Tuesday, May 31, 2022

The Case for Involuntary Commitment

Writing in The American Conservative John Hirschauer makes the case for involuntary psychiatric commitment. As longtime readers of this blog know, I have recommended this solution-- however stopgap it may seem-- to the problem of school shootings and other act of mass murder and mayhem.

In many of the cases, the shooter was flagged by psychiatric authorities or at least by family members. Whether in Aurora, CO or Sandy Hook, CT or Parkland, FL or Buffalo, NY civil authorities knew about the dangers the shooters presented, and did nothing.

Of course, it is easier to blame guns than it is to hold the psychiatric establishment to account. And it is certainly easier than to accuse the civil libertarians who promoted the daffy idea that we should empty psychiatric hospitals, the better to liberate the mentally ill from the chains of medical oppression.

Considering the extremely small number of mass killers out there and considering the extremely large number of guns, you would think that it would be more effective to commit dangerous people involuntarily, and to get over the notion that these people can exercise free will.

Now, Hirschauer reports on the American attitude toward involuntary commitment by advancing a tale of two states, Connecticut and Texas. Whereas Adam Lanza, the Sandy Hook shooter, and Payton Gendron, the Buffalo murderer were referred for psychiatric evaluation and were not seen to be dangerous, Salvador Ramos was ignored. Unfortunately, it is also far easier to commit someone in Texas than it is in Connecticut. 

In Connecticut the problem was the lack of psychiatric beds. In Texas it was the blindness of family and community. The mother of Salvador Ramos explained that she saw no signs of mental illness or emotional distress. Perhaps the reason was that she was a drug addict. And she did not mention that she had abandoned her son and had thrown him out of her house.

So, begin with Connecticut, a test case for the civil libertarian attitude toward mental illness, and a place where psychiatric hospitals were shut down many years ago.

Hirschauer explains:

Connecticut, like most states, was winding down its inpatient population. State and federal law had made it more difficult to commit someone who was not imminently dangerous to himself or others to an inpatient facility. By 1995, the average patient who remained at the hospitals was generally sicker and more expensive to treat than the average patient had been 40 years prior. By the time Rowland announced the closures, no one in Connecticut was being institutionalized for “hysteria” or “burnout.”

Naturally, liberal litigators came to defend those who had been committed involuntarily:

Civil-rights litigators also pressured the state to reduce its institutional population. In 1990, a group of non-profits brought a class-action lawsuit against the state on behalf of people with traumatic brain injuries and intellectual disabilities in each of the three state hospitals. Attorneys for the plaintiffs argued their clients were placed in inappropriately restrictive settings in violation of federal law. They kept the class-action suit going for more than four years. By the time the case was settled, Connecticut had already announced it was closing the hospitals in Preston and Newtown.

The result could have been predicted, assuming that anyone had cared:

In the decades since two of its three mental hospitals closed, Connecticut, like most states, has suffered an acute shortage of psychiatric beds. The statewide inpatient-utilization rate, which measures the number of psychiatric patients treated in inpatient settings versus the number of beds allocated by the state and private providers, is upwards of 120 percent. In other words, there were more psychiatric inpatients in Connecticut than there were beds allocated to treat them.

What are the direct consequences:

This is presents several problems. For one, it forces suicidal, homicidal, and otherwise acutely ill patients to wait in emergency rooms for days or weeks on end for a vacant hospital bed. As of this writing, there are no vacant beds in the civil section of Connecticut’s large state hospital in Middletown. For another, it discourages people with acute conditions from coming forward to seek inpatient care in the first place. Finally, by effectively reserving the beds at the large state institutions for the most difficult cases—those immediately dangerous to themselves or others, and those with treatment-resistant psychosis—individuals with mental illness living in the community who need more intensive services than the community can provide are left to devolve until they become so ill that they either make an attempt on their own lives or, in rare cases, the lives of others.

As it happened Adam Lanza, the Sandy Hook shooter, lived just a few miles from an abandoned psychiatric hospital:

You cannot draw a straight line between the closure of a hospital and an act of mass violence by a person with mental illness, but there is at least a chilling irony in the fact that an 18-year-old man with untreated serious mental illness killed 19 children at Sandy Hook Elementary School less than five miles from the grounds of the abandoned Fairfield Hills Hospital.

Things are different in Texas, where inpatient psychiatric treatment is more readily available and where involuntary commitment is easier to obtain:

Texas operates ten state hospitals and funds more than 2,200 public psychiatric beds. Its inpatient-utilization rate is less than 100 percent, reducing the chance that a psychiatric patient will be stranded in an emergency room.

State law also allows prosecutors and family members to initiate commitment proceedings when a person is unable to care for himself or is otherwise so disabled as to require hospital care, allowing families and communities to intervene before a person with serious mental illness deteriorates to the point of violence.

Yet the tragic events of Uvalde demonstrate that robust commitment laws and a well-funded network of state hospitals are of little use if the family and community surrounding a dangerous individual fail to intervene.

