Antidepressants & The Undead
Several of us involved in RxISK.org monitor other groups setting up to offer information on medicines. Some of these, like eHealthMe, offer useful information sometimes with innovations we wish we had thought of first. The general sales pitch is under the umbrella of Personalized Medicine.
As ever, pharmaceutical companies are in there early. The Brintellix website, as noted in We Should Talk about Brintellix, is a masterclass is how to appear patient centered, and patient friendly. How to move with the times and make the new way of doing things yours – “Give us your stories of the impact of treatment on you… segues sweetly into:
“Keep, ancient pharma, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!”
It is likely that many will view the concern expressed on websites like the Brintellix one as genuine. People have to be let make their own minds’ up; the sites come clearly badged for what they are.
AllTrials is a much greater conundrum. Friend or Foe? Liberation Movement or Trojan Horse?
Iodine
Into this mix, a little over a year ago, stepped Iodine.com. San Francisco based, it proclaimed itself as totally independent of the pharmaceutical industry with an awesome panel of pharmacists and MD-PhD candidates. It aimed at offering people-powered information on medication to guide you in your choices.
Billed by Time as the Yelp of medicine, and by the New York Times as addressing a notable information gap in healthcare, it seemed like the kind of thing to keep an eye on – with perhaps the kind of mixed feelings that Buffy clearly had with the arrival of Faith. Always good to have another Vampire Slayer but where exactly is she coming from?
Several weeks ago Iodine launched Start – a new way to tell if your antidepressant is working for you. You would interact with it and it would guide you without – it promised – giving any of your data to the pharmaceutical industry. It offered reports to help you work out if your medication was helping or not. Sounded a bit too close to RxISK for comfort.
Its testimonials say it’s empowering and that being able to track your personal journey to wellness makes a big difference.
Some of us downloaded it. The technoranti (tech-ignorant) among us couldn’t get it to work, which is where the real story lies. Others could get Start to start.
If you’re tech savvy (technoscenti) you’ve got time left over to be mischievous. So one of us began Brintellix with the intention of becoming suicidal on it to see what Start would do. Despite a clearly deteriorating mental state, Start stuck to a line that it was best to continue with the medication as that’s what works – and works even better in anyone who is seriously ill. The prompts to fill reports come in relentlessly and no matter how suicidal the report, the response was invariably a cheery message that salvation through pharmaceuticals is just around the corner – even if your doctor does have to switch you to something else.
Here are Start screenshots and testimonials.
Vampire manual
The responses for something like this have to be generic – in other words it’s vampire meets human body rather than vampire meets you. If the vampire ever becomes concerned about you, it’s the vampire equivalent of salt losing its bite – as Angel found out when he fell in love with Buffy.
Being generic, the responses have a certain timeless and universal quality. They keep going for the same spot – the jugular. The Start responses map eerily onto the responses in a medication guide for Prozac produced by Lilly in the mid-1990s – long before Apps were born. A different millennium. But close to word for word the same – no matter how bad you are feeling keep taking the meds.
Calling it Night by Night would have been too much of a give away. Here is the Day by Day brochure. It’s difficult to see this information – billed as helpful – as anything other than more poisonous than the medication.
No smell?
But as I said the real story lies with the technorant. You might not be able to get something to work but it’s almost impossible not to be able to download it. If you live in the US, Iodine will install Start on your phone for you if you call them.
But if you can’t then get it to work, it doesn’t go away. It continues to message you for months even though you haven’t filled up the rating scales necessary for your report. You could be swinging from the chandelier or in your grave but the beeps will still come – as long as there is life in your phone.
For centuries, maybe millennia, people have worried about evil spirits and vampires because of unsettling features like the fact that nails and hair keep growing after death. The possibility of possession seemed real enough to make it look like a good idea to dispose of a corpse quickly.
Who knows what the peasants of Eastern Europe – or an Irishman like Bram Stoker – would have conjured out of Start?
Sorry Buffy, getting beeped when the Apocalypse comes is so last millennium. The beeps from the Undead go on beyond the Apocalypse – beyond even the Twilight of the Undead.
Whatever about a mirror image or a pulse, a clue for any technoscenti tracking down the new vampires is that they have no smell.
