I think we have great high end care but I think we suffer from over-institutionalization...

I disagree to a certain extent. I would argue that the resources are inappropriately distributed and in many cases people are under-institutionalized. Back in the day when I worked as an EMT you would see people inappropriately referred to psych ERs, sometimes for the ease of the caretaker. For example, nursing homes would send poor 80/90/100 year olds that simply had regular senile dementia, who were just a little eccentric or harmless or who just needed extra help. Often times this would be connected to the gentleman's lack of insurance. Once the guy was out of the facility they could give the bed away. Nice. Then we had the local crazies who would always seem to get let out of the psych facility after a day or two no matter what they did or how many times they were there or how much they really needed to be admitted-- those situations usually ended badly for all concerned.

Now that I moved to the city I see people frequently who are probably in need of some inpatient services. At my old apartment you'd get this random woman who without fail would walk to the same spot across the street every 9am, M-F and begin launching this weird schizophrenic tirade against various government agencies. You get the people with obvious mental issues who are clearly self medicating with who knows what.

It is sad, really.

This is what I meant by that being the inappropriate word to use. I didn't mean patients are over-institutionalized. I think people who do medical work suffer from over-bureaucratization. That's a better word for what I was saying there.

It is easy to buy small plaster models of what you think life is like.

We just got my father-in-law out of the hospital a couple of weeks ago, after he had to have his leg amputated due to a persistent infection.  The nurses, were, without fail, very caring.  But the case managers, were, without fail, completely clueless, and we got handed from one to another like a hot potato.  It seemed they wouldn't even read the file before talking to us, because everything we told them was a complete surprise.  They were supposed to be helping us set up a therapy regime for the old man, but they were worse than useless, and everyone kept telling us "We can't do anything until the case manager lets us know what's happening."

He was at two hospitals, the one where he had the surgery, and a rehab facility, and in both places, the case managers were useless.  He spent an extra week in the surgical ward just because the case manager(s) couldn't get it together to transfer him over to rehab.

 He spent an extra week in the surgical ward just because the case manager(s) couldn't get it together to transfer him over to rehab.

Is the bill itemized? If so he should refuse to pay for the last week or so, and have his insurance company do the same. They won't pay if it was medically unnecessary. I bet after a few dozen/hundred of days/weeks of hospital write offs the institution would get somebody more competent.

that money goes is the kitchen. Even though my experience was in a nursing home, I imagine the "institutional" part of it remains similar, almost exact. See, even though a lot of the residents are fairly sedentary, and hence don't ever work up much of an appetite, you're required to try and get (or force) what would be enough food for a normal active person into them every day. A variety is also required by the state (and everything is tracked), so you can't just serve cheaper food and buy in bulk, although there are plenty of bulk foods to buy as well. Can you save the leftovers? Nope-- that would be abuse. (Technically, the staff isn't allowed to eat the remainders either, for obvious reasons, though this wasn't only sporadically enforced. Not a serious problem, really.) So if there's 50 residents at a place, that's 150 fresh meals a day, with employee hours to handle all the preparations. (In a nursing home, this can include changing food texture to a varying degree. You haven't lived until you've seen pureed hamburgers.)
    Does this add up to 6K per resident per month? Probably not, but it certainly adds up. From what I've heard from nurses who'd worked a variety of places, almost all nursing homes fell into either the "lots of help all the time" model, or the "pinch every dollar 'til it screams" style. No happy medium or even an unhappy medium either.

Ex ignorantia ad sapientiam; e luce ad tenebras

I can agree with that, I've worked in big institutional kitchens before and each meal would have at least one and usually more 55-gal trash barrels full of unserved food being thrown away- and there weren't any sedentary types there, either.  Spent a lot of time working the deep sink (pots & pans) and we were free to eat whatever we wanted, though.  We're talking unserved stuff from the serving trays, not peoples' plates by the way.  Hard to believe but slaving in that dishwash area under totally non-OSHA conditions with substandard equipment and multiple-felony coworkers was one of the more fun/rewarding jobs I've had.