The last point deserves emphasis. People around Ramos had seen the signs of his distress and derangement. They did nothing. Was it not obvious, even to a non-professional?

The Texas shooter reportedly tortured small animals and made regular threats against his classmates. His peers reported that he showed up to school with self-inflicted face wounds. He may simply have been an evil person who did an evil thing. We tend to medicalize evil, and should not assume that the shooter was “mentally ill” without evidence. But in a sane society, his behavior would be grounds for intervention regardless of its clinical significance. A half-century ago, it would have landed him in a state hospital.

Whatever his behavior constituted under law—whether the threats were criminal in nature or the self-harm sufficient evidence to initiate a commitment hearing—it was clearly worthy of examination. What is more, it demanded a period of retreat—”asylum”—from his social milieu.

So, in Texas, even with far better psychiatric treatment, someone like Salvador Ramos fell through the cracks-- because no one in the family, the community or the school system was sufficiently alert to the danger.

School Lockdowns and Learning Loss

Consider this post a follow-up or an add-on to yesterday’s post about the emotional cost of pandemic school lockdowns. Today, we examine learning loss--how badly damaged schoolchildren have been by the same policies.

Of course, we have been following this problem from the onset. And we have joined those who warned that school lockdowns were a very bad idea, indeed.

Now, we have a study performed by Harvard University’s Thomas Kane and others. Kane’s conclusion-- the learning loss was worse than had been imagined, and that it was especially bad for minority children. As for holding the teachers’ unions and Democratic politicians accountable, we have not quite reached that point. Kane obscures the responsibility issue:

Starting in the spring of 2020, school boards and superintendents across the country faced a dreadful choice: Keep classrooms open and risk more COVID-19 deaths, or close schools and sacrifice children’s learning. In the name of safety, many districts shut down for long periods. But researchers are now learning that the closures came at a stiff price—a large decline in children’s achievement overall and a historic widening in achievement gaps by race and economic status.

The achievement loss is far greater than most educators and parents seem to realize. The only question now is whether state and local governments will recognize the magnitude of the educational damage and make students whole. Adults are free to disagree about whether school closures were justified or a mistake. But either way, children should not be stuck with the bill for a public-health measure taken on everyone’s behalf.

By the numbers:

One-fifth of American students, by our calculations, were enrolled in districts that remained remote for the majority of the 2020–21 school year. For these students, the effects were severe. 

Growth in student achievement slowed to the point that, even in low-poverty schools, students in fall 2021 had fallen well behind what pre-pandemic patterns would have predicted; in effect, students at low-poverty schools that stayed remote had lost the equivalent of 13 weeks of in-person instruction. At high-poverty schools that stayed remote, students lost the equivalent of 22 weeks. Racial gaps widened too: In the districts that stayed remote for most of last year, the outcome was as if Black and Hispanic students had lost four to five more weeks of instruction than white students had.

So, Kane, who is an expert in these matters, was shocked to see the extent of the learning loss. And he is largely pessimistic about anyone’s ability to institute programs that will recover the loss. For the record, this blog has been equally pessimistic:

Like any other parent who witnessed their child dozing in front of a Zoom screen last year, I was not surprised that learning slowed. However, as a researcher, I did find the size of the losses startling—all the more so because I know that very few remedial interventions have ever been shown to produce benefits equivalent to 22 weeks of additional in-person instruction.

We will make the best of the situation as we find it. One way is extensive tutoring:

High-dosage tutoring—which educators define as involving a trained tutor working with one to four students at a time, three times a week for a whole year—is one of the few interventions with a demonstrated benefit that comes close, producing an average gain equivalent to 19 weeks of instruction. One of those leading the charge on tutoring is Tennessee Department of Education Commissioner Penny Schwinn, who is offering matching funds to encourage school districts to launch tutoring initiatives. Tennessee’s goal is to provide high-dosage tutors to 50,000 students a year for the next two years. School systems elsewhere have similar ambitions. The educational-policy think tank FutureEd, at Georgetown University, reviewed the pandemic-recovery plans of thousands of districts and found that a quarter had tutoring initiatives in the works.

Other possible remedies will run afoul of-- you guessed it-- the teachers’ unions. They would require extra work for teachers-- good luck with that:

Many district leaders I know are considering three additional measures. One option is voluntary summer school, which, according to prior research, has yielded about five weeks of instructional gain per student. Another option is an extra period each day of instruction in core subjects. A double dose of math over the course of an entire school year has been shown to produce gains equivalent to about 10 weeks of in-person instruction, although the evidence on reading is weaker. (Our team will be working with districts to measure the efficacy of these and other catch-up efforts over the next two years.)

Like tutoring, double-dose math will be hard to scale up. Staffing the additional sections of math requires hiring more math teachers amid a historically hot labor market. Unlike tutors (who can be contractors), districts are hesitant to add permanent teaching staff for a short-term catch-up effort.