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Hello, love your stuff, however a bit of literary criticism… Your analogies make no sense to me as I dont watch Buffy, whatever…
I kind of know what you are getting at, but it comes across as confusing,
are you trying to say
1 the site is a con paid for by pharma
2 it is so poorly programmed, it doesnt upload
3. its a bit like those horrible search engines, that once you have, damn hard to get rid of,,, norton search is damn bad, but try some of the worse ones!
4. do you want others to test this site, who are computer literate, and have some fun?
its never too late to start watching – the basic message is if you want the universe saved better hand the job to a woman D
As I am computer literate (and actually finally feeling better, after 18 months of withdrawal hell)
if I can crash the new ubeaut telstra website, which I did, was so damn angry…… and get congratulatory comments, and damn wonderful christmas party photos from sophie and alice (yes some of the the blokes that work there!). it was seen as good fun (except by the boss)…. but I was angry, I was a very disgruntled customer……
So I offer my services, happy to test any sites you wish.
Guess I’m not of the ‘in-scene’ group as far as Buffy is concerned although I’ve caught glimpses of some pretty horrific scenes when it was watched here only to be told “you can’t judge unless you watch it” and it seems that that may well be the case. Not sure that it matters whether a job is done by a male or female – as long as it’s done with integrity. As for these ‘new’ websites, I feel that your message seems to be ‘look before you leap’ and ‘don’t judge a book by its cover’. Either that or we are expected to read between the lines – if that’s the case, let’s hope we choose the right lines to read between!
Antidepressants and the unread
On balance, I think Donald Sutherland has a wow factor:::::::O
https://www.youtube.com/watch?v=2Potv40kkT0
Just like alternative medicine, they think if you just fool the patient into believing the treatment will work then it will, automagically,
Love that you seem to appreciate The Buffy series as much as I do. Great stuff and vastly underrated.
“It’s difficult to see this information – billed as helpful – as anything other than more poisonous than the medication.”
True. I don’t recall ever being given this particular handout yet the information is familiar and reminds me of stuff I bought into, years ago, when I trusted doctors. I couldn’t finish reading it. Made me nauseous.
Cover your eyes, Laurie……the carriage is, Buffeting……
http://www.madinamerica.com/2015/12/antidepressants-the-undead/
12 thoughts
http://www.madinamerica.com/2015/12/researchers-develop-new-model-for-understanding-depression/
42 thoughts on “Researchers Develop New Model for Understanding Depression”
truth on December 12, 2015 at 11:49 am said:
“I get physically sick every time I see another Dr. David Healy article in MIA on the horrors of psychiatric drugs, knowing this “doctor”, highly esteemed and admired,promotes and advocates on behalf of a barbaric assault that is simply causing brain damage.
The Liberty!
Unwarming
Detected
http://amazingbeautifulworld.com/wp-content/uploads/2013/08/10.-Tidal-Waves.jpg
http://www.bmj.com/content/351/bmj.h4320/rapid-responses
Faced with the suicidal events in Study 329, Drs Verdolini and Agius invite readers to consider the underlying neurobiology but their letter has no links to neurobiology whatsoever. It offers a series of claims regularly made by those with a mania for bipolar disorder. There is no link in these claims to biology and it is not clear that there is any clinical footing to the claims either.
For the record, healthy volunteers become suicidal on serotonin reuptake inhibitors. Are all of these bipolar? The rate of suicidal events on SSRIs in non-depressive indications is roughly the same as it is in depression – are these eating disorder and other patients all bipolar?
The rate of suicidal events on anticonvulsant supposed mood stabilizers in clinical trials of bipolar disorder is roughly double the placebo rate in the same trials – the results map onto the rates for suicidal events in antidepressant trials. It goes without saying these suicidal patients actually bipolar but offering this as an explanation would be ridiculous.
The rate of suicidal events in trials of anticonvulsants used for migraine and epilepsy is again similar to that in bipolar disorder trials – what are we to make of this.
What are we to make of the fact that the rate of suicidal events in antipsychotic trials is also roughly similar – regardless of indication?
