Program Archive - Capital District Humanist Society

Dr. Bill London is a professor of public health at Cal State LA, and editor of Consumer Health Digest. His topic was “Quackery: a neglected public health and societal menace.”

The key concept in defining the quackery he talked about is promotion – of health products, services, or practices of questionable effectiveness or validity for intended purposes. Unproven effectiveness itself does not necessarily denote quackery. Medical practitioners can responsibly try unproven therapies in certain circumstances, where better alternatives are not available. Responsible practitioners are not promoters. But Dr. London also said that true believers can be more dangerous than intentional deceivers.

He presented a hierarchy of scientific evidentiary support for medical treatments. Topped by randomized controlled trials. But he noted that it matters how well such studies are done. And lower down are “pre-clinical” studies that can provide a basis for further testing. London cautioned about the importance of having a plausible hypothesis to support such testing; if you test for something whose underlying theory is implausible, there’s a danger of false positives.

London listed varieties of “quackogenic harm.” There’s direct harm when the treatment is actually bad for the user. Indirect harm, more common, where it interferes with the person getting proper medical care. There’s financial harm – wasting money. Psychological harm of various kinds. And societal harm, eroding our foundation of shared truth.

An audience participation effort identified red flags for quackery and why people fall for it: among them, distrust of the medical/pharmaceutical establishment; fears; confusion about the natural causes and courses of illnesses; and seductive tropes like “natural,” “helping the body heal itself,” “purity,” “mind-body,” et cetera. Religion, spiritualism, mysticism, and ideologies come into play.

London cited a 1984 Congressional Committee report calling quackery a $10 billion scandal. And some other documents of similar vintage – saying that this actually shows this has been a neglected problem. Indeed, he noted that the government itself has muddied the waters, having in 1992 (responding to political pressure from Iowa Senator Tom Harkin) created an “Office of Alternative Medicine” at the National Institutes for Health; later renamed the “National Center for Complementary and Integrative Health.”

London sees this as giving undue legitimacy to what is really still quackery. With “alternative medicine” a euphemism that has achieved some cachet in the public eye. He quoted Richard Dawkins that something can’t be false in the ordinary sense but true in an “alternative” sense (as with “alternative facts.”) London said there’s only medicine.

Now there’s been a move to replace the term “alternative medicine” with “complementary medicine,” with the idea of mainstream practitioners using it together with “conventional” medicine. Which London thinks should better be termed “regular medicine.” And he particularly hates the “integrative” word here, crafted for positive associations. We don’t, he said, “integrate” fantasy with reality.

London got some pushback from attendees who accused him of a black-and-white take, and said they’d benefited from what they took to be non-conventional medicine. In response he acknowledged that regular medicine has a lot of deficiencies, especially in treating “the whole person” which, though it might sound touchy-feely [my term: FSR] is actually important. In this regard he spoke about the placebo effect, a major factor in medicine.

This was particularly relevant when he addressed questions about acupuncture and chiropractic, both raising complex questions, and which have elements that make patients feel better even if what they do may actually be medically nugatory. Regarding acupuncture, he said that in controlled studies, the tighter the controls, the smaller the actual physical impact shown. Suggesting that acupuncture is a “theatrical placebo.”

Beck Krefting is Chair of American Studies at Skidmore. Also a former standup comic. Her academic work concerns social and cultural issues around humor. Krefting’s CDHS talk was titled, “Charged Humor from McCarthyism to Covid.” She said her aim was not to make us laugh; and indeed, the presentation was fairly laugh-free.

She began by explaining what she means by “charged humor.” As distinguished from ordinary humor. Charged humor has an edge based on projecting some viewpoint about social or cultural matters. It can both attract and repel hearers. She said that it spotlights problems and also points toward solutions. Krefting also said its being charged is not incidental or accidental; it’s clear what the comic is up to, and they cannot be misunderstood.

She sought to present an “historical through-line.” The story begins with blackface minstrelsy, which Krefting deemed the earliest standup comedy. Emerging in the 1700s, the performers were originally Black, and they were actually mocking white European pretensions; only in 1840s did minstrelsy change to denigrating Blacks, becoming much more popular.