How about summer school? It will not nearly be enough:

Meanwhile, summer school has historically struggled with low student attendance. In a typical pre-pandemic year, only about 6 percent of students attended summer school. Even if districts managed to triple that number, enrollment would still fall far short of the magnitude required to eliminate learning loss.

Or else, we could extend the school year:

A third alternative would be lengthening the school year for the next two years. Of course, districts would have to pay teachers, janitors, and bus drivers more, perhaps at time and a half, to work the extra weeks. But unlike with tutoring or double-dose math, districts already have the personnel, the buildings, the buses, the schedules. As long as educators, parents, and students view the extra instructional time as just an extension of the school year—like days added to make up for snow closures—the power of family and school routine will deliver higher attendance than summer school.

Yet, the teachers’ unions would never agree:

The primary problem with a longer school year is political, not logistical. After opposition from the local teachers’ union and some parents, the Los Angeles Unified School District was able to add only four optional days of school next year. This is, to be sure, more make-up time than many other school systems have planned, but quite inadequate given that the nation’s second-largest school district was remote for three-quarters of 2020–21.

Kane suggests that it’s all a challenge, but he is none too optimistic:

High-dosage tutoring may produce the equivalent of 19 weeks of instruction for students who receive it, but is a district prepared to offer it to everyone? Alternatively, suppose that a school offers double-dose math for every single student and somehow convinces them to attend summer school, too. That, educational research suggests, would help students make up a total of 15 weeks of lost instruction. Even if every single student in a high-poverty school received both interventions, they would still face a seven-week gap.

So, that’s the best information we have on the topic. It is not looking very good, at all.

Monday, May 30, 2022

The Cost of School Shutdowns

If you were looking for some bad news, you’ve come to the right place. This time, the news concerns the fallout from the pandemic school shutdowns. As you know, because you have been reading this blog faithfully, shutting down schools was a very, very, very bad idea. It hurt children, causing cognitive and emotional damage. Not only that, but it was unnecessary; the children who were damaged by the shutdowns were at only minor risk of contracting the virus.

Anyway, the New York Times offers an extensive assessment of the consequences of the school shutdowns. Naturally, it says nothing about the teachers’ unions and the Democratic politicians who foisted this horror on American children, but at least it recognizes the negative effects of this absurd and sadistic policy. We should ask ourselves, in all seriousness, why the perpetrators of this horror are not being identified and held to account. And yet, as long as the perpetrators do not belong to the oppressor class, no one cares.

As of now, school counselors and teachers are doing their best to help children make up for what they have lost. They are naturally optimistic about children’s resilience in the face of this modern form of horrific abuse. And yet, as we have been suggesting for some time now, it is not at all obvious that the loss can be mitigated.

The Times offers up some serious dollops of bad news:

American schoolchildren’s learning loss in the pandemic isn’t just in reading and math. It’s also in social and emotional skills — those needed to make and keep friends; participate in group projects; and cope with frustration and other emotions.

In a survey of 362 school counselors nationwide by The New York Times in April, the counselors — licensed educators who teach these skills — described many students as frozen, socially and emotionally, at the age they were when the pandemic started.

“Something that we continuously come back to is that our ninth graders were sixth graders the last time they had a normative, uninterrupted school year,” said Jennifer Fine, a high school counselor in Chicago. “Developmentally, our students have skipped over crucial years of social and emotional development.”

Nearly all the counselors, 94 percent, said their students were showing more signs of anxiety and depression than before the pandemic. Eighty-eight percent said students were having more trouble regulating their emotions. And almost three-quarters said they were having more difficulty solving conflicts with friends.

The numbers are frightening. We are not just talking about a small group of students. We are talking about nearly all the children. If anyone but the teachers’ unions had visited this level of emotional abuse on children, they would be in jail.

Have the children made up what they lost? For the most part, they have not. So much for being optimistic:

And even though schools have, with brief exceptions, been open this year, students have not yet made up the losses. Seven in ten counselors said that they had seen some improvement in social and emotional skills but that there was still work to be done. Just 11 percent said there had been a lot of improvement since the fall, while 17 percent said there had been none.

Only six of the 362 counselors said that behaviors and social-emotional skills were back to normal for their students’ age or that they hadn’t seen lagging skills this year.

So, we have, thanks to teachers’ unions and Democratic politicians, produced a nationwide mental health crisis in children:

Since the fall, there have been increasingly loud alarms about children’s mental health. Doctors who work with children called it “a national emergency,” and Dr. Vivek H. Murthy, the U.S. surgeon general, warned that the effect of the pandemic and other stressors on youth mental health were “devastating.”

One consequence of online learning was the degradation of social skills:

Another weakness was social skills. Sixty percent said children were having more trouble making friends, and half said there had been more physical fighting and online harassment of peers.

