate review of policies and procedures and, but, you know, once the bureaucracy gets entrenched and once the lefties get control of these community apparatuses, So this is known, this was known from before the Second World War.
	Do they change course?
	No.
	I think it's because the hard leftists and the communists, this is the chaos and the violence and destruction that they want and then somehow they're gonna blame this on the free market, on freedom, on Now, it's not just an outward violence issue, it's also a being-on-the-receiving-end-of-violence issue.
	In addition to committing more crimes, people with severe mental illness are much more likely to themselves be victimized.
	The mentally ill are more likely to be involved in deadly altercations with police.
	Estimates of the number of police killings involving a mentally ill subject range from 25 to 50 percent.
	Right?
	There's this breakdown in executive function.
	There's this thirst, you know, if you're... I remember When I worked up north, Gold Panter and Prospector, I was with a guy who got so thirsty, he didn't bring his water and I was out, he got so thirsty he drank from moose tracks.
	That's a very bad idea, and he got sick, right?
	So if you can't get fresh water and you're desperately thirsty, you'll just take whatever.
	If you can't, or you won't get the medication, or you're off the medication, or you don't think you're ill anymore but you're still tortured, you will try and get a hold of drugs.
	They will wreck your executive functioning.
	They will put you in a very desperate situation because then you have mental illness plus addiction plus withdrawal symptoms.
	And the suicide by cop is pretty important.
	Now this didn't used to happen.
	Now imagine this is traumatic for the society.
	This is traumatic for the cops as a whole.
	I mean, I guess it's great dime fodder for the newspapers and so on.
	But again, because we were talking earlier about the prevalence of mental health issues are not evenly distributed across various ethnicities and races.
	Therefore, you may end up with a higher proportion of some groups being involved with these kinds of issues.
	Oh, it's racism and so on.
	But you took people out of a safe environment.
	It was safer for them.
	They were getting professional care.
	They were getting help.
	And you put them out into society where they cannot function.
	And this lays waste to entire neighborhoods.
	I mean, did you have this when you were a kid?
	I'm just curious.
	Let me know in the comments below.
	Did you have this where it's like, oh, we can't go there because the crazy guy is in that park?
	I did.
	It's appalling.
	So this, you know, this proves causality, right?
	Because there's such higher rates of violence among the mentally ill.
	And again, Lot of mentally ill people, not violent at all.
	But statistically, right, when you get 25 times, 9 times, 23 times more...
	Yeah, you have a problem.
	So this shows you that when you take the people out of the institutionalized safety of a mental health hospital, you put them out into these community health care centers, blah, blah, blah, they just turn to crime so often.
	And then people panic and they freak out.
	Now, of course, government loves it in a way.
	Hey, look, more power, war on drugs, more budget, more bureaucracy, more spending, more funding.
	It's an interesting question.
	I don't think anyone's calculated the total cost of all of this stuff.
	Trillions of dollars, I bet.
	Trillions of dollars.
	So, do discharged psychiatric patients commit crimes?
	Well, there's a way to test this.
	On a city-by-city basis, it's turned out, the data is clear, that reductions in the number of per capita mental hospital beds correlate with a subsequent increase in violent crime and arrest rates.
	Throughout the United States, right?
	So not all cities are going to reduce the availability of hospital beds for people with mental illnesses at the same time, right?
	So one city does it in January, and then at some point later there's an increase in violent crime.
	Another one does it in June, and at some point later there's an increase in violent crime.
	And you can see this repeated throughout the United States.
	So yes, This is causation, this is not correlation.
	A 10-year follow-up of 1,000 severely mentally ill patients discharged from mental hospitals in 1986 reported that 40% had a criminal record compared to less than 10% of the general public.
	The most frequently occurring crimes were violent.
	Another follow-up of discharges from a psychiatric hospital found that 27% of released patients admitted to committing at least one violent act within four months of discharge.
	Now that's just admitting!
	And the 40 to 10%?
	Remember the 10% includes the 40% so the ratio is actually higher.
	Mental illness-related incidents more than tripled in Pennsylvania from 1975 to 1979, a period of rapid deinstitutionalization, right?
	Kicked out of mental hospitals and end up on the streets and you get these incidents, right?
	States with easier criteria for involuntary commitment have dramatically lower homicide rates.
	For patients who have been institutionalized after committing a crime, longest days in psychiatric care lead to substantially lower recidivism rates.
	So what this means, of course, I'm sure you can follow it, right?
	So, you commit a crime and you're institutionalized.