Around the turn of the 20th century, Vaudeville was the primary venue for comedy performance. There were some Black Vaudevillians – who, Krefting said, were forced to caricature themselves. Standup in its modern form emerged around mid-century, with a big boom occurring in the 1980s with a proliferation of comedy clubs. This also entailed the rise of “shock comedy,” not doable on network TV, but gaining a wide audience through clubs and also cable TV.

Krefting noted that while there were niche audiences for such material, a comic could not make a big mainstream career from it. But she cited the case of George Lopez, who did make a big name for himself with “family-friendly” comedy on network TV but then went on, building from that, to edgier “charged” humor.

Meantime, however, the routes for bucking conventional standards were growing. Krefting spoke of comics doing not simple jokes with punchlines but rather telling stories. And, in particular, new opportunities for them to flourish in genres outside the traditional ones. Women, especially, who’d been unwelcome in old-line comedy could now spread their wings. Krefting went on to talk about further niches – African-American comedy (which, while the larger comedy boom fizzled in the 1990s, became much more prominent); Arab-American comedy in the wake of 9/11; and queer comedy.

Audiences, she said, were hungry for such fare. And they got hungrier after the 2016 election, which kind of demanded attention being paid. Then there was the rise of the metoo and BLM movements, with a similar effect. All this made comics feel they had to start being more meaningful, in a time of historical reckoning; and Krefting saw them as rising to the challenge.

But, meantime, she also spoke of pushback. For example, the metoo movement widely being seen as going too far, women being cast as a bunch of whiny complainers. And there is also a genre of alt-right charged humor.

All of which goes to show that comedy is, indeed, no laughing matter.

Terry O’Neill is an attorney specializing in police-related matters. He spoke about his experiences in the context of currently prominent issues and a longtime overall problem of systemic racism.

Relations between policing and, particularly, minority communities have indeed been fraught; brought to the fore by the recent George Floyd and Breonna Taylor killings and others. O’Neill also discussed the death of Daniel Prude in Rochester. These cases gave new energy to the “Black Lives Matter” movement and efforts to “Defund the Police” (a politically maladroit slogan which O’Neill explained really means shifting funding from police to other kinds of interventions).

He pointed to COMPSTAT, a program originating with New York City’s police in the 1990s, aiming for data-guided policing. The idea being to devote police resources to areas statistically shown to need them most. But Black communities felt this meant singling them out for unwelcome police aggressiveness. O’Neill said this was aggravated by “stop-and-frisk” policies that caused a lot of ugly interactions between police and minority citizens, with actually very few resulting arrests or finding drugs or guns. And when “stop-and-frisk” was ended, crime did not rise, but continued falling.

O’Neill said the biggest problem for police forces is to build trust and respect in the communities they serve. This has been the focus of “community policing” efforts. However, there is a tendency among police forces to feel that the way they’ve always done things is the right way, so they are resistant to change. Reform often being forced upon them by outside forces, such as the courts. Meantime, communities often feel they don’t get the policing they need, while what they do get disserves them, causing tension and alienation.

Accountability is a key issue. O’Neill said people demanding reform often don’t really know what they should be asking for. He noted that since 2000, Albany has had a citizens’ review panel – but it has never consummated disciplinary action against a police officer. The panel simply lacks teeth. Right now efforts are underway in Albany to do something about this.

But pushing back against accountability are powerful police unions. They wield political clout because elected officials are afraid of them, lest they be branded “soft on crime.” Such unions have been very successful at negotiating contracts that make it almost impossible to discipline officers for misconduct.

Looking toward a way forward, O’Neill also discussed his experience relating to Northern Ireland, with a long history of severe police abuses. There, an ombudsman was introduced to facilitate oversight; and also a policy of hirings to better reflect community makeup (in that case, hiring as many Catholics as Protestants.)

Dr. Caleb Lack, at the University of Central Oklahoma, is a clinical psychologist and author of six books. His topic: Why You Can’t Trust Your Brain.

Well, whose brain can you trust? Actually, the brain is an extremely complex organ, with 86 billion neurons (give or take maybe a dozen), and 100 trillion connections. But it’s easily fooled – by itself.

