“Men do not think they know a thing till they have grasped the “why” of it (which is to grasp its primary cause).  Aristotle’s Physica, Book II.  This is the opening quote to a chapter titled “Causes” in Policy Paradox, one of our textbooks for this class.  What an appropriate quote to begin this chapter.  The text discusses the framework for (yes, you guessed it) causes as a way of identifying the source of blame for a problem.  In this chapter the author explains four different types of causal theories.  She describes these in a quadrant-like grid using “actions” and “consequences” as the variables.  I will briefly explain the four here.

In the words of Stone,

Unguided (actions) and Intended (consequences) leads to a Mechanical Cause:

–       Machines that perform as designed, but cause harm

–       Rigid bureaucratic routines

Unguided (actions) and Unintended (consequences) leads to an Accidental Cause:

–       Natural disasters, fate, bad luck

Guided (actions) and Intended (consequences) leads to an Intentional Cause:

–       Oppression, Conspiracies, harmful side effects that are known, but ignored.

Guided (actions) and Unintended (consequences) leads to an Inadvertent Cause:

–       Unanticipated harmful side effects of policy, avoidable ignorance, carelessness.

I read the article the other week that I included in this post and believe it appropriately enhances the concepts of Stone’s chapter.

Was the intent of closing mental health hospitals in the 1970’s to fill the prisons with its ex-patients?  I don’t think so.  What was the purpose of this action?  My guess is that it was to “cut costs.” Right?  Unfortunately, it seems this decision had an unintended consequence.   An excerpt from the article:

“Ms. Barr is currently representing a man charged with jumping a subway turnstile, denying the city $1.50. The prosecution’s deal? One year in prison. This would cost the state $69,000 for his incarceration. This is clearly not a rational way to deal with the cost to society of a jumped turnstile.”

I would prefer to think this policy decision is an inadvertent cause over an intentional cause.  However, what doesn’t make sense to me is the idea of where were these patients suppose to go if they no longer had the hospital as an option?  “Outside of prison, there are essentially no services for the mentally ill” explains Barr, an advocate for the mentally ill in New York City.  If treatment options for the mentally ill are cut, what do we expect these people to do?

The article does a great job painting the picture of unintended consequences for the mentally ill and society alike.  If overcrowded prisons were an unintended consequence to cutting the resources for the mentally ill, how can policies be re-vamped to address this error that could have been avoided to begin with?


One thought on “Causes

  1. The deinstitutionalization of the mentally ill was “supposed” to shift the responsibility to the community. The community was “supposed” to design resources like group homes to offer a less restrictive environment to individuals suffering from mental illness. Our society is “supposed to do many things”, but we constantly fall short on our responsibilities. So, our penal system picked up the slack. What were they “supposed” to do? Yes, we already have a lack of resources for mental health. What will occur if we cut funding more? Hmmm, I wonder what we are “supposed” to do.

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