Disucussion for September 11 session - click "Edit" to add your notes/questions, then "Save":

Todd's questions

Fuller Torrey's Nowhere to Go:

• How does the story of deinstitutionalization reflect the importance of universities? Have universities acted responsibly given their power and influence?

• The abandonment of state hospital care for the mentally ill contrasts with another approach that might have been taken - putting more resources into state hospitals. Why was the approach chosen (CMHCs) such a radical departure from what had come before? Does this reflect any tendencies in academia?

• "In retrospect, one wonders where public officials, builders, and psychiatric professionals thought the individuals who had been living in the housing units being demolished were going to go." (p. 142) - Why do you think so little consideration was paid to this question? Are there lessons in this for universities?

• Torrey writes at length about the maldistribution of psychiatrists both geographically and in terms of the patient populations they treat. How did this happen? What is the role of universities in this?
  • Response by Dave: In placing the attention on prevention, Caplan effectively took emphasis (and thus, resources and prestige) away from treatment. In other words, the most rewarding population to work with was no longer the institutionalized, but the mentally well. As Torrey notes on p. 168, “by 1980 mental health professionals were concentrated in areas of the United States with ‘higher income…and more insurance availability’” (168). This focus on money, I would guess, is a result of the privatization of healthcare and the rise of the HMO in the 1960’s. This transformed medicine into a business in which doctors stood to make more money in communities in which they could charge their patients more money. The consequence of this was the noted migration to more affluent areas. As experts in their fields, professors of medicine should done more to reverse with evidence (something it seems Caplan was without) the impact Caplan’s book had on the public. Also, they should have foreseen the shift the rise of the HMO would have on medicine. In short, they seem to have failed as society’s censor of it’s actions.

Barbara Ehrenreich's "The High Cost of Being Poor":

• Ehrenreich describes several examples of what might be called regressive private-sector taxation on poor people. How did this situation arise?

Albert Camarillo's "Reflections of a Historian Teaching a Service-Learning Course About Poverty and Homelessness in America":

• Camarillo identifies "three distinct motivations for service -- charity, project, and social change" (p. 111). The work we did at Glide was, at best, charity, whereas his course is more at the project level. What is required for a social change approach?

Bjorn Johnson's "SHAC" (note: SHAC was the organization under whose section this appeared in the Stanford Disorientation Guide in 1997):

• Assuming Johnson's characterization is accurate, why do you think Stanford did not help the people displaced by the Sand Hill developments?

Palo Alto Weekly editorial, "Who Are the Homeless?":

• Why is the homeless population an older one?

• Why do homeless people in palo alto have so many illnesses?

• Why is it important that, in Donald Barr's words, "This is not a migratory crowd"?

Tom's questions

• Why is the excerpt from Nowhere to Go by Fuller Torrey included in the readings on homelessness?

• Given the dismal track record of the psychiatrists and psychologists that Torrey recounts, is it really a problem that 'private practice is grossly maldistributed geographically, unavailable to minority group members or the poor, and not aimed toward the high-risk groups who need the care most' (p. 170)?

• Camarillo's article raises the question of how far teachers should go in advocating social change. Is it inappropriate -- or even unethical -- for professors to bring their personal political views into their teaching?

• In the readings and discussion on inequality last Friday, a distinction was repeatedly made between income and wealth. Ehrenreich's article demonstrates the importance of making this distinction in understanding the problem of poverty in America. How?

• Why did the Palo Alto City Council outlaw sitting and lying on downtown sidewalks? Why did SHAC (and many others) oppose the ordinance? Why did the Palo Alto Weekly bring up the ordinance in connection with the Opportunity Center?

• Homeless advocates often have to argue against the claim that providing more services for the homeless will have a 'magnet' effect -- that is, will attract homeless people from other communities. Studies that have been done on this (such as the one reported on in the Weekly article) have found no evidence for such an effect. Why wouldn't homeless people move to the community with the best services?