Oh, absolutely, I have long argued for the legalization of marijuana.  As a treatment for mental illness, marijuana would be as good or better than many drugs that are now prescribed, but that is a relatively minor reason for legalization.  The treatment of cancer and AIDS patients, which you mention, is more important - apparently there is no other drug which is as effective as marijuana for the treatment of nausea.  And there are several other very important benefits which could be had from legalization.  Society bears an enormous cost by persecuting people for their relatively harmless pursuit of happiness.  (I call smoking marijuana relatively harmless, not completely harmless, because inhaling smoke, whether tobacco, marijuana, or any other kind, does present some health risks.  And there are some other possible results of long-term use which are undesirable in terms of mental effects, not just the effect on the lungs.  But these are not excessive risks for those who choose to take them.  Indeed, all drugs, legal or illegal, have side effects.)  

Legalize marijuana and collect a sales tax on it, while eliminating a major law-enforcement expense, and the US could make a good start on paying off its ridiculously large national debt - only if the war in Iraq is ended as well, of course.  Speaking of which (we might as well stay on topic) war is very bad for people's mental health as well.  You get all those cases of Post Traumatic Stress Disorder.

Do you think that there is a chance of legalization of marijuana if Barack Obama wins the Presidency?  He might be more open-minded than other recent Presidents (although President Carter, interestingly, actually did try to legalize marijuana but couldn't get the necessary support in Congress).

Since criminals only get locked up after they commit crimes, don't you think it would be preferable to deal with social conditions that lead to crime?  Or are you counting on someone else to be the victim of the crime that gets that criminal locked up?

...don't you think it would be preferable to deal with social conditions that lead to crime?

Lead paint remediation is fairly straightforward: choose either removal (chemical stripping, for instance) or encapsulation (painting over the lead paint with fresh paint). Removing the criminal influence from a neighborhood is similarly straightforward: toss the criminals into prison.

You must mean

That's an awfully short list.

You seem to have some sort of idea that the crime rate is essentially constant.  But the truth is that it varies, so there must be some sort of influence on it from social conditions.

Figure out what those influences are, and promote them.  The Vera Institute of Justice recently published a study parsing out various factors affecting crime rates.  They found that incarceration had some effect, but that there were many others which were more cost-effective.  (Here's a short summary)

You seem to have some sort of idea that the crime rate is essentially constant.  But the truth is that it varies, so there must be some sort of influence on it from social conditions

It isn't feasible to reduce the fraction of the population that is young and male, of course. I am in favor of promoting higher educational attainment, hiring more police officers (within reason), and reforming the structure and practices of correctional institutions. I am also in favor of generally higher wages and lower unemployment, but for the sake of the economy rather than the tiny effect that economic factors have on crime rates.

Still, you have to admit that once "society" has failed and a violent criminal has been produced, it's far better for society as a whole for that person to be removed.

I agree that some people are broken and need to be taken out of society.  However, we seem to be doing it to an awfully large number of people, many more than are necessary, and the way we do it leads to more crime, not less.

There are more cost-effective ways of reducing crime than simply locking up so many people that we get the hard-core criminals too.

Z makes a good point.  One way we can stop crime in its tracks...stop it before it happens is to take a fresh look at Anthropological Criminology.  Odd bumps on the perp's head?  5 years.  Bushy eyebrows that meet in the middle? 6 years.  Sloping forehead? 10 years.  Heavy jaw?  Life. (Sorry Jay Leno)

It's the end of the world as we know it, and I feel fine

What do you mean?

No matter how poor, destitute or uneducated somebody is they have to know that stealing that stereo or kiting bad checks is wrong. From my experience here in this little slice of heaven I see very few cases of Jean Valjeans stealing loafs of bread to feed their family. However I do see a lot of people selling drugs, burglarizing/invading homes, mugging people and generally doing blatantly idiotic things that leave real victims.

Who knows. Maybe that 36" HDTV is the new Wonder Bread.

When I say that it is MORE socially useful to prevent crime than it is to apprehend and incarcerate criminals after they have committed crimes, that does not in any way mean or suggest that it is not also useful to apprehend and incarcerate criminals.  But let's consider murder, for example.  Which is better, to prevent someone from being murdered, or to allow the murder to occur so that the murderer can then be locked up for life (at enormous taxpayer expense)?  What if the murder victim was you?  Would you happily sacrifice your own life for this social benefit?  I think not.