“There is horrific violence and bullying,” said Alaina Casey Mangrum, a counselor in a Pittsburgh elementary school. “There are physical altercations every single day.”

Violence and bullying are pervasive now. In the absence of socialization children revert to "Lord of the Flies" level behavior:

Nearly all counselors said they were seeing more students with signs of anxiety or depression, and trouble regulating their emotions. In children, these issues often appear as acting out — yelling, fighting or arguing. “The smallest things will trigger an extreme emotional response that is disproportionate with the trigger,” said Stephanie Coombs, an elementary school counselor in Wagener, S.C.

And, as it happens, cutting off children’s social interactions does not just produce anxiety and depression. It produces more suicidal ideation:

Many had seen an increase in suicidal thoughts, even among those in elementary school. “My department is conducting far more student safety screenings for suicidal ideation, gestures, plans, attempts than ever before,” said Helen Everitt, a middle school counselor in Cary, N.C.

Obviously, the more the schools were closed the worse it was:

At schools closed to in-person learning for a year and a half or more, three-quarters of the counselors said children were physically fighting more often, compared with less than half at schools that were open longer.

Naturally, those who are trying to navigate this nightmare maintain a certain level of optimism. If they did not they could not do their jobs. And yet, this optimism contradicts everything that the article had previously reported:

Despite counselors’ deep concern, they had reasons for optimism. Most had seen improvement once schools and in-person extracurricular activities reopened. Dozens said they were struck by children’s resilience. And some said the experiences of the past two years had helped children grasp the importance of mental health.

Sunday, May 29, 2022

Cardinal Richelieu on the Russia-Ukraine War

Because we maintain a healthy skepticism regarding the media-driven party line reporting about the war in Ukraine, we have done our best to offer contrary opinions and even contrary analysis.

We did so yesterday, and we will provide some extra added contrary analysis today.

The author of this analysis is the famed 17th century French foreign policy maven, one Cardinal Richelieu. The good cardinal was a leader of the French Catholic Church and simultaneously a minister in the court of Louis XIII.

David Goldman, who obviously has better sources than you or I, has channeled the good cardinal, allowing him to offer his analysis of the situation in Ukraine. We are grateful.

Therefore, these following texts should be understood as coming from one of history’s great foreign policy minds. So, pay them special heed.

Richelieu begins:

Did I not tell you at our last meeting that Putin’s object was not to do this or that with Ukraine, or to rule Ukraine or to compel Ukraine to adopt one policy or the other, but to be done with Ukraine once and for all – to ruin it utterly, depopulate it and eliminate the possibility that Ukraine might become a venue for Western weapons pointed at Russia?

Unsurprisingly, Richelieu has no respect for the lame analyses offered by Western pundits. In that he is in accord with the views we have expressed on this very blog:

One hears from self-deluding Western pundits that Putin wants to be a new czar presiding over a new Russian empire, and that his attack on Ukraine was motivated by national pride and territorial ambition. If that were true, mon ami, he would not scorch the earth and drive out the people! The damage to Ukraine’s infrastructure alone exceeds $1 trillion, in a country whose national output did not reach $160 billion a year before the war started! Simply repairing the country would require six times the country’s national product, which of course is impossible.

Even if the money could be found, who would make the repairs? Before the war Ukraine had 45 million people on paper but only 33 million actually in the country, because half the adult population had left to work elsewhere. At least 14 million of those have been driven from their homes, and most of them will not return. After all, the Poles, Hungarians and Germans are short of people and will gladly accept immigrants from Ukraine rather than from the Middle East or Africa.

It takes a large quantity of cynicism to imagine that the Eastern European countries are accepting large quantities of Ukrainian immigrants because they need more workers and because they would prefer Ukrainians to Syrians and North Africans. But, alas, such is the cardinal’s viewpoint. Of course, you thought that these nations were the souls of charity. Seriously?

But then there is the question about America, our very own nation. Richelieu is not overly optimistic about American moral character. Apparently, though he does not use the word, he sees America as a decadent state, in cultural decline. Who knew?

“About the Americans do not worry so much. They are becoming accustomed to humiliation. Does no one remember their unseemly departure from Afghanistan last year? They thought they were clever in cultivating Ukraine as a de facto member of NATO, perhaps with anti-missile systems that could be converted into short-range missiles with nuclear warheads if the need were to arise.

Putin believed that he had an agreement with the Europeans under Minsk II to keep Ukraine neutral and to guarantee autonomy to Russian-speaking parts of Ukraine in the East, and he believed – with some justification – that Washington sabotaged this agreement. So he attacked.”

About America’s management of the crisis, Richelieu is less positive than, say, Tom Friedman. The Biden administration, far from being a locus of foreign policy intelligence, is more like a ship of fools:

The Americans thought Putin’s economy would collapse! It did not. They thought the Russian people would revolt! They did not. They thought their expensive toys, Javelins and Switchblades and Stingers, would stop the Russian army. They did not. They simply killed a lot of Russians. But as Hitler’s best general von Manstein said of the Russians, just when you think you’ve killed them all, another bunch of them comes over the hill.