Dr. Lack said “doubting yourself” has negative connotations, but it’s actually the hallmark of an enlightened mind. Being a critical thinker and skeptic is hard to actually do. The problem is the human brain being “logically illogical.” That is, there are reasons why it does what it does, programmed by evolution.

Two key factors are cognitive biases – predictable patterns of judgment – and mental heuristics – shortcuts or general rules of thumb to decrease effort in decision-making. These tend to oversimplify reality and cause systematic decisional errors. But they are not all bad. We don’t always make bad decisions. In fact, there’s a “less is more” effect – folding too many factors into a decision may impede a positive outcome. And we can never have access to all the information, and must act on what we do have. That means “good enough” decision making. As opposed to investing too much effort in a decision. That’s why we did develop these seeming cognitive quirks – they are actually adaptive in balancing between effort and result.

Dr. Lack focused on two related metal biases: confirmation bias and belief perseverance. The former is the tendency to welcome information confirming already held beliefs or ideas. We discount any problems undermining that information, and recall it later. The other side of the coin is that information at odds with one’s belief is discounted, nitpicked, and soon forgotten. The more emotionally charged a belief is, the more deeply held, the more confirmation bias applies. This is why we developed the scientific method, whose raison d’être is subjecting theses to attempts to disprove them.

Belief perseverance is (surprise) the tendency to stick with an initial belief even after seeing disconfirming information. Indeed, that actually causes people to “dig in.” That’s why it’s generally pointless to argue with persons adhering to a certain political party or personage, which will go nameless here. Not to mention religious believers.

Dr. Lack spoke about three manifestations of belief perseverance. One concerns self-impressions, beliefs we hold about ourselves. Another he called “social impressions,” beliefs about other groups of people – like, oh, I don’t know, maybe certain ethnicities. The third is “naive theories” about how the world works. As an example he gave the Sun appearing to move around the Earth. Though many of us have gotten wise to this.

He also spoke about illusory correlations – seeing relationships between things not actually connected. The word pareidolia applies to interpreting random stimuli as being something particular. An example was the “face on Mars,” a geographical feature which, photographed in certain light, looked like a human face. We are in fact especially apt to see faces everywhere, a biological adaptation, because interacting with other people is so important for our thriving. More generally, we are subject to patternicity, seeing all sorts of patterns where they don’t exist. Also adaptive: you’re better off wrongly seeing a bunch of pixels as a predator than making the reverse mistake. And agenticity is when you see patterns as being caused by something. Like a deity. These cognitive quirks are big reasons why we have religion.

Another example Lack discussed was a spate of concern in the ’70s and ’80s that Rock music had “backmasking” – Satanic messages when played backwards. Lack played an example. He deemed it pretty far fetched to imagine musicians actually managing this trick – or anyone being influenced by messages almost impossible to decipher.

A final phenomenon he spoke about was priming – the influence of “implicit nonconscious memory” – stimuli in one context affecting behavior in another. He displayed a woman’s face. Then an image which could be seen as either a saxophone player or a woman’s face. Having been primed by the first image to see a woman’s face, that’s what we saw in the second.

Dr. Lack concluded by saying we can’t rid ourselves of cognitive biases but can decrease their effects. One must examine one’s own beliefs, and use tools like the scientific method. And humility, he said, is crucial to critical thinking.

Eleanor Aronstein has degrees in education and history, and has been active on the “death with dignity” issue. She called this a topic nobody wants to talk about. However, in fact, nobody gets out alive.

Aronstein attributed her activism to her mother’s 1972 death from ovarian cancer, with eleven months of suffering, regretting that at the time, there was nothing she could do to ameliorate the ordeal. Aronstein contrasted that experience with the peacefully eased death of her beloved dog, wondering why people cannot have likewise.

At the end of life, she queried, shouldn’t you want to determine what treatments you want or don’t want, and how much pain you must suffer, if it can be avoided? Noting that most people say they’d prefer to die at home, whereas most don’t get to do so.

