Comment by javajosh | Hacker News Reader

Comment by javajosh | Hacker News Reader

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Does anyone know a) how often this sort of pattern presented itself historically, and b) what people did back in the good old days? For example, what would a small rural town have done to support someone like Michael? Would they have treated him somehow? Would they have assumed he was possessed by a demon and tried an exorcism? Or would they have found a way to get rid of him in a hunting accident, and had a dirty little town-wide secret? Or what? It's a really hard problem, obviously, and history might at least give us some ideas (possibly some very bad ones, granted).

Of course, since his outbursts are so episodic, it would be interesting to consider installing some sort of drug system in the kid, remote-controlled that either knocks him out or just sedates him when he gets belligerent, similar to how diabetics have insulin dispensers. It would be interesting to see if his "sweet, sunny" self would accept this leash on his evil twin, or even the particularly interesting possibility that he can be taught to observe the episode and trigger the device himself. It would also, of course, be interesting to get an fMRI of his brain before and after an episode - he could advance our knowledge of the biological basis of rage and hatred. Heck, if he's really that smart he'd probably do well to consider a neuroscience track so he can study himself, eventually.

> Of course, since his outbursts are so episodic,

My suspicion is that they very specifically aren't episodic - lots of kids with this style of behavior problem are excellent manipulators. You can't discount the possibility that he's behaving well and poorly in order to extract what he wants out of other people.

That doesn't sound consistent with the article at all. I mean, the kid seems to have uncontrolled outbursts which don't sound manipulative to me. I mean, he didn't want to go to the mental hospital but he repeated the behavior he knew would get him there. Perhaps it was a gamble to see if his mom would keep her word, but the way the article is written, it doesn't sound like that.

Outbursts can, from what i've seen, be a final attempt to manipulate somebody. If every time you bring up death/suicide, and you get what you want, well then... why wouldn't that child try that technique again.

Well, I can imagine as humans evolved and were still quite tribal, this sort of anti-social behavior simply wouldn't be tolerated. If one was a threat to the tribe's safety and didn't fit in the social order, they were culled our ejected and eventually unable to survive on their own.

I hope that clockwork-orange style behavior modification or remote "kill switches" in people are never socially acceptable answers to this problem :(

That seems like the most humane way to go. I don't see anyone else in this thread doing anything more than throwing their hands up in the air saying that it's a problem too difficult to solve, including you. So, rather than poo-poo my ideas, how about offering up your own?

You're right that there are no easy answers, especially for the mentally ill who may not be treatable. [Note: I come from NZ, so the perspective of a largely state-run health system].

I think that humane mental institutions would be a much better alternative to prison or surgical intervention.

A lot of people were locked up in mental institutions right up until the late 80s, early 90s. Often, people who should not have really been in them. I know people who were seriously fried by drugs administered largely to induce docility, and the brutal ECT of 50s-70s.

There were some serious problems with the way these institutions were run which were very difficult to fix. The pendulum has swung towards community care. In NZ at least, most of the mental hospitals have closed. The mentally ill were flooded back into the community. To be fair, the problems with the system were so severe that this was not an entirely bad outcome. Many have done well in the community.

From here we can divide the mentally ill into two classes: those who manage to function in the community, and those who end up in prison or dead. Sometimes it's the degree of social support they have which makes the difference, while some simply cannot be treated.

I think the pendulum needs to swing the other way a little. We need to identify the truly dangerous and incurable and care for them in humane environments before they hurt themselves or others.

Identifying when this needs to be done and ensuring the system works properly is obviously an incredibly difficult problem. Essentially you will be locking people up based on psychiatric diagnoses for things they haven't done yet. However in the current scheme of things even clear pleas from family members for intervention are ignored.

As an aside, I'd like to point out that you're proposing to take people who might be psychotic or schizophrenic, and implant remote control devices in them.

>As an aside, I'd like to point out that you're proposing to take people who might be psychotic or schizophrenic, and implant remote control devices in them.

A Kiwi, great. I've travelled fairly extensively through that part of the world, and it is a beautiful place - minus the sand flies, of course.

I think it is a good instinct to be wary of new ideas, but not good to dismiss them out of hand. One of the things I liked about the Kiwi culture is the can-do attitude. People are happy to try things for the first time, and maybe fail, but somehow the culture gives people a rush of success. It's a unique and great feature of the society.

And it's that attitude of empiricism that we've somehow lost. We don't see political or social solutions as experiments we see them as set-in-stone moral mandates. Remote medication may be a terrible idea, but we don't know. It certainly leaves a bad taste in my mouth - but frankly, it's a better taste than the one left by the OP's heart-wrenching article. The possibility that the boy could be given the remote himself is a hopeful one, similar to how diabetics or even epileptics can learn to see danger coming and take steps to prevent it.

And the "bright side" to this, if it worked, is huge. This person could be a real part of society, living as happy a life as any of us, rather than living out his life locked in an institution. Permanent institutionalization is societies way to kill someone without actually killing them.

In other words, I feel that this solution could be more humane, far more humane, than life-long incarceration in a mental institution, and it's an experiment that is worth trying.

(Of course, I'm assuming that life in a mental institution is pretty terrible, which I suppose is not really a given. If I could be convinced that such a life is actually worth living, then no, I probably wouldn't pursue such a questionable alternative.)

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