A much more parsimonious hypothesis is that certain drugs do not suit certain individuals. We have no idea what the biology is in these cases. We do not even know why some patients on SSRIs become intensely nauseated and others do not – a much more common side effect that suicidality. To suggest that we do know what is going on by bringing bipolar disorder into the frame, a disorder whose biology remains quite opaque, is not helpful
Competing interests: As outlined in Restoring Study 329
09 December 2015
David Healy
Professor of Psychiatry
Hergest Unit, Wales LL57 2PW
Click to like:
19
True, certain drugs do not suit certain individuals. All drugs!, not only psychiatric drugs. Psychiatric drugs don’t suit anyone except in the most dire situations and then for only a very short time.
I hope David Healy will contribute an article about genetic glitches on this website and on Mad in America . Until he does – read about about CYP450 and MTHFR. Everyone needs to be aware. Any doctor who writes a prescription without knowing the patient’s CYP450 and MTHFR status is negligent.
Some (very few) psychiatric facilities check CYP450 before they prescribe drugs. http://impact.camhx.ca/en/education-pharmacogenetics
http://www.drlucire.com/adverse-drug-reactions.html
https://www.youtube.com/watch?v=IEoSs6Yo0DA
http://mthfr.net/
Maie
There are stranger things in heaven and earth than were ever dreamt of by FDA or whichever company. Metabolism and Metabolites are important but wouldn’t it be a better idea to ask the person on the pill what is suiting or not – there is no better assay system than asking and listening, and there won’t be a better one for a long time.
David
Doctors don’t ask, they don’t listen, they opine, they hex, and they prescribe.
In psychiatry, if a patient gets worse, the doctors state that the ‘offending’ pharmaceutical is the right one because it unmasked a long-standing mental illness which needs several more pharmaceuticals to bring it under control.
I have no regret ordering genetic testing for my husband and having proof that he could not metabolize any of the drugs the killer cardiologists had given him. He felt worse and worse and worse and more and more and more pharmaceuticals were added – and then they told me he could drop dead any moment.
He’s improved but still in wretched shape. Almost all of the drugs have been removed. I’m watching the two which remain, and supplementing the nutrients which the drugs deplete. So far so good.
That said, even with his lousy genetics (i.e. not born to use pharmaceuticals), he never missed a day of school or work for the first 60 years of his life because of illness. The last ten years have been hell.
I’m all for genetic testing before potentially lethal drugs are given – all psych drugs are potentially lethal.
We agree they don’t listen – the point is that asking and listening if it happened would be so much better than any genetic test
As a psychiatric drug survivor after approximately 75 psychiatric drugs were used to treat my imaginary ‘chemical imbalanced’ brain that my psychiatrist said I had my life has been stolen, robbed, and destroyed by psychiatric addictions, drug induced suicidality resulting in at least 15 suicide attempts (I honestly don’t know how I am alive today – 2 resulted in coma), crippling depressions, mania’s that drove me to become a first rate alcoholic, psychosis, seizures, apathy, anger, rage, violence, and becoming homicidal (this is only a partial list). I am a 59 year old grandmother with 9 grandchildren. I should not know what it feels like to become so homicidal that I sat at my kitchen table planning a massive shooting for over 5 months.
I don’t understand how any of the psychiatric drugs are even legal and we give this to our children, in the millions. This is a crime. Given what I have experienced from decades on these drugs and as I watch at least 4 other family members going through the exact torture and suffering that I have all because they believed their psychiatrist or GP – this is the largest healthcare FRAUD I have ever seen in America. It’s a CRIME against Humanity in the worst way that I have ever witnessed. I am forced to watch my daughter slowly die from taking her ‘cocktail’ of drugs while her small children are being neglected and abused because their Mother can’t function anymore. WOW!
From Annie
I read Buffy…I took on board Buffy…I found examples of Buffy…and, yet, Buffy, has been the most undiscussed underrated underarticled article.
But on Mad in America there was no Talk about Buffy.
Tactical Error 1.
If an article appears from someone you respect do not start arguing with commenter’s.
Tactical Error 2.
Do not keep arguing with commenter’s.
Tactical Error 3.
Always bring the argument back to ‘The Buffy’.
Tactical Error 4.
Aid The Article, Do Not Sabotage It
Witching Psychotic Medications, sorry, Switching Psychotic Medications
A couple of S witchers..
http://switchrx.ca/
http://www.pulsetoday.co.uk/confirmation?rtn=http://www.pulsetoday.co.uk/clinical/mental-health/the-treatment-depression-in-adults/20030651.article
Pulse is probably the widest-read trade mag by GPs – this article (link above) outlines one GPs approach to treating depression – and at a guess is reasonably representative of current practice. It makes depressing reading – not least in citing augmentation therapy with antipsychotics as ‘new’ – which it ain’t. What might be new is that GPs are now doing this – in the past it was the role of secondary services/psychiatrists.
