The American Psychiatric Association noted that police are also more likely to use excessive force when they interact with unhoused people with mental illness. Even when “well-intentioned law enforcement responders” respond to calls for help, according to the Substance Abuse and Mental Health Services Administration, the situations often escalate due to “the presence of police vehicles and armed officers that generate anxiety.”

More than one-fifth of people experiencing homelessness currently have a serious mental illness like bipolar disorder or schizophrenia, and the US Department of Justice has found that “the prevalence of unmet behavioral health needs” is a key driver in why “people who experience homelessness tend to have frequent (and often repeat) interactions with law enforcement.”

The prefrontal leukotomy procedure developed by Moniz and Lima was modified in 1936 by American neurologists Walter J. Freeman II and James W. Watts. Freeman preferred the use of the term lobotomy and therefore renamed the procedure “prefrontal lobotomy.” The American team soon developed the Freeman-Watts standard lobotomy, which laid out an exact protocol for how a leukotome (in this case, a spatula) was to be inserted and manipulated during the surgery. Get a Britannica Premium subscription and gain access to exclusive content. Subscribe Now lobotomyThe use of lobotomy in the United States was resisted and criticized heavily by American neurosurgeons. However, because Freeman managed to promote the success of the surgery through the media, lobotomy became touted as a miracle procedure, capturing the attention of the public and leading to an overwhelming demand for the operation. In 1945 Freeman streamlined the procedure, replacing it with transorbital lobotomy, in which a picklike instrument was forced through the back of the eye sockets to pierce the thin bone that separates the eye sockets from the frontal lobes. The pick’s point was then inserted into the frontal lobe and used to sever connections in the brain (presumably between the prefrontal cortex and thalamus). In 1946 Freeman performed this procedure for the first time on a patient, who was subdued prior to the operation with electroshock treatment.The transorbital lobotomy procedure, which Freeman performed very quickly, sometimes in less than 10 minutes, was used on many patients with relatively minor mental disorders that Freeman believed did not warrant traditional lobotomy surgery, in which the skull itself was opened. A large proportion of such lobotomized patients exhibited reduced tension or agitation, but many also showed other effects, such as apathy, passivity, lack of initiative, poor ability to concentrate, and a generally decreased depth and intensity of their emotional response to life. Some died as a result of the procedure. However, those effects were not widely reported in the 1940s, and at that time the long-term effects were largely unknown. Because the procedure met with seemingly widespread success, Moniz was awarded the 1949 Nobel Prize for Physiology or Medicine (along with Swiss physiologist Walter Rudolf Hess). Lobotomies were performed on a wide scale during the 1940s; Freeman himself performed or supervised more than 3,500 lobotomies by the late 1960s. The practice gradually fell out of favour beginning in the mid-1950s, when antipsychotics, antidepressants, and other medications that were much more effective in treating and alleviating the distress of mentally disturbed patients came into use. Today lobotomy is rarely performed; however, shock therapy and psychosurgery (the surgical removal of specific regions of the brain) occasionally are used to treat patients whose symptoms have resisted all other treatments.

numerous non-human species suffer from psychiatric symptoms. Birds obsess; horses on occasion get pathologically compulsive; dolphins and whales—especially those in captivity—self-mutilate. And that thing when your dog woefully watches you pull out of the driveway from the window—that might be DSM-certified separation anxiety. "Every animal with a mind has the capacity to lose hold of it from time to time" wrote science historian and author Dr. Laurel Braitman in "Animal Madness

When a former psychiatric patient killed two people on the streets of Chapel Hill, North Carolina, and then sued the psychiatrist who had treated him for failing to prevent the murders, the mental health world dismissed the suit as frivolous. But when a jury agreed with the killer and awarded him $500,000 in damages, bewilderment was the order of the day (1). Can it be true, psychiatrists asked, that murder pays—as long as you can blame your psychiatrist for your deed?

After diagnosis, 40 percent of cancer patients report developing significant distress that can include serious worry, panic attacks, depression, and PTSD, or posttraumatic stress disorder

200,000 autistic teenagers set to come of age in the United States ove

Opening the workplace to people with autism could harness their sometimes-unusual talents, advocates say, while decreasing costs to families and taxpayers for daytime aides and health care and housing subsidies, estimated at more than $1 million over an adult lifetime.

“There’s a prevailing philosophy that certain people can never function in the community,” Ms. Stanton-Paule told skeptics. “I just don’t think that’s true.”

but only through a generalized approach, hitting the entire brain. ("Carpet-bombing," one neuroscientist calls it.) And the 50 percent success rate of antidepressant drugs suggests that they aren't hitting depression's central mechanism. The network approach, on the other hand, focuses on specific nodes, pathways and gateways that might be approached with various treatments — electrical, surgical or pharmacological. This small trial appears to confirm this model so emphatically that it's already changing the neuropsychiatric view of the brain and the direction of research.