	If you stay longer in psychiatric care, you are less likely to recommit a crime when you leave.
	This is essential stuff.
	This is essential stuff.
	So, these are all statistics.
	They're hard to connect with emotionally.
	So here's a couple of concrete examples of the carnage that can result and often has resulted from kicking mentally ill people out of the institutions that care for them, who really are not ready to deal with the social world, the economic world, the living world in peaceful and productive ways.
	A fellow named Herb Mullen was committed and released from psychiatric hospitals multiple times without requirement for further treatment.
	Between 1972 and 1973, he slaughtered 13 people after voices in his head told him a blood sacrifice to nature was needed to prevent an earthquake.
	Mullin's victims were random and included a homeless man.
	This is a guy he beat to death with a baseball bat.
	A college student that Herb Mullin picked up hitchhiking.
	This college student that he picked up, he cut open her body to release the pollution inside and left her remains in the wilderness around the Santa Cruz mountains.
	So what about the rise of mass killings or rampage killings?
	So rampage killings are defined as, and I quote, multiple victim killings that were not primarily domestic or connected to a robbery or a gang.
	And let's look at these two charts.
	There's a couple of pictures below, of course, of people you may remember from the news.
	So this is rampage killings with multiple victims, at least one of whom died from 1949 to 1999.
	So you can very much see 1949 there was one, nothing happened until 1966, great year for philosophy, 2, 1, 1, 1, 2, 2, very low, right?
	And as you can see, as the effects of deinstitutionalization begin to accumulate in society, you start to see rising 4, 5, 8, 9, 10, 12, 13.
	Now this smaller graph on the bottom left here shows the relative rate of rampage killings per decade from the 1950s through the 1990s normalized for population.
	Thank you.
	Thank you.
	From the 1950s through the 1990s.
	Boom, boom, boom.
	It rises.
	Exponentially.
	It's harder to get people institutionalized if they have mental health issues.
	They can often leave and boom.
	What happens?
	Half the offenders in these situations had a formal psychiatric diagnosis before they killed and the diagnosis was often schizophrenia.
	And of course, this is blamed on guns.
	It's not blamed.
	It's not guns.
	It's not guns.
	Think of the rise in divorce rates, right?
	You take mentally ill people, you put them out in the general population, they have lots of sex, they don't think about consequences, they have sex without protection, they get married, massive divorces, and then you get single moms who are crazy raising children!
	Huh, I wonder what that's like, right?
	I mean, this is a recipe for disaster.
	I mean, The West's failure to treat the mentally ill, to take care of the mentally ill, puts everyone at risk.
	I mean including the mentally ill themselves.
	It also provides this pretext for taking away the rights of law-abiding citizens to protect themselves and their families through gun ownership.
	The cause of these mass shootings is not guns.
	It's untreated and undertreated mental illness.
	And of course, the sources for all of this are below.
	The criminalization of mental illness.
	Yes.
	The number of mentally ill prisoners is now many times greater than the total number of patients in all mental hospitals.
	So, correctional facilities, whatever you want to call them, have now become America's de facto psychiatric inpatient care system.
	Now, since I believe a lot of mental illness results from trauma and abuse, putting mentally ill people in with violent criminals and truly evil people is only going to reactivate earlier trauma and cause massive problems and psychotic breaks and you name it, right?
	So what happened was you dumped people out of mental institutions, they turned to drugs, they turned to prostitution, they turned to crime, Violence exploded.
	Murder rates exploded.
	And then what happened was everyone said, "Oh my God, we've got to fix this." And there was a giant war on drugs which took crazy people off the streets where they had been dumped and put them into prisons.
	This is appalling.
	Now, ironically and painfully, some decommissioned state hospital facilities have actually been converted into jails for the mentally ill.
	Right?
	So the more things change, the more they stay the same because they say, oh, well, you see, we shouldn't put people who are crazy into mental hospitals because it violates their rights.
	Well, first of all, people have a right to a secure neighborhood.
	And secondly, if they end up back in there because they've committed crimes and they've been tried, They're back in there in a far less voluntary way, in a far less humane way than they would have been if they'd been put into a mental hospital.
	Psychiatric hospitals have been shut down.
	Patients have been released and laws have been changed to make putting them back more difficult.
	But changing the laws doesn't magically cure severe mental illness.
	Society still needs a way to get severely mentally ill people off the streets!
	So listen, this is from a 1972 study on the unintended side effects of national mental health policy, and I quote, As a result of laws that make involuntary commitment more difficult, mentally disordered persons are being increasingly subject to arrest and criminal prosecution.