Campus Climate Change Campaign

*In the spirit of universities working for the public good, check out the Stanford Climate Change Campaign website: http://sustainability.stanford.edu/climatecrew/Stanford%20Climate%20Crew/Welcome.html

This is a student effort to get Stanford University to lead in environmental sustainability efforts. This is an issue Stanford, as a citizen of the global community, should be championing. Read our report on the Climate Crew homepage for more information.

We met with Hennessey in June, and his response was initially enthusiastic but followed up with this entirely unhelpful email: "I enjoyed our discussion regarding the possibilities Stanford might consider to address the greenhouse gas issue. Clearly, this matter will require thorough examination, which will take time."

Let's change this!

Inconvenient Truth/General Life Q

*A bunch of us went to see An Inconvenient Truth, which makes a remarkably strong case for the reality and severity of global warming. One of the side effects of global warming is that storms will become stronger, as in the case of Hurricane Katrina.

My question: Katrina didn't galvanize a second war on poverty, or a serious effort to address global warming. If neither the destruction of an American city nor a plethora of scary scientific evidence can motivate the public, what exactly does it take to motivate social change? (Josie)

Al Gore mentioned that people often go to quickly from denial (of problems) to despair. How do politicians, universities, and other people contribute to this rapid descent into despair. What are some compelling methods to instigate more action? (Diana)

Student Questions

In the editorial, "Who are the Homeless" Dr. Barr states, "We hope those who remain fearful will take a closer look at the facts of who the homeless really are and where they truly come from. Be watchful and critical, but base concerns on facts and experience, not fear and stereotypes." Can you relate this statement to our experience at Glide Memorial Church. Further, suppose we are talking about a homeless person or someone who is addicted to drugs. Should we aid these people (give money to panhandlers) or condemn their actions?

Danny

Why does Don Barr highlight the non-migratory status of many of the Midpeninsula's homeless?

In Al Camarillo's class on homelessness and poverty, the idea of an immersive experience for Stanford students, like the one that Barbara Ehrenreich experienced in Nickeled and Dimed, came up on numerous occasions. What do you think are the potential benefits and pitfalls for students, the community in which they would be immersed, and the issues of poverty and homelessness at large?

Ashley

I may be opening up a can of worms with this comment/question by inciting a discussion that may branch off from the readings, but I still feel it is important raise. Today’s topic is on “Homelessness and Poverty,” and I think it is therefore necessary to bring up global poverty to shed some perspective on the local poverty discussed in the readings. By no means am I about to suggest that we neglect the poor and homeless in our local communities, but I bring up the following statistics just to provoke thought about where some of the priorities of university aid could/should be shifted:

“More than one billion people in the world live on less than one dollar a day. In total, 2.7 billion struggle to survive on less than two dollars per day. Poverty in the developing world, however, goes far beyond income poverty. It means having to walk more than one mile everyday simply to collect water and firewood; it means suffering diseases that were eradicated from rich countries decades ago. Every year eleven million children die-most under the age of five and more than six million from completely preventable causes like malaria, diarrhea and pneumonia.”

-For more: http://www.earthinstitute.columbia.edu/endofpoverty/oda.html

What responsibility might American universities have to communities (with HUGE needs) beyond their borders, particularly in the developing world? It seems unfair that the communities that so happen to be located by universities receive major/disproportionate benefits, while the remaining communities (including American ones) are generally neglected. Thoughts?

Nabill

In "The High Cost of Being Poor", Ehrenreich suggests that not treating a medical condition soon enough (in the interest of saving money) could potentially lead up to a "$100,000 problem on your hands." Does this justify free health care, so that those who cannot afford the otherwise pricey costs of medical treatments can do so, and not fear not being able to pay for their other basic needs?

President John F. Kennedy sought to "encourage the development of comprehensive community mental health centers 'which will return mental health to the mainstream'" (Torry 113). Is the unification of mental and physical (the "mainstream") treatment a good thing? Why do you think there has been such a division of treating physical and mental problems in the West, whereas many Eastern cultures have a history of a more holistic approach to health? Lastly, how do you feel the former approach affects the way mentally-ill poor people in our society are treated?