Basically, the “death with dignity” paradigm allows people facing fairly imminent death to get access to the means to die at a time of their choosing, provided they’re still competent to make the choice. Aronstein noted that most people who do have access to the necessary pharmaceuticals actually don’t use them, finding that the sense of control by itself is an important source of comfort.

She put this in the context of a trend toward expanding human rights. With northwestern European countries already very progressive on this, some even allowing physicians to administer the coup de grâce. A sizable majority of the U.S. population favors something similar, but so far only ten states and the District of Columbia allow it, none of them permitting doctors to actually perform the deed. New York is not one of those states, legislation here being stalled since 1997. It’s opposed mainly by the Catholic Church and “Not Dead Yet,” a disability rights group, making “slippery slope” arguments.

Aronstein referenced a number of organizations promoting liberalization, including End of Life Choices NY, Death With Dignity, Compassion and Choices, and Final Exit Network, the one she’s active in. FEN, she said, advocates “a good life and a good death.” It does not encourage ending life, or provide the means, rather just offering information, support, and comfort.

Also discussed were the sorts of documents involved in control over the dying process: advance directives, living wills, health care proxies, powers of attorney, “Do Not Resuscitate” orders, etc. The main thrust is to set forth in advance your preferences for end-of-life care, and to empower someone trusted to intercede for you with medical personnel, if you yourself are not in position to do so. Absent such intervention, the medical system’s default is to do everything possible to keep someone alive.

Robyn Blumner is a lawyer, CEO of the Center for Inquiry, and head of the Richard Dawkins Foundation. Her topic was the assault on church-state separation, focusing on the Supreme Court, with six of the nine justices now on this mission.

The First Amendment says “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” Blumner said the two clauses must be read in tandem and in light of the history behind them. That included a Puritan colony where religious dissenters were hanged. The issue came to a head in Virginia in 1784 with proposed legislation for taxpayer funding of religious teaching. James Madison successfully fought it, arguing that state entanglement would corrupt religion. This idea of what Jefferson later called a “wall of separation” between church and state led to the First Amendment.

Thus Blumner contended that when they seek to give religion a governmentally privileged status, the Supreme Court’s so-called constitutional “originalists” are actually disingenuously ignoring those ideals and values that were originally baked into the document, as intended by the founders they supposedly venerate. She quoted the late Justice Scalia (who said the Devil is real and is mainly into promoting atheism) that the First Amendment does not bar the government from preferring religion over irreligion.

The Court was not always like this. Blumner referred to the 1965 Griswold decision holding Connecticut’s (religion-inspired) law banning contraception violates an inherent constitutional right to privacy. [She didn’t mention 1963’s Abington Township v. Schempp outlawing school prayer. I met Schempp. In a men’s room. – FSR.] Blumner noted that in her confirmation hearings, now-Justice Amy Coney Barrett refused to endorse the Griswold decision.

Since that era the Court has been dominated by Scalia disciples. Thus the recent case of the (giant) Bladensburg cross, a WWI memorial maintained with taxpayer money. Only two justices (Sotomayor and Ginsberg) had a problem with this; common among the others was the idea that historical meaning gives the cross a constitutional pass. Blumner said this dooms efforts to remove monuments with religious symbolism from public property.

Other pertinent cases include:

• Espinosa, where the Court voided “Blaine Amendments” in most states barring state aid to religious institutions, holding that they can’t be excluded from programs of general public applicability;
• Our Lady of Guadalupe, barring Catholic School teachers from suing for employment discrimination, extending a “ministerial exception” allowing congregations to hire whoever they want as clergy;
• Burwell v. Hobby Lobby, holding that a private business can invoke religious beliefs to escape the Affordable Care Act’s requirement for contraception coverage in employer-provided health insurance; and
• Masterpiece Cake Shop, holding the baker was a victim of religious hostility when his state’s equal rights agency ruled his religious beliefs could not justify refusal to provide a cake for a gay wedding.

And coming up: the Fulton case, concerning a Philadelphia Catholic foster parenthood outfit, which claims a right to taxpayer funding while invoking religious doctrines to bar same-sex applicants. Blumner thinks they’ll win.