	This is from 1971, people!
	The quote continues, they are often charged with crimes such as public drunkenness, disorderly behavior, malicious mischief or possession of dangerous drugs.
	Frequently, mentally deranged youth come to police attention because of their disorderly public behavior and are found to have some marijuana in their possession.
	On occasion, concerned friends or relatives inform police that a mentally disordered person has a stash of marijuana in his room in order to secure his involuntary detention and treatment.
	Police seem to be aware of the more stringent criteria under which mental health professionals are now accepting responsibility for involuntary detention and treatment, and thus regard arrest and booking into jail as a more reliable way of securing involuntary detention of mentally disordered persons.
	Here's from another study focusing on Wisconsin, and I quote, There was an increase of 73% in criminal commitments following court decisions and legislative revisions setting forth new civil commitment criteria.
	Right?
	So you make it harder to put people in mental hospitals and then boom!
	73% increase in criminal commitments.
	The quote continues, aside from the obvious untoward effects per se of criminalizing mentally ill persons, other untoward effects occur in terms of prolonging hospitalization, depriving those people of prompt treatment, and putting unnecessary and inhumane pressures on the family and the community, as well as on the mentally ill person himself.
	Look, I should not have spent 20 years of my life dealing with a mentally ill person.
	I shouldn't have.
	And if you're out there and you're in the situation, like my heart goes out to you.
	If you've lost a family member, if you've been the victim of a crime, if you've been bullied, if you've had danger in your environment because of this, my heart goes out to you.
	And unfortunately it is just the result of very specific government policy, I believe driven by leftist desire to disrupt and undermine and corrupt society as it stands.
	It's not easy.
	It's not easy to know when people are quirky or the old British phrase, uh, he's eccentric, right?
	There's this crazy person with money that was eccentric.
	And there are times when people get unjustly thrown into mental institutions and it's a complicated and difficult line to draw, which is why you can't draw it using the mere power of law and bureaucracy.
	It just turns into self-interested and easily corrupted empires of money and power.
	When extreme addicts were institutionalized, there was less need to limit the rest of the population from accessing drugs.
	A lot of people use drugs, you know, Paul McCartney style, and they move on from it, right?
	After deinstitutionalization, the number of addicts on the streets went up enormously, along with drug-related crimes and demand for drugs.
	The war on drugs and all of its horrible consequences is, at least in part, a reaction to the chaos unleashed by the dissolution of the nation's mental health system.
	It's terrible stuff.
	I mean, I hate to keep repeating this, it's absolutely the carnage, the violence, the chaos, the disorder, the abuse.
	So we can see the mentally ill are filling up the jails, right?
	All right, so this is residents and mental hospitals, again, adjusted per population, this is 100,000 from 1850 through to the late '90s.
	And of course, you can see resident patients, it's increasing.
	And some of this, of course, if you're out in 1850, there's going to be fewer facilities available.
	And I think you could argue that the settlers are robust people who are not easily stressed or broken down and so on.
	So you get The solid line is the total, the dotted line is the additions, and as you can see, again, in the 60s, late 50s, early 60s, you get this collapse, and the number of residences goes down by 90%.
	And the stays are 12 times shorter, right?
	6 months to 15 days.
	If you look at this bottom graph, percentage of jail and prison inmates with serious mental illnesses, right?
	So, the 1841, right, there's a lot there, and then they, those people get shipped to the state institutions, and then, boom, you see this, they're just being transferred, they're coming out of the mental hospitals and going into the jails.
	So, mid-19th century reformers like Dorothea Dix worked hard to awaken Americans to the plight of mentally ill prisoners.
	Housing the mentally ill in hospitals dedicated to their care rather than throwing them in prison with criminals was a major moral victory at the time, and rightly so.
	But, as a result of deinstitutionalization, that moral victory has been largely undone.
	There are now as many mentally ill prisoners as before the majority of mental hospitals were built.
	You see this line on the bottom, right?
	So it's top graph.
	Complete rise and fall of state-run mental hospitals between 1850 and the year 2000.
	Bottom graph.
	Percentage of jail and prison inmates with serious mental illness.
	That was once virtually zero.
	Now it's climbed to the highest level in 150 years.
	than 150 years.
	Now, jailing the mentally ill is inhumane, ineffective and extraordinarily expensive.
	So in Orange County, Florida, 44% of mentally ill inmates are back behind bars within three months.
	One inmate has been in and out of jail more than 100 times over the past 20 years.