"So we turn it on," Mayberg told me later, "and all of a sudden she says to me, 'It's very strange,' she says, 'I know you've been with me in the operating room this whole time. I know you care about me. But it's not that. I don't know what you just did. But I'm looking at you, and it's like I just feel suddenly more connected to you.' " Mayberg, stunned, signaled with her hand to the others, out of Deanna's view, to turn the stimulator off. "And they turn it off," Mayberg said, "and she goes: 'God, it's just so odd. You just went away again. I guess it wasn't really anything.'

"These soldiers get sent away for six months, they come back and all they want to do is return to their old home. But their old home isn't there, because everybody's changed. It takes some tough rearranging sometimes."

We might even stop indulging the romantic notion of depression as intrinsic to one's identity.

Most people think of depression as a deficit state," Mayberg says. "You're low, you're negative. But in fact, talk to a depressed person, and you have this bizarre combination of numbness and what William James called 'an active anguish.' 'A sort of psychical neuralgia,'

(Or, using another metaphor, if the brain is an orchestra, then the neurochemical approach focuses on how well individual players listen and respond to the players adjacent to them; the network approach, like a conductor, focuses on how the orchestra's sections — strings, winds, brass, etc. — coordinate and balance volume and tone. When both are working well, you've got music.)

“Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to get them to leave the country.”

And then when I had finished the Coke, they said, “Okay, now we have the final parts of the ritual. First you have to put your hands by your sides and stand very straight and very erect.” And I said, “Okay,” and then they tied me up with the intestines of the ram. In the meanwhile its body was hanging from a nearby tree, and someone was doing some butchering of it, and they took various little bits of it out. And then I had to kind of shuffle over, all tied up in intestines, which most of you probably haven’t done, but it’s hard.

“Williams have great interest but little competence. But what about a person who has competence but no warmth, desire or empathy? That’s a sociopath. Sociopaths have great theory of mind. But they couldn’t care less.”

the primacy of such circuits suggests that human sociability rises from evolutionarily reinforced mechanisms — a raw yearning to connect; fearfulness — that are so basic they’re easy to undervalue.

Williams research and the social-brain thesis is whether our social behavior is ultimately driven more by the urge to connect or the urge to manipulate the connection.

In most mammals the neocortex accounts for 30 percent to 40 percent of brain volume. In the highly social primates it occupies about 50 percent to 65 percent. In humans, it’s 80 percent.

According to the social-brain theory, it was this need to understand social dynamics — not the need to find food or navigate terrain — that spurred and rewarded the evolution of bigger and bigger primate brains.

The theory, called the Machiavellian-intelligence or social-brain theory, holds that we rise from a lineage in which both individual and group success hinge on balancing the need to work with others with the need to hold our own — or better — amid the nested groups and subgroups we are part of.

The dorsal areas play a strong role in vision and space and help us recognize other peoples’ intentions; ventral areas figure heavily in language, processing sounds, facial recognition, emotion, music enjoyment and social drive. In an embryo’s first weeks, Galaburda says, patterning genes normally moderate “a sort of turf war going on between these two areas,” with each trying to expand. The results help determine our relative strengths in these areas. We see them in our S.A.T.

Here they had these great cognitive deficits. Yet they spoke with the most ardent and delightful animation and color.”

people with Williams can have trouble deepening relationships. This saddens and frustrates them. They know no strangers but can claim few friends.

Many with Williams have so vague a concept of space, for instance, that even as adults they will fail at six-piece jigsaw puzzles, easily get lost, draw like a preschooler and struggle to replicate a simple T or X shape built with a half-dozen building blocks.

They told the group of the genetic accident underlying Williams, the heart and vascular problems that eventually kill many who have it, their intense enjoyment of talk, music and story, their frustration in trying to make friends, the slights and cruelties they suffered growing up, their difficulty understanding the world. When they finished, most of the bikers were in tears.

number of psychopathic attributes were actually more common in business leaders than in so-called disturbed criminals—attributes such as superficial charm, egocentricity, persuasiveness, lack of empathy, independence, and focus.

Psychopaths, without batting an eye, are perfectly happy to chuck the fat guy over the side.

More than 70 percent of those who scored high on the Self-Report Psychopathy Scale correctly picked out the handkerchief-smuggling associate, compared with just 30 percent of the low scorers. Zeroing in on weakness may well be part of a serial killer's tool kit. But it may also come in handy at the airport.

detractors

recalcitrance

Such a profile allows those who present with these traits to do what they like when they like, completely unfazed by the social, moral or legal consequences of their actions.