Personally I am strongly opposed to crime.  I think that society should take every reasonable measure to reduce the amount of crime taking place, and then, should also take every reasonable measure to apprehend and incarcerate the remaining criminals.  Even capital punishment, controversial and flawed though it is (given that many people turn out to have been wrongly convicted, and no one can be brought back to life after being executed) seems to be justifiable in at least some cases.  But I do believe that society benefits more from the prevention of crime than it does from the incarceration (or the execution) of criminals.

In a perfect world there would be no crime.  This is a very unlikely degree of perfection to ever be achieved, although in theory there are ways to do it.  For example, universal telepathy, merging the entire human race into a single group mind (a strategy that we have discussed before on this site, in the context of radical methods of preventing war; it also prevents crime, loneliness, and various other problems).  I can think of other strategies as well, but they are also very difficult.  It is not yet possible to create a world without crime.  But we can aspire to that ideal.

Which is better, to prevent someone from being murdered, or to allow the murder to occur so that the murderer can then be locked up...

Actually, I think that there are many cases of law-abiding citizens who in some unusual circumstance snap one day and kill.  There are, of course, also other people who are habitual or professional criminals who have committed any number of crimes prior to their first murder.  In any event, none of this seems to have any particular relevance to the point I was making, that it is more socially useful to prevent crime than it is to subsequently prosecute criminals.

I don't know how you can see my statement as a false dichotomy.  Either a person commits a crime or he (or she) doesn't, right?  This is a perfectly valid dichotomy.  So if we have to choose between those options, I would prefer for the crime not to be committed.  How can we bring this about?  Well, as you have discussed previously with Jimmy Havok, there are many ways to prevent crime.  And although we are not in a position to prevent ALL crime (although it would be wonderful if we could, as I discussed in my previous comment) we can certainly reduce the crime rate by various means.  And it is socially useful to do so.  That is my point, a perfectly reasonable point whose logic should be obvious, so I don't know why you are arguing about it.  

You seem to have originally interpreted my comment to mean that we should prevent crime rather than arresting people who have committed crimes, but that is in no way what I was saying as I have already explained to you.  It is BETTER to prevent crime, but failing that, it is still necessary to enforce the law and to arrest and incarcerate criminals.  I could compare this to the problem of disease (of course, the whole topic came up precisely because of the comparison to mental illness).  You can (sometimes) cure people after they get sick, but it is BETTER for them to remain healthy so that they do not have to be cured.  Generally speaking it is better to prevent disease (whether physical illness or mental illness) than it is to have to treat it after people get sick.  Similarly, it is better to prevent crime than it is to incarcerate criminals.  I don't know why you have trouble seeing this.

Actually, I think that there are many cases of law-abiding citizens who in some unusual circumstance snap one day and kill

As far as the false dichotomy, perhaps I misunderstood you. Were you saying that it's better to have locked up a criminal before he murders? If so, then I agree.

Were you saying that it's better to have locked up a criminal before he murders? If so, then I agree.

Astute as always, Z.  Sadly though, I don't think the technology is there yet.  It might be best to stick to phrenology for now.

It's the end of the world as we know it, and I feel fine

I don't think the technology is there yet

Really? I don't think I've ever heard of such a thing happening

It may be more common than you  think.

I googled about half of the stories here and the ones I saw all involved someone who was previously a "law abiding citizen".

It's the end of the world as we know it, and I feel fine

I guess you missed the part about, "ex-postal employee...a history of mental illness."

Since when is mental illness a crime?  Me, I'm thinking he had a unibrow with big jaws and a weak chin.

It's the end of the world as we know it, and I feel fine

Well yes, it is better to have locked up a criminal before he murders.  Better still, would have been to have in some way encouraged and enabled the person in question to pursue some honest profession or activity, rather than becoming a criminal.  There are reasons why people become criminals, you know, it's not just a random event like a meteor impact, that falls upon us from out of the heavens.  