	In one New York prison, the average stay for inmates with mental illness is 215 days compared to an average of 42 days.
	Prisoners with mental illness cost 50 to 100% more than regular prisoners.
	So I'll talk about the higher mental health costs.
	They don't include incarceration rates or loss of property values or so on.
	Mentally ill inmates assault jail staff at rates of up to 40 times higher than regular inmates.
	This is brutal too.
	Brutal too because they're in a highly stressed environment.
	They're subject to violence and they may be short of medication.
	They may be short of certainly short of talk therapy and so on.
	And this changes the kind of person who wants to work in a prison too.
	Among mentally ill prisoners, 8% of males and 23% of females report sexual victimization within the past six months.
	So people were really mad at state hospitals.
	Oh, they're abusive.
	Oh, there are problems.
	Oh, there's violence.
	Oh, this is, I believe, comparable or worse to state hospitals that they're very worse.
	So the shortcomings and the challenges of mental hospitals, they've not been fixed.
	They've just been moved to jails where arguably they're worse, much worse.
	Homelessness.
	Okay, this is something that people, this is such a huge issue, homelessness.
	But there is a qualitative difference in homelessness before and after this deinstitutionalization of the mental health care system, this collapse, systemic collapse of the mental health care system.
	In studies before the 1970s, here's a quote, homelessness mostly meant living outside family units, whereas today's meaning of the term is more directly tied to the absolute lack of housing or to living in shelters and related temporary quarters, end quote.
	The vast majority of such pre-modern, quote, homeless people lived in cheap short-term housing which they paid for themselves, concentrated in parts of cities called skid rows.
	In the era before deinstitutionalization, most social scientists who studied skid rows noted that they were declining in size and expected them to all but disappear by the 1970s.
	This is a constant problem.
	Governments need broken people.
	They need dependent people.
	They need people who require them.
	They need to be needed.
	So if the free market and rising wealth is solving problems, the government will often step in to fix them or tidy up the last little bits and then they end up reopening the wounds and starting the problems all over again.
	Poverty was being solved in the 1950s and 1960s until the poverty rate was declining by 1% a year.
	We were going to run out of poor people.
	Then the government stepped in with the war on poverty.
	Bingo bango bongo.
	You have.
	Poverty entrenched in society.
	Government can't do without people who are dependent upon it.
	So skid rows were declining and they were going to all but disappear, but then that trend changed.
	In January 2015, over half a million people, or 176 per 100,000, were homeless in the U.S.
	on a given night.
	were homeless in the US on a given night.
	69% were in shelters, 31% unsheltered.
	And the people say, oh, we need more government control, more government spending to deal with this problem.
	It's like, no, you need to fix your mental health care system.
	Help people who can't help themselves!
	It's a basic civilized thing to do.
	Don't turn them out on the streets and lecture people about Marx.
	Homelessness is up exponentially since the beginning of deinstitutionalization.
	It's not a lack of funding.
	More money is being spent on mental health issues than was ever being spent in the past.
	It's not a lack of money.
	Let's look at the rise of homelessness.
	This is the number of homeless people in New York shelters each night, going back to the late 70s, early 80s, up to now.
	Now, New York City's population has only risen about 20% during this time, so per capita homelessness has increased 300% since the early 1980s.
	This is incredible.
	Chicago, Illinois, Philadelphia, Pennsylvania.
	Homelessness before and after.
	So we're going to compare 1958 to 2015 in Chicago, 1960 to 2017 in Philadelphia.
	So Chicago, the 1960 population was 3.55 million, and it had 975 shelter beds.
	That was total capacity, they weren't necessarily used.
	And there were about 100 people sleeping on the street.
	You understand that?
	3.55 million people, back when there were mental hospitals, only 100 sleeping on the street.
	2015, you've got a population of 2.71 million.
	Interesting that it declined so much, but I think we all know the reasons for that.
	And there were 5,329 in shelters, 965 sleeping on the street.
	Do you understand?
	Almost 10 times more people sleeping on the street despite a decline in population.
	Philadelphia.
	1960 population, 2 million.
	About 500 in shelters, only 64 people sleeping on the street.
	2015 population, 1.57 million.
	A lot of that, of course, is due to white flight.
	4,737 in shelters, 956 people sleeping on the street.
	I mean, this is appalling.
	Now, nationwide data on homelessness before the 1960s isn't very reliable and was pretty rare.
	It's incredible.
	Even adjusting for population size, but especially when adjusting for population size, Chicago and Philadelphia's homeless populations have risen by massive amounts since the beginning of deinstitutionalization.