As for the Russians, the cardinal has no illusions about their awesome military: 

The Americans understand nothing about the Russians. The Russias gripe, they get drunk and they follow orders. They do not need America’s high-tech toys. They simply send drones to scout the location of the enemy, feed in the coordinates and fire vast numbers of artillery shells and rockets. They are unimaginative, stolid and unrelenting. If you want to know about the Russians, I will introduce you to von Manstein, Charles XII and Napoleon. But the ghost whom you really should conjure is Bismarck. He said: ‘Kämpfe nicht mit Russen. Auf jede List reagieren sie mit einer unvoraussehbarer Dummheit.”

Goldman translates Bismarck: “Don’t fight with Russians.” “To every stratagem of war they react with some unforeseeable brutishness.”

And Richelieu offers up a few words from Henry Kissinger-- recently attacked for suggesting that Ukraine will need to cede territory if it wants to negotiate the end of the war-- and he adds a view of history, especially the history where we Americans have run proxy wars, using other nations’ soldiers:

Every country in the world will call to mind Kissinger’s bon mot that it is dangerous to be an enemy of the United States – but to be its friend is fatal. America is generous with other people’s blood: Hungarians in 1956, Czechs in 1968, the Kurds in Syria and today the Ukrainians. American pundits say that from Ukraine, Taiwan should draw the lesson that it must prepare to defend itself now, like a porcupine. But it is quite a different lesson that the Taiwanese have learned – namely that it doesn’t pay to fight as an American proxy.

What will Germany and the rest of Europe do? Glad you asked:

The Germans will have the choice of rearming, and in particular restoring conscription, or accommodating Putin. Which do you think they will do? The Hungarians will congratulate themselves for refusing to join the sanctions against Moscow. The French will remember that Marine Le Pen came within a cannon-shot of beating Macron in the last elections by proposing to remove France from NATO command, and Macron will carefully distance himself from Washington. The Poles will make a terrible noise, but to no avail; the difference between the Hungarians and the Poles is that the Hungarians do not make the mistake of thinking that they matter. And India will continue to buy Russian oil and sell consumer goods to the Russian market.

And, as for China, here is the Richelieu analysis of the Middle Kingdom’s policy toward Russia and Ukraine:

“China will eat melons, to use their idiom; they will stand on the sidelines, watch and do nothing at all except enjoy the misery of the United States. They will show the instruments of torture to Taiwan in the expectation that their actual application will not be necessary. They will build more hypersonic weapons and other nasty devices that make the American navy rather unwelcome in their part of the world. And they will quietly tell countries of interest to them that the United States failed once again in Ukraine as it failed in Afghanistan, and that China will have to be reckoned with as a new pole of global power.

Given that we have offered the considered views of a great statesman and an expert in foreign policy, we will refrain from commentary this morning.

Saturday, May 28, 2022

Do They Really Believe It?

If you would like a dose of optimism with the morning coffee, consider this question, asked by Matt Margolis (via Maggie’s Farm).

He asks: Does anyone really believe the ideology of transgenderism?

But really, does anyone honestly believe that men can become women or vice-versa? Honestly, I would say that while there are plenty of people who claim to be LGBT allies and just love to virtue-signal their tolerance with pride flags, masks, and stickers, only a tiny fraction of them genuinely believe that “men can get pregnant” or that “trans women are women,” etc.

If no one is really stupid enough to believe this, then what in the name of everything that is holy, is going on? 

Are people lying? Are they going through the verbal motions? Are they lying to themselves? 

And then there is the larger issue? Since transgenderism is a belief and nothing but a belief, one that has no basis in reality, how many of these who identify as transgendered really believe that such is the case? How many of them are getting caught up in the cultural maelstrom, and are taking actions that are designed to convince others and themselves that they are true believers? How many of them would rather have their bodies mutilated, than to admit that they have been duped?

No matter the case, this is an appalling part of today’s cultural reality. 

An Update from the Ukraine Battlefield

The war in Ukraine has fallen off the front pages. For now, at least. Rather than use it to attempt to make a pathetic demented fool into a great wartime leader, our propaganda media is hard at work blaming white Republicans for the gun violence that has been proliferating, and not just in Buffalo and Uvalde. As always, with most of the media, the issue is how best to score political points for Democrats. 

One feels compelled to note that violence seems endemic to a nation that is divided against itself, where half the people hate the country, where patriotism is routinely derided, where public monuments are destroyed, where history is rewritten to deprive people of their national pride-- in short, there’s more to it than guns. And let's not forget, a nation where people believe that there is a special virtue in mutilating children.

Meanwhile, back in Ukraine, the war does not seem to be going so well for the Ukrainians. This might be one reason why we are not hearing so much about it. I will note, in passing, that I have remained skeptical about the glowing reports of Ukrainian success. It was too good to be true, and  you know what happens when something is too good to be true.