The result of all this: religious institutions can’t be excluded from public funding available to others; they’re held to lower standards of accountability; and religious beliefs exempt them from anti- discrimination strictures otherwise applicable. Blumner called this a recipe for ending the religious peace that America has enjoyed for two centuries thanks to the “wall of separation.”

She concluded by discussing Attorney General Barr’s Notre Dame speech deeming secularists’ “unremitting assault on religious and traditional values” responsible for all the nation’s putative moral decline. Blumner called this delusional – indeed, having it backward. Because on basic measures of social health, more secular nations (and within America, more secularized states) do better. And “if he wants to see moral depravity,” she said, Barr “should look at the guy he’s working for.”

Jacob Appel is a physician, lawyer, psychiatrist, bioethicist, and author, with more masters degrees than you can count on one hand, even if you’ve got six fingers.

His talk was about rethinking resource allocation in this time of pandemic, highlighting all the ethical conundrums. He posited three categories of scarce resources: 1) “hard scarcity” (like organs for transplant); 2) “soft scarcity” (with some wiggle room, like funds for health care); and 3) “evaporating or conservable” resources (like antibiotics, where too much use impairs effectiveness).

The big picture, which he called “macro-allocation,” concerns how overall societal resources get allocated – Appel pointed to our nation spending 17-18% of GDP on health care, versus about 6% on education. Our health spending is considerably higher than in other advanced countries, with different systems. Appel noted that ours, dominated by employer-provided insurance, grew out of WWII wage controls, preventing companies from competing for workers on salary, so they competed instead on fringe benefits. [Which are deductible as businesses expenses, and constitute non-taxable income to employees – FSR.]

Also at issue is what specific things we choose to fund. For example, work on HIV/AIDS and cancer is over-funded in comparison to mental health. Appel noted that sickle cell disease (associated with Blacks) is under-funded compared to Cystic Fibrosis (associated with whites). And he said we’ve way underfunded pandemic preparation, undermining what might have been our response to Covid-19.

The health care funding realm presents fundamental ethical dilemmas. We don’t like the idea of “rationing” health care, but resources are never infinite, so we have to make choices. Appel illustrated this with the Slim Watson case – this guy had a rare condition treatable only at great expense. The question being whether to keep him alive and thus effectively deny funding for other things that could actually save many more lives. We have trouble with such issues because they pit “visible victims” (like Watson) against “invisible victims.”

It’s a really acute issue because about 30% of total Medicare spending goes on patients in the last year of life; a third of that in the final month. Is this worth it, compared with what health improvements that money could buy if spent on other people? Appel also pointed to the 1983 “Orphan Drug Act,” incentivizing work on rare diseases. Seemingly altruistic, but there are numerous such illnesses affecting small populations, and treating them all would cost trillions.

Mentioned too was an Oregon attempt at rationally allocating health care, aimed at saving the most lives for a given sum of money. Thus not spending it on cancer patients deemed to have a small chance of recovery. Another example here was the allocation of limited dialysis machines, with a committee established to vet applications from patients seeking their use. Appel presented an actual transcript from the committee’s deliberations, trying to figure out which patients best merited the limited dialysis capability. The excruciating ethical conundrums were obvious.

Of course similar issues can apply regarding ventilators in this time of covid, and who makes the decisions. It may be unethical to put them in the laps of health care workers on the spot. Another option is a “blinded committee” like the one described above (with all the problems that entails). Appel also noted that standards vary greatly from state to state, so identically situated patients can get treated very differently.

Vaccination presents such issues too. Development can be speeded by trials with volunteers exposed to covid after getting a trial vaccine. Is that ethical? Then, who gets a vaccine first? The most vulnerable versus frontline health workers, for example? And should government make vaccination compulsory? Appel suggested that winning public “buy-in” would work better.

Cheryl Roberts spoke about electing New York State Supreme Court Justices – and why your vote hardly matters. She lost out in a 2019 bid for one of those judgeships.

Despite its name, the State Supreme Court is not New York’s highest court, but actually the lowest, the trial level. Next up is the Appellate Division, and the highest panel is the Court of Appeals. There are almost 400 Supreme Court judges divided among 13 multi-county judicial districts. Albany is in the seven-county 3rd Judicial District.