	Now again, correlation causation, is homelessness really driven by mental illness?
	Well, 20 to 25 percent of homeless people suffer from a severe mental illness.
	That's four to five times the US average.
	In one city study, 70% of the homeless were receiving treatment or had in the past.
	70% of the homeless.
	In another study, 27% of discharged psychiatric patients became homeless within six months.
	Understand this.
	More than a quarter of the discharged psychiatric patients became homeless within six months.
	Among mental health patients treated for schizophrenia, bipolar disorder, or major depression, the prevalence of homelessness is more than 15 times the population average.
	See, you can have your criticisms of the state hospitals, mental health hospitals, sure.
	But sleeping in the streets?
	Outside the supervised environment of a mental hospital and living on their own, most of the homeless mentally ill do not keep up with their medication routine, which compounds their problems.
	Homelessness is incredibly costly.
	So, a longitudinal study followed over 500 homeless chronic alcoholics over a three-year period.
	During this time, the cohort tallied 2,335 ambulance rides and 3,318 emergency room visits.
	In hospitals, they have doctors right there, if they're in a mental health hospital, and no or limited access to alcohol.
	Again, Pareto Principle, it's a tiny number of chronically homeless people who are extremely expensive outliers.
	Some individuals have been found to cost their communities upwards of $100,000 per year in ER and hospital costs alone.
	During 2004, at one single California hospital, and I quote, five individuals made 117 trips to the emergency room and spent a combined 523 days at the hospital in the course of 64 admissions.
	You understand what this means.
	It's not just tragic, of course, for the people who are in this revolving door in the ER.
	But, I guarantee you, people died because of this.
	People who had to wait.
	People for whom doctors weren't available.
	People who went home because it was just too long to wait and ended up dying.
	Because of this, people are dying.
	The rate of criminality among the mentally ill homeless is extremely high.
	Even compared to other mentally ill people, the additional burdens on policing resources is enormous.
	Drug and alcohol addiction.
	So, most drugs and alcohol are consumed by people who are mentally ill or who have suffered from mental illness, right?
	So, look at this graph.
	38% of alcohol is consumed by people who are currently mentally ill.
	And an additional 31% is consumed by people who have been mentally ill in the past.
	The percentages are similar for cigarettes and higher for hard drugs like cocaine.
	So remember we were talking very few people are mentally ill.
	So if you look at these proportions, alcohol, cigarette, cocaine, abuse and destruction and all of the attendant costs of drunk driving and ER visits and then lung cancer treatments and you name it.
	The people who smoke don't tend to exercise, so you've got heart problems.
	I mean, come on!
	Is this really some massive significant improvement in society?
	Now, of course, booze and cigarette companies love this stuff, and so do governments with sin taxes, right?
	Pay people welfare, they go out and spend money on booze and cigarettes.
	Governments get proportion, well, a lot of that money in taxes and so on.
	So, it's just, again, incentive problems are everywhere.
	And here is another terrible and terrifying, though of course not surprising fact, that mental illness destroys families.
	So I'm just going to touch on these graphs.
	You can pause, you can zoom in, you can go to the sources and Here you can see schizophrenia shreds families enormously, right?
	So the bottom line is the graph of intact families, like the bottom rows, the blue rows, right?
	Bipolar disorder shreds families.
	Unipolar depression shreds families.
	People who don't have families where there's no schizophrenia or bipolar or unipolar depression stay pretty.
	Pretty intact over the age of the child, right?
	This is from age 1 to 17 for the children.
	And this doesn't even take into account other mental illnesses.
	These are just the big three, I suppose.
	So children of parents with severe mental illness are far more likely to be in foster care or in single-parent households.
	By contrast, the majority of children whose parents are not severely mentally ill live in intact households.
	This graph, like these graphs, show the cumulative distribution of household type by child's age.
	Is the child living with both mother and father, mother and father alone, or with step parents, or is the child in foster care?
	So this blue segment, this is the intact families as the children age.
	There's a huge difference between the rate of intact families in situations without severe mental illness in the bottom right quadrant compared to the three categories of mental disorder in the top left.
	Single mothers are twice as likely to have moderate to severe mental disability compared to partner mothers.
	Teenage pregnancy among girls with severe mental illness is also three times higher than average.
	And this is the issue, right?
	Severe mental illness doesn't just destroy families.
	Remember, some of it is also highly heritable.
	Highly heritable.
	Now, heritability of mental illnesses, we touched on this earlier, I want to give you guys some data.
