Welfare Reform
Editor: Carolyn Colvin, secretary of human resources, must be highly commended for her ideas. Welfare is like the weather -- everyone complains about it without trying to deal with it. The way welfare has been traditionally administered is to hand out the money; that's the cheapest way -- no counseling, no accountability, no follow-up.
There is no money for these three necessities if the people on the rolls might escape this generational trap. It is not popular to vote for more money for welfare; prevention or correction are not considered. Adequate pre-school child care and training for jobs are some of the answers to diminish the rolls and give participants a chance for self-reliance.
Ms. Colvin's ideas are basic, realistic and should be tried. But it will take more education of the public to understand what is needed.
Lucretia B. Fisher.
Baltimore.
Gun Deaths
Editor: I was disturbed by Abraham Tennenbaum's proposal in "Handguns Could Help" that we should "encourage honest citizens to carry and use guns."
He argues that such a policy could reduce the frequency and severity of situations such as the recent tragedy at Luby's Cafeteria. Conspicuously absent from his logic, however, is the anticipated effect of such a policy on overall firearm deaths. Where are the data to support this Rambo policy?
In 1987, 3,392 children aged 1-19 died from firearm-related injuries and violence, or 11 percent of all deaths for this age group, according to the U.S. Department of Health and Human (( Services. For children aged 1-9, approximately one-half of these deaths were unintentional.
Likewise, from 1933 until 1982, over 10 percent of all firearm deaths were unintentional, the Journal of Trauma estimates.
Does Mr. Tennenbaum believe that the proliferation of handguns would decrease these numbers?
Would his policy lead to enough heroic shoot-outs to justify these kinds of statics?
How many unintentional deaths, suicides and impetuous killings would this proliferation generate?
Charles B. Reuland.
Baltimore.
Camden Beacon
Editor: While riding with my daughter on a recent night, I noticed the lights on at the new Oriole Park at Camden Yards. We thought this was great! Brilliant beacons that can been seen for miles!
I did not recall that the MVP award was being announced that night, so we simply drove to the stadium hoping to get a glimpse of the progress. Instead we were surprised to learn Cal Ripken was coming. Naturally, we waited. Soon there were about 60 of us gathered on the access road along Russell Street.
Cal was gracious as ever, waving to the crowd and holding his daughter. But the highlight of the evening came when Orioles officials decided to let those of us outside come inside the park. ++ It was a wonderful gesture, not to mention the thrill of being among the first to see how the stadium really looks.
Thanks to the Orioles who appear to be going out of their way for public favor -- the new team logo (with Baltimore in it) for example. It was a night both of us will savor the rest of our lives.
Bob Costantini.
Washington.
Dignity of Choice
Editor: The members of the Alliance for the Mentally Ill of Maryland are pleased that The Sun is publicizing the plight of people with mental illness who reside in one of Maryland's state hospitals. Much of what Suzanne Wooton reported is not so much the particular problem of the Spring Grove institution as it is the harsh reality of mental illness itself.
Families of people with mental illness have come to some conclusions on what is needed. Continuity of care helps. So does a good community support system. These are best realized by treating patients in a location as close as possible to the
bTC place they will live upon leaving the hospital. In probably 80 percent of cases, that will be with the patient's family. Warehousing is more likely when geographic distance excludes family participation in the treatment process.
Sad to say, Spring Grove is not the place that the "forgotten of society" wind up. They end up on the streets or in our jails and prisons. Treatment at Spring Grove, meager as it may be, is more humane than those alternatives.
As your editorial points out, a lot of money is necessary to manage a gentler treatment system. The person who has the illness is unlikely to have necessary financial resources. Thus mental illness becomes a state responsibility. The Maryland alliance has proposed a legislative bill that would forbid health insurance discrimination against mental illnesses. It would go a long way to relieve financial pressures. And it would give many more of those who have a mental illness the dignity of choice of where to seek treatment.
Elsie Roberts.
Baltimore.
The writer is president of the Alliance for the Mentally Ill of Maryland, Inc.
Prozac: When Sadness is Not Depression
Editor: Diane Oklata Wood's recent Opinion * Commentary piece, "If Hamlet Had Prozac," makes it obvious that she has never suffered from depression.
Had she any experience at all with depression, Wood would know that it's more complex than just feeling sad or having strong feelings.
Your feelings are completely out of sync with what is happening to you when you are depressed. Your feelings are so strong that you can't function and you are a menace to yourself and everyone around you.
You don't want to feel the way you do, but you are helpless to control it. That's what depression was like for me; I suffered with it for almost 40 years.
Prozac is not a feel-good drug. To compare Prozac (a drug that can help you gain control) to marijuana (a drug that can make you alienated and paranoid) is appallingly ignorant.
As to the question about Hamlet and Prozac, that's an interesting topic for academic papers or cocktail party conversation. Would Coleridge have written "Kubla Khan" without opium? What would a sober Hemingway or Fitzgerald have written?
Interesting questions all, but they are not relevant. It would be more relevant to ask whether doctors are over-prescribing Prozac (as some did with Valium), not whether Prozac is a useful drug.
Stan Modjesky,
Baltimore.
Editor: When people can sit in a public place and talk about their Prozac, it indicates that these psychiatric illnesses are on the path to destigmatization.
There is an important distinction that psychiatrists make in determining a person's emotional distress. It is the difference between sadness and depression.
Sadness is a human emotion arising out of loss, frustration, anger or demoralization. But sadness does not leave us hopeless, gloomy and suicidal or give us a sense of unworthiness.
Depression is an emotional state that grips a person. It is a sense of despair, melancholy and hopelessness which may leave a person contemplating suicide as their only relief. Unlike sadness, depression may last weeks, months or years.
In discussing the use of Prozac or any antidepressants, let us not confuse the treatment of a medical illness (depression) with the experience of normal human emotions (sadness).
David W. Goodman, M.D.
Baltimore.
Editor: Since Prozac helps people with a biochemical need (which can result from psychological causes), it usually does not have much effect on those within the normal range.
It helps lift depression and curbs obsessive "holding-on" so that a more optimal, and effective, psychological balance may be achieved. I have never seen it produce the "I don't care" attitude she describes.
That it is prescribed to many is true; that it may be improperly prescribed by those without psychiatric training is also true.
However, the public often underestimates the severity of emotional problems and is often unaware of the pain and suffering of friends and co-workers.
This is particularly important to recognize today, as insurers actively seek to reduce psychiatric benefits.
Hamlet was rendered inactive because of the strength of his Oedipal conflicts, unleashed by his father's death and his mother's marriage to the man whom Hamlet, even before he encountered the ghost ("Oh, my prophetic soul, my uncle!"), suspected had murdered him.
L He certainly had more than a simple "chemical" depression.
If he had had psychoanalysis or analytic psychotherapy, he might neither have tormented Ophelia nor acquiesced to his uncle's rule. He might have been able to act when his uncle was praying, instead of obsessively rationalizing passing up his chance for revenge.
F: Seven unnecessary deaths might then have been avoided.
Jesse M. Hellman, M.D.
Towson.