Roberts explained that the State Supreme Court handles cases like divorces, mortgages, foreclosures, and felony crimes (most of which though, upstate, are heard in county courts). Another key jurisdiction is Article 78 proceedings, challenging governmental actions.*

New York is one of only a few states electing (rather than appointing) such judges. Roberts characterized our system as very political and “incredibly unfair.” The party nominees in judgeship elections are chosen in judicial conventions, by delegates elected in primaries. In practice, because of the large numbers of delegates, and those primaries being under the radar, there are never contested ones, the delegates being simply picked by party leaders.

Our Third Judicial District used to go both ways politically, and Democratic and Republican leaders would often agree on bipartisan endorsements. Nowadays Democrats typically prevail. At some point the district’s seven Democratic county chairmen came to a deal divvying up the judgeships among themselves. In 2019 it was seemingly Columbia County’s turn, and the county backed Roberts. However, Albany – the most populous and hence most powerful county in the district, with the most delegates – backed Justin Corcoran. He had been (after a big fight) the party’s nominee in 2014, but had lost the election. This time Corcoran did win both the nomination and election.

Though knowing her bid was doomed, Roberts says she stayed in the race, to highlight a need for more diversity among the the judges (one might remember a bunch of letters-to-the-editor at the time so arguing for her candidacy). She also wanted to throw a spotlight on the system’s undemocratic cronyism. Though changing it would require a constitutional amendment – which in turn would require the initiative of the state legislature. Good luck with that, in the People’s Democratic Republic of New York.

Dr. Abby Hafer has her doctorate in zoology from Oxford University and currently teaches at Curry College. She has authored the book Unintelligent Design, among others, and claims to be famous for testicles. (Not her own; see below.) Her talk was about what today’s fighters against fake news can learn from Darwin’s apostles.

She started by suggesting that pre-Trump we could not have imagined an American president establishing a bizarre, counter-factual, evidence-free narrative, yet succeeding in gulling much of the population. But “Welcome to my world,” Hafer said – every evolutionary biologist has always had to deal with such an environment of factual denialism. “Objective reality exists”; she insisted, steadfastly disregarding all the evidence to the contrary.

The Darwin apostles Hafer discussed were scientists who fought, against powerful entrenched interests,  to gain acceptance for his theory of evolution by natural selection. After a long hard campaign they succeeded to a great degree (despite pockets of resistance, notably including a high proportion of Americans). But meantime Hafer noted publication, in 1889, of a book, Lux Mundi, in which notables in the Church of England dilated upon reconciling their faith with evolution – which they already assumed was true.

John William Draper was a scientist who authored History of the Conflict Between Religion and Science in 1874. The lesson Hafer took from his efforts: don’t quail from battling fundamentalist religion, but work with religious people wherever it’s possible.

Alfred Russel Wallace was of course the guy who figured out evolution at about the same time as Darwin. Darwin had been afraid publishing would cause a big backlash. But Wallace, Hafer said, struck a different kind of terror into Darwin: not getting credit. So he finally got his book finished quickly enough to pip Wallace.

Joseph Hooker was one scientist who had long actually fought against the idea of biological evolution. But ultimately, he said, the conviction was “forced upon an unwilling convert.” He couldn’t fight the facts. That was intellectual integrity.

Darwin’s greatest proponent was Thomas Henry Huxley. Hafer discussed his lengthy battle with Richard Owen, who maintained that brain differences ruled out any close connection between humans and apes. Huxley showed Owen was just wrong on the anatomical facts: “Before I have done with that mendacious humbug I will nail him out like a kite to a barn door, an example to all evil doers.”

Huxley was indefatigable, working the “social media of his day” – newspapers. Letters to the editor, and replies, were a very big thing.

One audience member remarked that many people who most need to hear such messages refuse to listen. Hafer acknowledged this, and how a lot of these issues have become politicized. But she held that persistent efforts to debate such issues, vigorously battling error, in the public sphere, can have an effect. And Americans are actually leaving evangelical Christianity in droves, indeed angry because they feel they’ve been lied to.

