Army misdiagnosed and kicked out thousands of mentally ill vets

http://hereandnow.wbur.org/2015/12/09/discharged-soldiers-mental-health

Previous investigations revealed how the VA was underprepared to meet the medical needs of the War on Terror vets, and the backlog for mental health care was horrendous.

Not sure if it's related, but a new study found that the Army systematically under-diagnosed soldiers with "adjustment disorder" rather than PTSD/depression (a vague classification from the Vietnam era that suggests a soldier is *temporarily* experiencing poor emotional/behavioral symptoms after a deployment). The former implied that the soldier was unable to perform his/her duties stateside and should be dishonorably discharged (i.e. it's the soldier's fault). However, if they were diagnosed with PTSD/depression, that is considered a debilitation due to their military service (i.e. it's the war's fault), which is an honorable discharge that guarantees lifetime free medical care for themselves, spouse, and kids (equivalent to losing a leg or an eye).

That Vietnam vets site above suggested that the military "saved" $12B on medical/disability payments for Vietnam vets who were misdiagnosed.

In many cases, suffering vets got both civilian and Army psych evals. The civilian diagnosis was depression, but the Army diagnosis disagreed (even after reviewing the civilian diagnosis). It's possible that the civilian doctors were sometime wrong, but not to the tune of two thousand independent cases.

Since 2009, the Army has also kicked out 22,000 vets for various misconduct. But when a soldier has PTSD/depression, that increases the likelihood that they will fall into a misconduct situation (dereliction of duties, fighting, substance abuse, etc.). So we're not sure how many of the 22K were misdiagnosed, but I would bet it's at least a third. There is now a Congressional inquiry about this issue due to NPR's reporting.

You can't get a mortgage unless you can prove that you can afford it. We shouldn't go to war unless we can prove that we need to, we are likely to win, and our gov't can and will handle the costs.

Student suicides at Gunn High in Silicon Valley

http://www.kqed.org/a/forum/R201501290900

3 student suicides this academic year (one was a recent alum), and 9 since 2009. Most of the cases had some element of stress/pressure to meet very high academic expectations. I didn't hear the whole program, but an interesting comment from a former teacher said a peer counseling class and less stressful vocational courses (like wood shop) were recently eliminated to make room for more AP courses.

The school is considering modifying the class schedule and homework levels, but I think those are just band-aids. Failing to meet the sometime ludicrous and frankly perverse expectations/goals in that community is not an indication that the student is a failure at life and should die. I would hope that the rabid competition and obsession to achieve (or fit some template of what success looks like) do not overwhelm students and make them forget that there are other ways to feel happy and successful in this life. That message has to start with adults, who should encourage balance over excess and set healthy examples that Silicon Valley Values are not the only values in the world.

The biggest civil rights violation you've never heard of

http://www.npr.org/2013/07/10/200644779/history-professor-kept-mexican-repatriation-alive
http://public.csusm.edu/frame004/history.html

"If we were rid of the aliens who have entered this country illegally since 1921, stealing in as burglars might enter our homes, our present employment problem would shrink to the proportions of a relatively flat spot in business." - J Quinn, LA Supervisor

CA and the US southwest have historically had a higher % of Latino residents due to proximity to Mexico and former Spanish-Mexican sovereignty. Since the first days the US settled the West, we have been importing cheap Mexican laborers. Some of those people had children here who were born US citizens, supposedly with full legal rights on paper. They didn't sneak in here... they were asked to come here and had families in accordance with US laws. They helped Americans survive and prosper, despite often being treated inferior.

The "Mexican Repatriation" under Hoover during the Depression was an outrageous response by a desperate nation to keep "American jobs in the hands of REAL Americans." Where have we heard that before? As if getting rid of Mexicans would have ended the Depression - it probably would have exacerbated it! Next there was the illusion of immigrants "sucking America dry" and living off the gov't teat. People of Mexican descent were only 12% of the welfare rolls, consuming on average $20/month of gov't assistance (and that assistance was passed on in the form of consumer spending, often to white businesses). Yet deporting them cost taxpayers $68/family. So what were we gaining? Some of the people we kicked out were taxpayers and "job creators" too.