Less depressing are a couple of brilliant below-the line-comments: challenging the impartiality of the evidence cited and the serious dangers of toxic reactions.
As far as the ghastly Eli Lilly booklet for people taking Prozac given above – it reminded me of a comment by a friend, a now retired GP, who said to me recently when I mentioned how sick the SSRIs had made me (amongst other things) ‘Oh yes – we always had to tickle people through the first three weeks’.
And an urgent request: does anyone know where the ‘1 in 4 will suffer from mental illness at some point’ mantra originated? I come across it ALL the time – but have never been able to track down the source..I’d be so grateful if anyone knows.
Forgot to say – thanks for posting David’s (un)rabid response on the BMJ, Annie: ‘a mania for bipolar disorder’ – brilliant.
And – I took a look at the Start app – it looks pretty feeble – hasn’t attracted enough reviews to get rated. It struck me that if it is a Big Pharma initiative – it’s quite weedy. Insidious and dangerous – but weedy. That’s occurred to me before – their social media efforts on Twitter are stunningly boring – and the Wikipedia whitewashing pretty crude (although I would never underestimate the dangers of this – given how many people use W for info about drugs).
Although they have charities and academia well tied up – and manage the cloak of invisibility very well – I don’t think they are all that good at infiltrating other media? I wonder why
Hello, Sally, is this worth pursuing, or, shall we give it a rest…I leave it to the moderator..
Now we know why our gps and psychs were so rude to us…some of this is human nature at its worst.
Not one person discussed Buffy.
Not one person contributed to Antidepressants and the Undead.
Not one person did some research to help the article along.
Not one person saw the message behind the tale.
A private person had all manner of people probing in to his life.
This is almost a parody of how gps and psychs missed the antidepressant lurking in the background.
1 in 4 will have a mental illness at some point in their life……if I read this correctly 1 in 4 have experienced Rx Pills, but, don’t even think about bringing that up….
I have long held the opinion that mia is caught in the trap of who shouts loudest and, personally, I find the authors comments a little indulgent and sometimes spurring on their argument which sometimes is fallacious.
30 thoughts…
UngodlyOutraged on December 17, 2015 at 5:20 am said:
Your psychiatric nurse uniform is extremely triggering. Is it necessary for you to present that image here, where so many have been hurt by your kind?
Ouch, Katie..
T(o)uring Pharmaceuticals..nothing to do with price hike..
http://news.sky.com/story/1607766/drug-tycoon-martin-shkreli-arrested-by-fbi
The thing with antidepressants is you can’t win. If they do help you’re going to be on them forever more and you’ll never know how you would have been if you didn’t take them. If they don’t work or worse still cause you harm you will be on them forever more.
Much the same as this Start app. It doesn’t matter if you’re not alright because this will tell you that you are.
Just keep taking the tablets folks …
http://rxisk.org/
Congratulations RxISK Team, this is a Triumphant Redo…Love the new format and user friendly design…a lot of thought went into this, as usual, from..Rx
45 thoughts on Nothing To Do With “Antidepressants & The Undead”
Where are the moderators? How did this Buffy turn into this Buffy?
45 thoughts on “Antidepressants & The Undead”
BPDTransformation, B.A. on December 17, 2015 at 11:53 pm said:
Just make sure it doesn’t get replaced with this photo of Nurse Ratchet, Katie:
https://www.pinterest.com/pin/338332990728016356/
Not sure culling the comments did enough to address the damage..but, better late than never..
38 thoughts on Nothing To Do With “Antidepressants & the Undead”
38 thoughts on “Antidepressants & The Undead”
Grand total was 47 – 38 = 9 published/retracted
Anyway, they have moved on…
Annie, you picked some interesting cherries for your scathing report–
I was not offended by the psych nurse bashing comments you picked to share, or the first commenter who bashed Dr. Healy. I responded respectfully to what was shared in earnest by people who have been harmed by the profession I am no longer a member of.