A point she emphasized was that to overcome biases you have to tailor the message to engage people. Mention was made of Galileo’s experiments with the motions of balls, illustrating his points in a visually unarguable way. Hafer also pointed to her own work on how the human body actually shows un-intelligent design. A prime example is testicles, hanging vulnerably outside the body cavity, whereas many other animals have them safely inside. It’s because human testicles have to be kept cooler. (I asked whether there was any connection between testicles and Galileo’s balls and she gave me a straight-faced answer.) Anyhow, the point was that when you start talking about testicles, people sit up and listen.

She also said the current pandemic is a golden opportunity to make people grasp the importance of being serious toward science. A further point was that the virus, of course, evolved.  If it weren’t for evolution, there’d never be any new diseases.

Hafer avowed that we are struggling today not only for the soul of this nation – but for its brain. Its integrity. Scientists are on the front lines of this battle. And their latter-day apostles are us.

She paraphrased Martin Niemoller: First they came for the evolutionary biologists . . . .

Cheryl Roberts is an ex-Judge, currently serving as Executive Director of the Greenburger Center for Social and Criminal Justice, as well as corporation counsel for the City of Hudson.

Her topic was mass incarceration – the criminalization of mental illness and substance disorders. America has the highest incarceration rate of any country. That’s right, of any country. We have less than 5% of the world’s population, but 25% of its prisoners. Our incarceration rate is five to ten times higher than for other democracies.

Is it because we have that much more crime? Of course not [although we do have way more gun crime because of our insane gun culture – FSR]. Roberts noted that U.S. incarceration numbers rose from about 200,000 in 1973 to 2.2 million in 2009. Since then they’ve stayed at about that level. [But during that interval crime rates actually fell dramatically. Imprisonment of dangerous people probably contributed somewhat to that decline. Nevertheless, an eleven-fold increase in incarceration obviously can’t be justified on the basis of crime rates. – FSR]

What it does represent, Roberts said, is not a response to rising crime, but rather a policy choice to use prison as a response to crime; and it’s that policy that’s criminal.

The policy disproportionately affects mainly minority men under 40, who are already disadvantaged, educationally and economically, etc. For all Americans, the lifetime chance of being imprisoned is 6% [a scary enough figure]; for black men it’s 32%. And meantime, over half of the prisoner population suffers from some kind of mental illness. Such people are ten times likelier to see the inside of a prison cell than a psychiatric facility.

For those with untreated mental illness, the risk of dying in interactions with police is 16 times greater than for people not so afflicted. And it’s not because the mentally ill are more likely to be engaged in criminality. Actually, according to Roberts, they are more likely to be victims of crime.

And prison, she said, is the last place they should be, suffering horribly there. [Hard enough to cope with imprisonment even for “normal” people.] Roberts cited a Virginia study of 400 prison deaths, finding 41% associated with solitary confinement, 44% were suicides, 18% were tasered, etc.

How did we get here? Roberts quoted John Ehrlichman (a Nixon confidante, speaking decades later) saying that the Nixon administration wanted to hit two “enemies” – blacks and anti-war leftist protesters. Launching a “war on drugs” with harsh penalties was a way to kill two birds with one stone. It’s the war on drugs that still accounts for the bulk of America’s over-incarceration. [Treating drugs as a public health issue rather than a criminal justice one would go far toward solving the whole problem – FSR.]

Mentally ill people used to be put in asylums; one such gave us the word “bedlam.” They were not indeed pleasant places. Thus a big societal push to get folks out of them. One impetus was adoption of a Medicaid rule prohibiting payment for most hospital care for the mentally ill.

Roberts noted that in the 1960s we had about 560,000 psychiatric hospital beds; four decades later it was down to about 50,000, for a national population double the size. Those beds came to be used for people coming out of the criminal justice system, deemed incompetent to stand trial. While perhaps incongruously, what was originally the psychiatric hospital population was largely shifted into prisons. (And into homelessness.)

Roberts concluded by discussing Hope House on Crotona Park, a North Bronx project of the Greenburger Center to serve as an alternative to incarceration for people charged with crimes who have serious mental illness, which will include treatment for drug problems and other issues.