	Now remember, heritability doesn't necessarily mean genetic alone, right?
	So common psychiatric disorders have been found to share several of the same single gene markers.
	Almost half of children in inpatient psychiatric care have at least one parent with a psychiatric condition.
	Children of depressed parents are twice as likely to be depressed and more than three times as likely to be bipolar.
	Now again, Environment, genetics, it's all such a complex web.
	We can certainly see that if you have a depressed parent who doesn't show much interest in you and doesn't show any joie de vivre, that you may end up inheriting that just through the environment.
	Parents with severe mental illness are more likely to have children with ADHD and other milder psychological issues.
	The risk of autism in children is about 70% greater than average if one parent is diagnosed with a psychiatric disorder.
	And twice as high if both parents have been diagnosed.
	Quite significant.
	So if we look at the rise of autism that has been occurring in society, I mean, of course, some of it is due to better diagnosis and so on, but some of it, I guarantee you, is also due to deinstitutionalization.
	Lifetime risk of schizophrenia.
	So for the overall population, just 1%.
	For the spouses of patients, it's 2%.
	Uncles and aunts, 2%.
	Nephews and nieces, 4%.
	Grandchildren, 5%.
	Half-siblings, 6%.
	Children, 13%.
	Siblings, 9%.
	Siblings with a schizophrenic parent, 17%.
	Disygotic twins, 17%.
	Just having parents, 6%.
	Monopsychotic twins, identical, 48%.
	Siblings with a schizophrenic parent, 17%.
	Dicygotic twins, 17%.
	Just having parents, 6%.
	Monocygotic twins, identical, 48%.
	Childs with two schizophrenic parents, 46%.
	So that is significant.
	And the costs and dangers of this are astonishingly high.
	And again, would these people, if they were institutionalized, be having a whack load of kids with this genetic issue?
	Loss of social trust, very important.
	So stories of this kind of derangement and horror have become all too commonplace in America's cities.
	So here's a typical example.
	At first, Larry Hogue was just another shambling homeless man who muttered to himself, slept barefoot in the snow, and ate from the garbage.
	But over the years, his behavior became more bizarre.
	He stalked a teacher and threatened to roast and eat her dog.
	He dragged a raggedy chair into a busy intersection, leaned back, and munched a bagel as Carve swerved around him.
	He jumped on the hood of a red Jetta and banged on the windshield as a terrified woman tried to pull out of a parking space.
	He heaved rocks through the vaulted stained glass windows of a landmark church.
	He knocked a schoolgirl into the street where she was almost struck by an unrushing truck.
	Mr. Hogue crouched behind cars, sneaking from one to another with his arm outstretched and his finger pointing like a gun.
	He set fires under cars and stuffed rags in their gas tanks.
	He ripped off side view mirrors, then wandered into the street and shaved with a knife as he gazed at his reflection.
	Even suburbs and small towns have not been immune.
	Ocean Grove, New Jersey, had the ill fortune of being only a few miles away from a state psychiatric hospital that was disgorging patients.
	At one point, discharged psychiatric patients made up more than 10% of the town's population.
	According to local residents, A store owner had to start locking his side door because of increased shoplifting.
	Men and women were frequently seen urinating and defecating in public.
	Hedges planted in the 1890s had to be removed because they were being regularly used as a bathroom.
	One woman noted, quote, My most unpleasant encounter was when jogging at the North End and coming upon a man with his trousers lowered masturbating on the boardwalk at seven o'clock in the morning.
	The mother of two small children said she was afraid to let them play in the yard.
	Another mother noted, quote, visiting friends, playing together in the parks and bike riding are not permitted unless I escort them.
	Some children picked up used condoms as playthings, thinking that they were balloons.
	The rise of stranger danger and the fear of letting kids outside alone since the 1960s is substantially attributable to the increasing presence of the mentally ill among us.
	Media terror.
	Now traditional news media, the corporate news media, is known to focus on violent crimes, particularly sensational ones.
	People with severe mental illness commit more crimes than average, but they are even more disproportionately responsible for the extreme sorts of stories that lead to media coverage that terrifies the population.
	Random or gruesome crimes are usually linked to mental illness.
	You remember John Hinckley Jr.
	was a serial stalker of actress Jodie Foster.
	He planned to assassinate President Jimmy Carter in order to impress Foster and get her to like him.
	Hinckley ultimately succeeded in shooting President Ronald Reagan in 1981.
	And John Hinckley Jr.
	was institutionalized after his trial.
	But before the assassination attempt, he saw a psychiatrist for depression and overdosed on antidepressant medication.