If you have never heard of a law-abiding citizen who some day snaps and kills someone, you seem to be out of touch with the world of crime.  Perhaps the most typical case is that of the jealous husband.  There are lots of people who have lived as honest, law-abiding citizens who then are overwhelmed with rage upon the discovery of their wife's infidelity.  It's practically a cliche of law-enforcement, and generally speaking, such people are treated more leniently than many other kinds of murderers are.  It is recognized that they are not basically a danger to society, they just found themselves in a particularly maddening situation that they couldn't deal with in a more appropriate way (by getting a divorce).  

O.J. Simpson might be a particularly famous example, although since he killed two people (his ex-wife Nicole and her friend Ron Goldman) and since he had no business being jealous of a woman from whom he was already divorced, his case is more egregious.  Still, if not for jealousy, O.J. would probably never have become a criminal, since he was already very successful (and wealthy) both as an athlete and as an actor.  Crime was not his chosen career path.

There are reasons why people become criminals, you know...

...a law-abiding citizen who some day snaps and kills someone...the most typical case is that of the jealous husband

...if not for jealousy, O.J. would probably never have become a criminal...

The number one reason is that they are evil.

So all we need to do is develop an evil meter, and lock up the people who make it twitch.  There goes the Republican Party!

Do you think that "evilness" is innate, or does it respond to social conditions?  Are there degrees of evilness, or is it all or nothing?

Frankly, you seem to have a view of human nature drawn from comic books.

Do you think that "evilness" is innate, or does it respond to social conditions?

Are there degrees of evilness, or is it all or nothing?

you seem to have a view of human nature drawn from comic books

comic books are eeeevil!

It is easy to buy small plaster models of what you think life is like.

Yes, I know. The number one reason is that they are evil.

Wait, what...evil like the "Devil Made Me Do It" evil?  Is this "number one" reason likely to stand up in court?  Do you have some stats?

It's the end of the world as we know it, and I feel fine

Is this "number one" reason likely to stand up in court?

Ladies and gentleman of the jury, even though most of evidence is circumstantial, the public defender incompetent, the witnesses are deal making criminals, and the defendant is a person of color...look into his heart and you will see he is evil....eeeevil!

What the Sam Hill is evil anyway?  And if it's the evil ones who are thrown in prison then why is OJ still walking around?

It's the end of the world as we know it, and I feel fine

And if it's the evil ones who are thrown in prison then why is OJ still walking around?

And his name still sits in a place of honor in Ralph Wilson Stadium.

Then again, being confined to Buffalo for all eternity may be a fate worse than life in a California Supermax.

Even if it is true that the #1 reason why people commit crime is that they are evil (and that is a simplistic explanation, even though there are certainly many people in the world who deserve to be described as evil) there are still reasons why some people are evil, and why others are not evil.  Again, this is not purely accidental.  There are psychological influences in a person's life, the way they are treated by their parents, their teachers, their fellow children, by society in general, and so forth.  While there isn't anything as simple as a one-to-one correspondence between the evil that is inflicted upon us and the evil that we then choose to inflict upon others, there is nonetheless a relationship.  People either learn to be good, or learn to be evil.  Then there are sociopaths whose pathology may involve a genetic defect (see my original comment in this whole discussion, about the need to prevent mental illness).  But the point is, it isn't JUST that people are evil.  People need help to become good rather than evil, starting in the womb (when they should be protected from fetal alcohol syndrome).

You also ask how I would prevent a crime that an otherwise law-abiding person might commit in a moment of passion.  Again, we are the sum of all we have experienced in life.  There is a reason why some people commit crimes of passion and other people, though they may experience passion, choose not to commit crimes even then.  There are countless different elements of any given person's life which will incline that person either toward violence or non-violence, sanity or insanity, criminality or honesty, good or evil.  But in general, if you are good to others, you will help them to become better people themselves by giving them a good example and an inspiration; similarly, if you do evil to others you may contribute toward making them more evil in turn, out of repressed rage and frustration and resentment, which build up in the majority of the population until we JUST CAN'T TAKE IT ANYMORE!!  

...in general, if you are good to others, you will help them to become better people...

There is much more that I could say beyond the simple suggestion of being good to other people; there are certain specific forms of goodness which are particularly applicable to the problem of crime prevention (however, I am not going to produce an extended essay on the subject because it is not he topic under discussion, which is the problem of caring for the mentally ill).  But yes, that is what I was talking about.  Glad to hear that you agree.