Anyway, the point of the propaganda exercise has been to make Joe Biden look good, so we maintain our skepticism.

For now, the dam seems to be breaking, with a piece in the Washington Post, explaining that things are not going so well for the Ukrainians. Since this counts as the first article in the mainstream media that runs counter to the party line, we pay it some serious attention.

Ukrainian leaders have projected and nurtured a public image of military invulnerability — of their volunteer and professional forces triumphantly standing up to the Russian onslaught. Videos of assaults on Russian tanks or positions are posted daily on social media. Artists are creating patriotic posters, billboards and T-shirts. The postal service even released stamps commemorating the sinking of a Russian warship in the Black Sea.

Ukrainian forces have succeeded in thwarting Russian efforts to seize Kyiv and Kharkiv and have scored battlefield victories in the east. But the experience of Lapko and his group of volunteers offers a rare and more realistic portrait of the conflict and Ukraine’s struggle to halt the Russian advance in parts of Donbas. Ukraine, like Russia, has provided scant information about deaths, injuries or losses of military equipment. But after three months of war, this company of 120 men is down to 54 because of deaths, injuries and desertions.

But Lapko and Khrus’s concerns were echoed recently by a platoon of the 115th Brigade 3rd Battalion, based nearby in the besieged city of Severodonetsk. In a video uploaded to Telegram on May 24, and confirmed as authentic by an aide to Haidai, volunteers said they will no longer fight because they lacked proper weapons, rear support and military leadership.

“We are being sent to certain death,” said a volunteer, reading from a prepared script, adding that a similar video was filmed by members of the 115th Brigade 1st Battalion. “We are not alone like this, we are many.”

So, the issue is Eastern Ukraine, not the capital city of Kyiv or the Western city of Lviv. Anyway, things do not seem to be going very well.

And then, there is Brazilian journalist Pepe Escobar, who writes like someone who favors the Russian side. Or else, of someone who is channeling the Russian mind. So, we are normally skeptical of Escobar and have resisted reported his analysis. And yet, after reading the Washington Post story, we confess that Escobar sounds more reasonable. See also, this slightly more optimistic, but still sober analysis, from The Week. And this, from Reuters, via the New York Post.

Escobar writes this:

Back in the real world, Russia, slowly but surely has been rewriting the Art of Hybrid War. Yet within the carnival of NATO psyops, aggressive cognitive infiltration, and stunning media sycophancy, much is being made of the new $40 billion US ‘aid’ package to Ukraine, deemed capable of becoming a game-changer in the war.

Is America’s $40 billion dollars going to save the day for the Ukrainians? Is it going to allow America to talk tough without taking any risks? Escobar has his doubts.

This ‘game-changing’ narrative comes courtesy of the same people who burned though trillions of dollars to secure Afghanistan and Iraq. And we saw how that went down.

Ukraine is the Holy Grail of international corruption. That $40 billion can be a game-changer for only two classes of people: First, the US military-industrial complex, and second, a bunch of Ukrainian oligarchs and neo-connish NGOs, that will corner the black market for weapons and humanitarian aid, and then launder the profits in the Cayman Islands.

A quick breakdown of the $40 billion reveals $8.7 billion will go to replenish the US weapons stockpile (thus not going to Ukraine at all); $3.9 billion for USEUCOM (the ‘office’ that dictates military tactics to Kiev); $5 billion for a fuzzy, unspecified “global food supply chain”; $6 billion for actual weapons and “training” to Ukraine; $9 billion in “economic assistance” (which will disappear into selected pockets); and $0.9 billion for refugees.

As for the question of whether Nato can assure Ukraine’s ability to export wheat, Escobar says that it will save the world from starvation:

Moreover, expect NATO this summer to come up with another monster psyop to defend its divine (not legal) right to enter the Black Sea with warships to escort Ukrainian vessels transporting wheat. Pro-NATO media will spin it as the west being ‘saved’ from the global food crisis – which happens to be directly caused by serial, hysterical packages of western sanctions.

Could it be that the sanctions are not such a good thing? Could it be that they are causing too much damage in the West. Escobar thinks that they are seriously hurting the German economy:

A key target being met with astonishing ease is the destruction of the German – and consequently the EU’s – economy, with a great deal of the surviving companies to be eventually sold off to American interests.

Take, for instance, BMW board member Milan Nedeljkovic telling Reuters that “our industry accounts for about 37 percent of natural gas consumption in Germany” which will sink without Russian gas supplies.

Does Washington have a plan? Escobar thinks that it does. It is going to fight Russia to the last Ukrainian:

Washington’s plan is to keep the new ‘long war’ going at a not-too-incandescent level – think Syria during the 2010s – fueled by rows of mercenaries, and featuring periodic NATO escalations by anyone from Poland and the Baltic midgets to Germany.