	Dorothea Puente was a schizophrenic serial killer who ran a Sacramento boarding house.
	She made national headlines in the late 1980s when the remains of seven of her guests were discovered in her backyard.
	Andrea Yates was treated for depression and psychosis in 1999.
	Two years later, she drowned her five children in a bathtub.
	The Destruction of Public Spaces So, many public spaces have been made unpleasant, unusable, and even dangerous by mentally ill homeless people.
	Quote, San Francisco, quote, one is hard-pressed to walk around just about any San Francisco neighborhood without having to run a gauntlet of panhandlers, step over passed-out drunks or drug addicts, maneuver around the mentally ill or try to avoid the stench of urine and the human feces littering the sidewalk.
	Men and women walk barefoot down Market Street talking to themselves or yelling obscenities at no one in particular.
	They sit quietly in dim doorways rocking back and forth or sprawling on nets of dirty blankets in barred corridors.
	Santa Barbara Public Library staff has seen an increase in the homeless population using the restrooms for bathing and storing their belongings in the facilities.
	Parks and Recreational staff are dealing with illegal and aggressive behaviors on a daily basis, including frequent drug use, excessive alcohol, prostitution, and overnight camping.
	Anxious parents say they've seen homeless men urinating in doorways and loitering near a New York City school.
	Many mothers have stopped letting their children walk home alone.
	The Parent Teacher Association is working with local police to increase security on the street near the playground.
	They say, oh, the rights of the homeless, the rights of the mentally ill, and so on.
	It's like, well, what about the rights of people to not be aggressed against, to not be frightened, to not Be stolen from or murdered?
	Rights are complicated.
	You just have to elevate one person, one group's rights at the expense of somebody else.
	It's a complicated ecosystem.
	Quote, on a cold night in New York City, every subway line had a homeless contingent.
	An older man on the A train had tied a luggage cart with some of his belongings to a pole while he slept.
	On the E, the motley crew of 45 slowly assembled.
	The man with the bag of cans.
	Men who muttered and smelled bad, but also young people, a bearded man in baggy jeans holding a kitten, a young woman in thin tights with a ratty suitcase.
	And of course, there are the infamous tunnels, right?
	Underneath New York City and other places.
	Here on this slide is, you've probably heard of this, the infamous San Francisco Poop Map.
	So this is an interactive map that allows residents to flag locations in the city where they have spotted feces left behind on sidewalks.
	Or on the streets or gumming up escalators in what used to be one of America's most beautiful cities.
	I did business there in the 90s and it was magnificent.
	Now, what about the burdens on the other institutions and the infrastructure as a whole?
	People with severe mental illness substantially increase the burden on the court system.
	An entirely new subset of courts has been created to deal with the mess.
	Mental health courts around the country are just another facet of the implicit, impatient system that has grown up to attempt to replace the old state hospital system.
	The additional burden on police forces from dealing with the mentally ill makes them less available for other tasks such as preventing or solving crimes or providing other types of community support.
	Here's an example.
	In 2009, North Carolina Police Department spent 228,000 work hours on 32,000 trips transporting psychiatric patients for involuntary commitments.
	Right?
	That's out and back, out and back, out and back.
	That's the equivalent of over 100 officers working full-time as drivers for psychiatric patients instead of doing actual police work.
	I mean, criminals love it.
	Diverts the police from catching them.
	In addition to the public health risks posed by the homeless mentally ill, people with severe mental illness are more likely to engage in behaviors that put them at risk for HIV, along with other contagious diseases such as hepatitis.
	A sample of psychiatric patients across multiple states found HIV prevalence eight times the US average.
	Hepatitis B and C rates were five times and eleven times the US average, respectively.
	Let's talk about the fiscal disaster of the current hodgepodge of policies.
	Since deinstitutionalization began, U.S.
	spending on mental health has risen from $1 billion a year to over $200 billion a year.
	This does not include the cost of dealing with mentally ill criminals or homelessness, which is substantial if not massive.
	Even using conservative figures and adjusting for inflation and, of course, population, per capita U.S.
	spending on mental health has risen about 14 times during this period.
	And the effectiveness of that spending has arguably declined, I would say, substantially.
	This explosion in mental health costs is one component driving the ongoing increase in overall U.S.
	healthcare expenditures.
	So we can see this, this graph shows U.S.
	health expenditures as a percentage of GDP.
	I mean, there are many causes behind this steep upward trend over the past 60 years, but the contribution of inefficient spending on mental health is not widely discussed, but it really, really should be.