I did not request moderation, and do not agree with the decision to remove any of the comments. Consistent with the kind of psych nurse I *was*, I abhor oppression, discrimination and most of all , negating the inherent value of each and every unique individual via authoritarian posturing– as it was displayed by MIA’s moderator and you here on this very lightly moderated site.
I wonder why the same traits and tactics that continue to cause harm for so many vulnerable people who are imprisoned on psych wards and by the MH system, appear in the places created for finding solutions and supporting the survivors of a heinously misguided *medical* specialty.
RE: AllTrials– and comments I have wanted to post here, but was distracted by a very compelling discussion on MIA. You recently re-posted a donation campaign for AllTrials– . With all due respects,I would caution you NOT to count your chickens, Annie–. Individuals who have both knowledge and position to confront and propose to constrain the corrupt practice of Big Pharma, should also have the personal commitment to addressing threats to public( as in health care consumers) safety — without hawking public donations. Recent example set by the first RIAT team effort speaks volumes on this concept–.
Up next……GSK/ you tube/ link
GSK @GSK Dec 18
Here’s David Redfern explaining today’s HIV announcement: http://gsk.to/1UI44A9
My PC comes up with a huge list of Up Next….and not all complimentary
This is an interesting clip:
GSK and their App..6.16
https://www.youtube.com/watch?v=TU52Y1_8I4U
There’s another work of Joss Wedhon’s that ever since I watched it I’ve thought it was meant as a reference to our societies quest to treat people to happiness. It is in his movie “Serenity”
There’s a group of people in it he calls the Reavers and their origins sound scarily similar to the utopia promised by just the right drug. But it goes horribly wrong. Here’s a summary but I encourage you to watch it because I think it is a great movie.
http://firefly.wikia.com/wiki/Reaver
There are a number of comments on this post that seem to have gone missing from Sandra Villareal and Annie.
Over on Mad in America the post had 55 comments with some removed by the moderator before the thread was closed. See
http://www.madinamerica.com/2015/12/antidepressants-the-undead/#comment-80191
These – as the missing comment from Annie says – left the topic of Buffy and what the Iodine App was all about and followed a line introduced by BPD transformation that this Healy dude is the biggest promoter of ECT in the universe.
The comments followed the comments on Shock, Mutilate and Poison: the Medical Mission from August 10 – https://davidhealy.org/?s=shock+mutilate+and+poison – with some of the same people anti ECT commenting (incognito).
1. Interestingly the thread was stimulated by BPD Transformation offering a link to a 2012 article by Peter Breggin claiming H was the biggest promoter of ECT in the universe.
There was no effort by PB in 2012 or BPD Transformation or most of the others in the recent series to establish any facts. Invitations re read more – the Shock Mutilate and Poison column – were met with claims that it was too nauseating. When Katie Higgins posted and her photo showed her in a nurses uniform, there were comments that this was provocative – a reminder of past trauma.
Its not my intention here to denigrate – the same person who was anti-uniform later made a penetrating comment that part of the problem is that everybody wants to hang on to their bit of the truth and this means everyone ends up on their own desert island without the chance to make a difference – at least this is how I read it.
2. There was the usual point made – on the basis of Peter Breggin finding a quote from Max Fink in the early 1960s that ECT consisted of inflicted head injury.
This is wrong. The original Fink comment was referring to the EEG profile of ECT immediately after a treatment – where like head injury it showed an organic effect. Different head injuries show different EEG tracings but all show an organic signature. He could have compared it to drug effects which all show organic signatures also.
At the time Fink had little interest in ECT – his research was on EEGs. He later became interested when ECT was under threat and became an advocate, insisting in particular on informed consent. He is the only person I know of who has produced evidence on cognitive tests of cognitive changes (adverse effects) that endure six months after treatment.
But he is still a proponent of ECT. The way the comments on MIA have gone, its likely that some would figure the only possible explanation for this is that Fink was making money out of doing ECT and the harms being done to his patients count less than keeping his wallet flush.
3. The names of John Read and Richard Bentall were invoked. I know both. I presented the fact that my job – any medics job – was to shock, mutilate and poison at an ISEPP meeting in Nov 2014. The guts of the talk were put up on RxISK – Die RxISKing it (1) and (2). John Read was in the audience. I’ve been in not infrequent contact with Richard since.