Last week, that pitiful Eurocrat posing as High Representative of the EU for Foreign Affairs and Security Policy, Josep Borrell, gave away the game when previewing the upcoming meeting of the EU Foreign Affairs Council.

Borrell admitted that “the conflict will be long” and “the priority of the EU member states” in Ukraine “consists in the supply of heavy weapons.”

How does he assess the war on the ground? He is not cheerleading the Ukrainians, to say the least:

It’s always important to remember that Operation Z started on February 24 with around 150,000 or so fighters – and definitely not Russia’s elite forces. And yet they liberated Mariupol and destroyed the elite neo-Nazi Azov battalion in a matter of only fifty days, cleaning up a city of 400,000 people with minimal casualties.

True, Mariupol has surrendered, and the crack Neo-Nazi battalion has been destroyed. 

According to Escobar, American commentators, men with great military experience, are misjudging the events on the ground.

While fighting a real war on the ground – not those indiscriminate US bombings from the air – in a huge country against a large army, facing multiple technical, financial and logistical challenges, the Russians also managed to liberate Kherson, Zaporizhia and virtually the whole area of the ‘baby twins,’ the popular republics of Donetsk and Luhansk.

Russia’s ground forces commander, General Aleksandr Dvornikov, has turbo-charged missile, artillery and air strikes to a pace five times faster than during the first phase of Operation Z, while the Ukrainians, overall, are low or very low on fuel, ammo for artillery, trained specialists, drones, and radars.

What American armchair and TV generals simply cannot comprehend is that in Russia’s view of this war – which military expert Andrei Martyanov defines as a “combined arms and police operation” – the two top targets are the destruction of all military assets of the enemy while preserving the life of its own soldiers.

As for Mariupol, it was a major Ukrainian defeat:

Ukraine must have lost as many as 20,000 soldiers in and around Mariupol alone. That’s a massive military defeat, largely surpassing Debaltsevo in 2015 and previously Ilovaisk in 2014. The losses near Izyum may be even higher than in Mariupol. And now come the losses in the Severodonetsk corner.

We’re talking here about the best Ukrainian forces. It doesn’t even matter that only 70 percent of Western weapons sent by NATO ever make it to the battlefield: the major problem is that the best soldiers are going…going…gone, and won’t be replaced. 

Azov neo-Nazis, the 24th Brigade, the 36th Brigade, various Air Assault brigades – they all suffered losses of 60+ percent or have been completely demolished.

So the key question, as several Russian military experts have stressed, is not when Kiev will ‘lose’ as a point of no return; it is how many soldiers Moscow is prepared to lose to get to this point.

And now, Ukraine is facing another series of defeats. Again, we do not read about his in the American media, so we are somewhat surprised:

The imminent loss of Severodonetsk and Lysichansk will ring serious alarm bells in Washington and Brussels, because that will represent the beginning of the end of the current regime in Kiev. And that, for all practical purposes – and beyond all the lofty rhetoric of “the west stands with you” – means heavy players won’t be exactly encouraged to bet on a sinking ship.

As for the sanctions regime, Russia is now pivoting toward Asia, to sell energy especially to India and China. And, of course, to run transactions in rubles, not in dollars. As we suspect, one of the major casualties of this policy might very well be the status of the dollar as a reserve currency.

Escobar notes:

On the sanctions front, Moscow knows exactly what to expect, as detailed by Minister of Economic Development Maxim Reshetnikov: “Russia proceeds from the fact that sanctions against it are a rather long-term trend, and from the fact that the pivot to Asia, the acceleration of reorientation to eastern markets, to Asian markets is a strategic direction for Russia. We will make every effort to integrate into value chains precisely together with Asian countries, together with Arab countries, together with South America.”

And, Escobar concludes:

Meanwhile, Russian President Vladimir “the new Hitler” Putin is in absolutely no hurry to end this larger than life drama that is ruining and rotting the already decaying west to its core. Why should he? He tried everything, since 2007, on the “why can’t we get along” front. Putin was totally rejected. So now it’s time to sit back, relax, and watch the Decline of the West.

Friday, May 27, 2022

Psychiatry and Its Discontents

Is psychiatry in crisis? Andrew Scull thinks that it is. So too does the former head of the National Institute of Mental Health, Thomas Insel. 

As it happens, and to descend a few rungs, life would probably be better if we saved the word “crisis” for real crises. Calling something a crisis evokes images of Hurricane Sandy bearing down on us. 

Even if we accept that America is in some very serious trouble, that the social contract has been sundered, and that appalling behavior had become the order of the day, blaming it on psychiatry is a bit facile. While we would have seriously preferred that young Salvador Ramos, along with the other mass murderers out there, had been committed involuntarily to psychiatric institutions, the fault, dear readers, lies in the culture at large, a culture, as I said yesterday, that has broken the American family and that has diminished and demeaned and derided and defamed fathers.