...there are certain specific forms of goodness which are particularly applicable to the problem of crime prevention (however, I am not going to produce an extended essay...)

Actually, even you, in your discussion with Jimmy Havoc, came up with a few examples of ways to help reduce criminality, such as the remediation of lead paint.  Lead poisoning increases the chance of both insanity and criminality.  And I have already noted that when pregnant women consume alcohol they may induce fetal alcohol syndrome in their unborn baby, and that syndrome also will increase the chances of both insanity and criminality.  People who are sexually abused as children are much more likely to sexually abuse others when they are adults.  

On a broader scale, unemployment, poverty, starvation, illiteracy, ignorance, political instability, and all major social ills are related to high crime rates.  Desperate people commit desperate acts.  There are lots of people in this world who have chosen crime as a profession only because they did not find any better alternative.  Therefore, anything that we do to make society better will correspondingly help to bring about less crime, among its other benefits.

...unemployment, poverty...are related to high crime rates.  Desperate people commit desperate acts.  There are lots of people in this world who have chosen crime as a profession only because they did not find any better alternative.  Therefore, anything that we do to make society better will correspondingly help to bring about less crime, among its other benefits

It is equally logical to suppose that the sort of behaviors that cause one to become a criminal are also likely to lead to unemployment and poverty.

No doubt there are people who because of their criminality wind up poor and unemployed (perhaps they had an employer, who then fired them for stealing from the company) and there are others who, because they lived in an economically depressed region and had difficulty obtaining honest employment, resorted to criminality.  It works both ways.

No doubt there are people who because of their criminality wind up poor and unemployed (perhaps they had an employer, who then fired them for stealing from the company) and there are others who, because they lived in an economically depressed region and had difficulty obtaining honest employment, resorted to criminality

When I mentioned "the sort of behaviors that cause one to become a criminal are also likely to lead to unemployment and poverty" I definitely did not mean "difficulty obtaining honest employment" (that's not a behavior at all, so maybe I should inquire if you know what the word means). The sort of behaviors that lead one to be a criminal are things such as impulsiveness and aggressiveness - those behaviors are not valued in the workplace and it is therefore likely that aggressive and impulsive people will have trouble holding down a good job.

The correlation between unemployment and criminal behavior is weak, and since there are many, many, many unemployed (and/or poor) people who do not commit crimes, the argument that unemployment causes crime is a tenuous one at best. The correlation between behaviors such as aggressiveness, lack of empathy, and impulsiveness is far stronger (not to mention far better documented) and since those traits, unlike unemployment, have been shown to be largely innate, criminal behavior is much more likely to be merely correlated with unemployment, not caused by it.

No, you don't need to spell things out in such exacting detail.  In fact, this whole off-topic discussion was really unnecessary.  It is my impression that you are engaged in an obsessive dissection of my comments, and no matter how clear and simple my statements are, you are going to find a way to infer something questionable about them.  And no matter how many explanations I give you, there are never enough.  So (as has already happened in a previous discussion) I am not going to continue with this.

this whole off-topic discussion was really unnecessary

You are always free to decide whether a given topic is worth discussing.  If it's not worth discussing, don't discuss it.  I personally do not post comments on all (or even most) of the topics that come up on this site.  When I don't post a comment it might mean that I don't think it's worth discussing, or more likely, that although it is worth discussing, I personally don't have very much to add to the discussion.  Or it could just mean that I don't have time to discuss everything that I might wish to discuss, since my life does not consist solely of posting messages on bulletin board systems, and there are other demands upon my time, some of which are more important.  However, when we do choose to participate in the discussion of a given topic, it is good to stay on topic.  These discussions do have some structure to them, they are not just excuses to argue about anything and everything that you can think of.  We are commenting an a particular story that someone has gone to the trouble of composing and posting for our edification.  That's the idea.  If you don't like the story, don't waste your time commenting on it.  Find some other story to comment on.  Or read a good book.  Maybe there's something worth watching on TV, you never know.

...there are other demands upon my time, some of which are more important

Now you are complaining because I was considerate enough to answer your own question!  Pretty good.  I will never reply to another comment of yours again.

You didn't answer my question. You answered your own question.