The fact that we haven’t come to blows doesn’t mean they agree with me or vice versa. I think there are reasons why their review comes to the conclusion it does. Their approach to the issues is partial rather than comprehensive – this doesn’t make it wrong. But it does mean taking the approach they took several major studies were left out of the reckoning and the book isn’t closed on these matters.
4. There were comments that H even seems to believe in the medical model – no one who believes in the MM should be allowed on here. The problems that survivors have were problems of living to begin with and their main problem now stems from having been fed into the medical mangle.
Its quite possible that the original problems of those who are most passionate now were problems of living and that their major problems now stem from having been mangled.
But this is not an argument against the medical model or ECT.
As outlined in shock, mutilate and poison – if this is what doctors do, it is important that it gets restricted to people who have conditions where there is a real possibility of benefit to weigh against the inevitable harms of treatment.
It is over fifty years since antipsychiatry took shape and the first protests against the harms of physical treatments took shape. Fifty years of rejecting the medical model later, those anti treatment have made little – perhaps no – progress. More people than ever are being treated.
Perhaps its time to stop banging heads against walls and to get clever and explore the possibilities of embracing the medical model.
5. One item that was new for me did come out of comments on MIA. Johanna Ryan raised the possibility that the use of ECT is increasing in frequency in the US, while it is declining in the UK, because the structure of healthcare reimbursement mandates procedures rather than medicines.
This is a perverse development.
Its the kind of development that you’d expect of the kind of Shape-Shifting Demon that Buffy spent her time battling – sometimes it adopts the shape of ECT, sometimes medication and sometimes even psychotherapy.
We all have a stake in finding this Demon’s weak point and doing whatever it is you might do with a stake.
DH
Dr. Healy,
You surely lost me there on your last comment. The only thing I understood was let’s hunt for demons.
RB/A clue is in the parrot….
GSK Retweeted
Sense About Science @senseaboutsci Dec 22
Dear PharmaChristmas This year we want all clinical trials REGISTERED and results REPORTED From everyone #AllTrials
#alltrials are invading the animal kingdom with parrots on their shoulder..
http://www.alltrials.net/news/why-alltrials-matters-to-vets/
I think the Demon that David’s talking about is whatever force subverts health care so that instead of the system serving patients, the patients must serve it. Psychiatry is probably a better “host” for this demon than some other fields, because it promises to answer big questions about what sort of people we ought to be, and whose fault it is when we fail.
Whatever it is, it’s not a scientific force — so you can’t expect to prove that either “biological” theories or “environmental” theories are the problem (or the solution). A lot of the brutality in 20th century psychiatry was justified by “environmental” theories, from Freudian determinism to behavior modification. We’re rapidly catching up in the 21st century, under “biological” banners.
I’ve no idea how to kill the Demon, and have found only a few rules for spotting it. One is to follow the money, of course. As long as you can make a nice buck on a treatment, that treatment will tend to spread. And the best way to launch a new treatment is to convince the powers that be that it’s a more “cost-effective” way to deal with problematic people than the old methods.
The other rule is this: Does your new theory effectively let the larger society, the powers-that-be, etc. off the hook for major problems? If rebels are rebels because they’re mad; if violence is caused by the individual mental illnesses of the perpetrators and/or victims; if folks on government relief are victims of their flawed brain chemistry or culturally-reinforced bad parenting — that’s when psychiatry really has a wonderful product to sell.
For quite awhile, well-meaning folks in NAMI and similar groups have been trying to train police to handle confrontations with the “mentally ill” with more skill and less violence. Suddenly in Chicago, you can see Mayor Emanuel and other politicians latching onto these programs like drowning men clutching at life-rafts. (Both they and NAMI shamefully embraced this “solution” to the tragic death of a young man allegedly high on PCP and charging the cops with a knife. Until the video showed that Laquan McDonald hadn’t charged anyone, but was walking away when he was shot to death.)
It sounds so great! Our cops aren’t brutal, or heaven forbid racist. They just lack the advanced professional skills needed to deal optimally with the increasing numbers of “mentally ill” out there disturbing the peace. Why aren’t agitated young college boys being shot to death in the North Shore suburbs, then? Don’t ask … or if you do, maybe you can show us that the poor are more likely to be mentally ill to begin with. Gosh. Maybe that’s why they’re poor to begin with, and why they have more “confrontations” with the police.