To imagine that psychiatry or any mental health professional can instantly solve this problem is naive. I would say the same about gun control and locked schools. The problem is bigger than all that.

Anyway, rather than read Scull’s book, I refer to Stephen Eide’s review in the City Journal. I found it through Maggie’s Farm, via one Dr. Joy Bliss. I will note a point that Dr. Bliss made and that even I have made before. We too often fail to distinguish between brain diseases like schizophrenia, metabolic disorders like bipolar illness and more everyday conditions, like depression, anxiety and narcissism.

Without making these distinctions, we are, as it were, flying blind. We too, with Scull, would like to know where mental illness comes from and how to cure it. For the record, Scull is a sociologist. Nuf said.

Now, I will simply review a couple of salient points. Scull apparently makes much of the movement to deinstitutionalize mental illness. Surely, our failure to commit young homicidal maniacs to psychiatric institutions is part of the fallout of this policy. True, some psychiatrists were behind the movement, but many were not. It was more leftist politics than effective treatment.

I would note that one reason we thought it was a good idea was the advent of new therapeutics, from neuroleptic drugs to certain types of antidepressants. When drugs like Thorazine and Anafranil were introduced they produced remarkably positive effects. The problem was that in order for them to work patients needed to take them. And many patients who were let go from psychiatric institutions did not take them. There was also the problem of the side effects, like tardive dyskinesia, which have not until recently been treatable. 

Eide summarizes Scull’s point:

Deinstitutionalization began slowly at first, in the 1950s, but the pace accelerated around 1970, despite signs that all was not going according to plan. On the ground, psychiatrists noticed earlier than anyone else that the most obvious question—where are these people going to go when they leave the mental institutions?—had no clear answers. Whatever misgivings psychiatrists voiced over the system’s abandonment of the mentally ill to streets, slums, and jails was too little and too late.

And then, more pertinent for my own personal consideration, is the fact that Freudian psychoanalysis, the therapy of choice until relatively recently, has now fallen into desuetude.

Eide explains:

The Freudians normalized therapy in America and provided crucial intellectual support for the idea that mental health care is for everyone, not just the deranged. Around the same time as deinstitutionalization, Freud’s reputation, especially in elite circles, was on a level with Newton and Copernicus. Since then, Freudianism has mostly gone the way of phlogiston and leeches. 

That happened not just because people decided the psychoanalysts’ approach to therapy didn’t work but also because insurance wouldn’t pay for it. Insurance would, however, pay for modes of therapy that were less open-ended than the “reconstruction of personality that psychoanalysis proclaimed as its mission,” more targeted to a specific psychological symptom, and, most crucially of all, performed by non-M.D.s.

One suspects that this paragraph refers to the advent of cognitive and behavioral therapies, which have largely supplanted psychoanalysis. In Great Britain the National Health Service will only pay for those treatments, because they have demonstrated their effectiveness.

But, then apparently Scull most clearly despises the pharmaceutical industry. I myself have known psychiatrists who were working with psychotic patients before the advent of neuroleptics and antidepressants. They would strongly disagree.

Scull loathes the drug industry and only grudgingly allows that it has made improvements in the lives of mentally ill Americans. 

He divides up the vast American drug-taking public into three groups: those for whom they work, those for whom they don’t work, and those for whom they may work, but not enough to counter the unpleasant side effects. He argues that the last two groups are insupportably large.

True enough, sometimes the drugs work. Sometimes they do not work. After all, people rushed out to take Prozac because the psychoanalytically oriented treatments that they had been undergoing were decidedly ineffective. 

And, it is worth mentioning, though I like to think that Scull has done so, that among the best new treatments for depression is conditioning exercise. This was discovered by scientists and it does not produce obscene profits for the drug manufacturers.

Eide summarizes Scull’s concepts:

Scull believes that psychiatry is in crisis because the most recent generation failed to deliver on its three defining promises: the promise to identify the biological (genetic or neurological) roots of mental illness, the promise to establish a definitive typology of mental illnesses (presented in the Diagnostic and Statistical Manual of Mental Disorders), and the promise to develop an array of effective medications for the mind. Psychiatry’s best and brightest participated in these efforts. Biological research, in particular, benefited from billions in federal funding. Americans, too, take more medication than ever. But decades on, psychiatry doesn’t seem to have much more of a handle on mental illness than when these initiatives launched.

As it happens, many purveyors of medication have made it seem that we all needed to take just another pill. But many psychiatrists are extremely grateful that these medications exist. 

And yet, the more salient issue, is that psychiatry did not cause America’s problems and is not likely to be the solution. As we saw during pandemic lockdowns, enforced desocialization produced spikes in severe psychiatric disorders. It did so especially among the most vulnerable, the young. These children do not just need a pill. They need to get their lives back.

We Americans bear some responsibility for the policies implemented by the politicians we elected. And we ought to recognize that our inability to produce a cohesive society is perhaps the most significant causal factor in the manufacture of mental distress.