During 1929-1944, over 2M people were deported under this program, and 1.2M of them (60%) were US CITIZENS. It's not like they got rid of all Latinos, so in some cases families were broken up in the indiscriminate dragnet and never reunited (like ICE's rounding up of illegals today). The social climate was so hostile to Latinos that many of them voluntarily left the US too, at the rate of 10K/month in 1931. Similar to the Chinese Exclusion Act, the Latinos who weren't rounded up were often blocked or intimidated away from gov't services and employment. So if US society wasn't letting them make a living, is it any wonder why some of them ended up on welfare? A self-fulfilling racist prophecy. The "we're getting rid of criminal Mexicans" myth was pervasive, but it was likely that more crimes were being committed against Latinos than by Latinos at that time (Latinos rarely reported crimes against them to authorities, and witnesses would rarely stick their necks out for them).

The program explicitly targeted Latinos, and I am sure they were dispossessed of their legal property like what happened to the interned Japanese-Americans (we often forget that they were US citizens too). It is a tragedy of our education system that me as a US-born citizen didn't learn of this until I was 34. Speaking of Japanese Internment, some speculate that the Mexican Repatriation was a "warm up" and learning experience for the US gov't so they were more able to efficiently handle the Japanese-Americans.

After what happened during the Depression, it is an amazing display of grace and forgiveness that Latinos still want to live here, especially when they have had to put up with similar shit over the decades (physical laborer and domestic worker abuse, prop 187, border fence, Arizona law, the Tea Party, etc.).

And here is the official US gov't response:

In February 2005, California State Senator Joseph Dunn (D-Garden Grove) introduced Senate Bill 670 to apologize for the "unconstitutional removal and coerced migration" of Californians during the Great Depression. Before "The Apology Act for the 1930s Mexican Repatriation Program" was passed on February 22, it had twice been vetoed by Governors Arnold Schwarzenegger and Gray Davis. - C Frame, CSUSM

They were supposed to erect a plaque commemorating this tragedy, but so far nothing has been done.

More on the rich-poor gap

http://www.slate.com/id/2266025/entry/2266026/

Most of this stuff we've discussed already, but it's all in one convenient place. I'd like for any conservative out there to give me a reason why it's in a society's best interests for an individual to be able to amass tens of billions of dollars of personal fortune, when the median income is 0.0004% of that? And median US household net worth is even smaller than income, due to debt. Is that billionaire even creating jobs with the money? Not really, apart from landscapers and nannies. And they're not investing in new ventures and companies either, since that's too risky with too much SEC red tape. They're just trading in currency and commodity markets, which make them an easy buck but don't really contribute to long-term economic growth. 

I thought the attached image was funny. I know that a president doesn't control the economy, world events are constantly in flux, and sometimes their policies don't really kick in until they are out of office, but still. For the bottom 80% of US incomes since 1948, their income growth rates were over 50% smaller when a GOP was president vs. a Dem. For the top 20%, it's about the same for both parties, as one would expect. So much for liberals' taxation and regulation killing the economy. Those forces can be harmful, but apparently a GOP president correlates with a much worse outcome.

Crazy like us: America's exporting of mental health

The quake reminded me of a recent thing I read:

http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?ref=magazine
http://www.kqed.org/epArchive/R201001110900

This journalist studied how America is exporting our "scientific" views on mental health to the rest of the world, and not always for the better. After the big Asian tsunami, a bunch of "white, upper-middle class" trauma counselors went to Sri Lanka and Aceh to console the locals. The author said that it's the purest form of American hubris to think that comfortable, complacent suburbanites can explain grief to poor people who have lived with war for decades. I know they mean well, but it is somewhat ridiculous. And I'm sure they will try again in Haiti.