	So, What has the reflection been of thinking about this stuff?
	This is three National Institute for Mental Health directors reflecting on their legacies.
	The first is the guy we talked about earlier, Robert Felix.
	He was the director from 1949 to 1964.
	Looking back on his accomplishments as the first NIMH director and a major contributor to deinstitutionalization in America, Robert Felix admitted to overreaching in his attack against mental hospitals but stopped short of taking any particular responsibility for the disasters that resulted.
	Here's what he said.
	Many of those patients who left the state hospitals never should have done so.
	We psychiatrists saw too much of the old snake pit, saw too many people who shouldn't have been there, and we overreacted.
	The result is not what we intended, and perhaps we didn't ask the questions that should have been asked when developing a new concept.
	But psychiatrists are human too, and we tried our damnedest.
	Stanley Yalls, the second director of the NIMH, went a bit further, even admitting that there will always be a place for custodial care.
	And I quote, but The current situation results in part from an assumption made in 1963 that has not proved to be correct.
	At the time, many community psychiatrists believed that almost all mental patients could be treated in the community.
	This optimism was too euphoric.
	It now seems probable that there will always be some chronic patients, say 15% of the total, who will require long-term residential care.
	This optimism was too euphoric?
	Stanley, you had data, you had facts, you had studies, you had information, you had experienced people screaming at you to not do it.
	Well, we were just optimistic.
	I mean, talk about covering up a horrendous flaw with a pretend virtue.
	Well, it's just too optimistic.
	The third director of NIMH, Bertram Brown, now openly admits that he and others foresaw elements of the approaching disaster.
	And I quote, yes, the doctors were over-promising for the politicians.
	The doctors did not believe that community care would cure schizophrenia, and we did allow ourselves to be somewhat misrepresented.
	We knew that there were not enough resources in the community to do the whole job, so that some people would be in the streets facing society head-on and questions would be raised about the necessity to send them back to the state hospitals, but it happened much faster than we foresaw.
	In the real world, in the market world, in the voluntary world, there are consequences for these kinds of disasters.
	What do you get from bureaucrats who unleashed a hellscape of mental dysfunction and violence on American society?
	Eh, well, stuff happens, mistakes were made, we're just human.
	So, what now?
	Severe mental illness has substantial biological causes, and it is strongly heritable.
	Again, that doesn't always mean genetic.
	Psychological or sociobiological interventions may help with marginal instances, but severe cases require sustained medical attention and often ongoing custodial care.
	This is just a fact.
	Many people with severe mental illness do not comprehend the nature of their illness, and will not voluntarily seek or sustain treatment.
	They're not merely in denial, but have brain damage which prevents normal self-awareness.
	If their families are unwilling or unable to take care of them, they may need to be institutionalized, even against their will.
	I mean, they're gonna most likely end up institutionalized against their will.
	Wouldn't you rather be in a hospital than a prison with a trail of bodies in their wake?
	The number of psychiatric hospital beds needed to deal with the seriously mentally ill is probably one to two million.
	Many times the current capacity.
	Rebuilding what has been lost, what has been consciously destroyed, will not be easy.
	I mean, there'd be plenty of money for it if you would shut down all of the community, quote, mental health care centers.
	You'd have tons of money, excess of money for it.
	But shutting down government stuff is really tough.
	The cost of not dealing with these problems effectively is in the hundreds of billions of dollars annually.
	And that's just money.
	Think of the human cost.
	The rights of the mentally ill to be crazy should not supersede the rights of other individuals to be safe.
	Enormous economic and political incentives caused the current mess and continue to push the mental health care system into further deterioration.
	The job security of bureaucrats, the virtue signaling of activists, and the profits of corrupt care facilities are just a few examples.
	I've certainly had my experiences dealing with crazy people.
	It is exhausting, it is debilitating, it is hopeless.
	Very often actually hopeless rather than just something that you feel.
	I really want to thank you for your time and attention in this.
	Please don't forget to like the video, to share the show, to comment, to support, to subscribe.
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	But I want to hear from you.
	There's a lot of pain out there.
	I know I've experienced it.
	My family members have experienced it.
	There's a lot of pain out there.
	And I want to hear from you.
	I want to hear what your experiences have been.
	What's it been like to care for someone?
	What's it been like to go through something like this?
	What has your experience been of the mental health care system, not just in America, but throughout the West, as it stands?
	I really want to thank you for taking the time to go through this presentation and process this information with me.
	Please engage this information, these facts, these realities in conversations with people around you.
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