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When it comes to criminality, we know that criminals can speak like butter wouldn’t melt in their mouth. The most prolific villains are known to be the most pleasant of personalities when engaged in a social setting. It’s not rocket science; people’s speech can be as honeyed and endearing as can be, but it is their actions that are the most revealing of their true nature or state of mind.


We don’t prosecute or acquit people on the basis on what they say; we judge them on what they do. This has been the way society has survived over the centuries; criminals get caught doing the deed and if not – we have courts that establish whether they did it or not. That’s the basis for Law and Oder! Anything other-than – is a recipe for a world where people can get away with murder – as long as they speak like they could not have possibly done it.


In Psychiatry, the current practice now it seems, is to ask the Patient how they feel. If they sound well – the clinician will form their diagnoses on that basis. But as we know - a Schizophrenic can sound clearheaded and in possession of all their faculties, but they can act in the most irrational way possible.


Medical Science – has been infiltrated by Political Correctness, which holds the person’s subjective experience as central to decision making: care-based morality as opposed to justice-based morality. The system in the UK seems to want to make feelings the most important factor in determining how mentally well a person is. Does anyone feel a sense of unease at this?


In the drive to be more caring and more responsive to the needs of the individual, the clinicians and support workers - are doing more harm than good. People need to have behavioural structure in their lives; a pattern of what is acceptable behaviour. It seems – in the drive to be more caring the system turns a blind eye to behavioural structure and expects society to simply allow for inappropriate behaviour because it’s the caring thing to do. Care in the Community at the expense of Community safety and peace.


They have to find a happy balance – else they are simply not doing their job and should not be payed accordingly.

No, a mental status exam takes into account the GAF--standards in the DSM for determining someone's level of functioning; ability to speak in an organized fashion without delusional ideation or evidence of hallucination. Schizophrenics are either disorganized in speech or have ideas of reference regarding paranoia.
It's only the personality disordered that can present in a manner that is truly deceptive; however, it's not that difficult to catch them in a lie.
Personality disorder is an axis 2 diagnosis, schizophrenia would be axis 1.
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I've always thought there needs to be some kind of middle ground between locking everyone up and turning them loose to run their own lives, how can we expect someone with a mental illness to take the steps to care for themselves properly when their illness causes broken thinking?
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VAuser - are you blaming your mother's psychiatrist personally for the closing down of most inpatient psychiatric facilities throughout the eighties and nineties?

Psychiatry is not rocket science, no. Rocket science is mathematics. Psychiatry isn't - or rather it will be, one day, but mathematics at a level of sophistication and complexity that we haven't begun to fathom. How's your quantum theory?
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Barb, exactly! Tough love. We had to with my schizophrenic brother. My mom had no choice. He was putting the family at risk with his behavior.

We tried a psychiatric hospital. They kept releasing him. He wouldn't take his medicine. My mom had little or no other options.

Now at age 65 he is in hospital due to a brain aneurysm. I had not seen him in years till this incident. The system failed us but especially him.
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Argee Barb. They have eyes & ears in their head & probably a bit of education too!

Eg: went with Sister to 1st apt with her new Psychiatrist. She said she never falls, well not anymore, not for a long long time. I wiggled MY thumb. Doc looked over at HER thumb- big blue bandage. Hmm what happened there? Oh I fell. On Monday. Then fell again on Friday! But I don't FEEL like I fall much these days...

It's a great topic though.
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Good psychiatrists don't operate merely on the basis of what patients tell them.

In the past, folks with mental illness were treated like criminals and locked up. It is certainly true that schizophrenics do better in structured situations and are at great risk for homelessness when they dont comply with their treatment regimens, including perhaps living in a supportive structured environment.

This is not, IMO, political correctness. This is the constitutional right to liberty and freedom of choice. On the other hand, as family members, we have no obligation to house or care for a mentally Ill family member. Sometimes walking away is the only way to get them the help they need.
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