Other highlights from his book:

- The author's main thesis is that America is exporting its views on mental health to the world, and actually homogenizing the way humans approach the subject. This is troubling because (1) the American way has its share of flaws and (2) the supplanting of older, local, EFFECTIVE beliefs on the psyche with modern American science has negative consequences, and also results in a loss of precious cultural knowledge. Instead, he thinks we should learn more and teach less, and cherry-pick what works best in various situations instead of completely relying on the American way. Like how herbal and Eastern medicine are popular when Western medicine fails, we should consider alternative approaches to mental health too.

- Clinical depression was very rarely diagnosed in Japan before the year 2000. People just dealt with their sadness privately, and didn't consider it a preventable disease. But then Glaxo-Smith-Kline wanted to sell more of their anti-depressants to the #2 economy, and started a major media campaign to Japanese doctors and such. Now Japanese consume over $1B/year in anti-depressants, yet suicides, happiness indices, and such are not any better.

- Anorexia was very rarely diagnosed in Hong Kong (and when it was, the symptoms were different than Ameican anorexia), but then there was a well-publicized death of an emaciated young woman in 1994. After that, curious media sources wanted to research the disease, and consulted the American psychological reference DSM-IV. By explaining what anorexia was (in the Western view at least), it got many women thinking that that they were afflicted. Eating disorder cases rose over 1000% by 1999, with 3-10% of young women showing some manifestations, this time perfectly in lock-step with the American definition.

- Strangely, with all our resources, "compassion", and science, a 30-year global WHO study showed that schizophrenics have a much lower relapse rate outside of the US and Western Europe, even in very poor nations with no available drug treatments. They attribute this mostly to culture: other "primitive" nations believe in superstitions suggesting that mental disease is not the patient's fault (evil spirits, curse, etc.), and in fact the community has a duty to support the sufferer and drive out the evil. Wheres in the West, we believe in the self-made man, and we believe that we are fully in control of our bodies. If we are sick in the head and not getting better, then we're not trying hard enough. So hovering, meddling relatives often judge and pressure schizos to improve. They think it helps, but it actually increases the chance of relapse. So the author is not saying that we should dismiss science and believe in demonic possession, but the ends can justify the means. If it works better (and costs a lot less) for them, then maybe their way has some value.

- You've all heard of those prison experiments where a subject will hurt a stranger (or thinks he/she is) under various stimuli. Researchers set up a study where a subject would administer a test on a person with mental illness either caused by genetics or by childhood trauma. If the ill person faltered, the subject would have the option to apply an electric shock of varying magnitude. It turns out subjects shocked the "genetically ill" patients harder than the "childhood trauma" ones. Science has tried to uncover genetic causes for various mental illnesses (but hasn't done a very good job so far). They believe that it will reduce the stigma of mental health if the causes are shown to be out of the patient's control. Like homosexuality is not a choice, but just nature. Well, the electric shock study showed that people are actually less compassionate to the mentally ill if they think their condition is genetic rather than social. So are we doing more harm than good?

- Manifestations of mental stress are very local and culturally dependent. Southeast Asia has a syndrome called "amok" (hence the term "run amok") where a young male will go on a violent rage and not remember anything. Victorian England saw many women exhibit "dead legs" and fear of paralysis when actually there was nothing wrong with their legs. This was possibly their subconscious responding to cultural pressures making women into fragile, inferior dolls to be kept by men. I wonder if modern American afflictions (PTSD, bipolar, ADHD, OCD, obesity, the list goes on and on!) are also our subconscious lashing out at social pressures that we can't deal with. We claim we are tough and we can deal, but obviously it's not the case. It's easy to say that it's just genetic and then pop a pill to fix it, instead of carefully examine possible cultural causes of these behaviors. Why is it that US soldiers are experiencing PTSD more frequently than foreign fighters in much nastier warfare situations? Maybe over-eating is a response to all the fast food media and rebelling against the health craze. Maybe ADHD is just bad parenting and a glut of distracting stimuli for youth. Maybe OCD cleanliness and home beautification are the result of all the germophobic paranoia in the mainstream, and the "house porn" on HGTV and such.