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(Mother Jones)   Remember all that deinstitutionalization of the mentally ill that was suppose to help them out? Well here's a timeline to see how that worked out   (motherjones.com) divider line 146
    More: Interesting, public hospital, James Watt, electroshock therapy, Wisconsin, private hospital, lobotomy, New York World, general hospital  
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4819 clicks; posted to Politics » on 29 Apr 2013 at 1:06 PM (50 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-04-29 08:23:28 AM
raygun exposed
 
2013-04-29 08:39:19 AM
We weren't deinstitutionalizing to help them out.  We were deinstitutionalizing so we could close those expensive mental health facilities.  Today we just throw these people into Supermax solitary.  Much cheaper that way, and the prison lobby LOVES the results.
 
2013-04-29 08:41:56 AM
Well, it was complicated, spongy.  Dutch was trying to win a cold war and all
 
2013-04-29 08:45:48 AM
criminal-justice system

LEGAL system. Call it what it is.
 
2013-04-29 08:56:45 AM

snuffy: raygunACLU, SSI and Pharmaceuticals exposed


FTFY

"According to American psychiatrist Loren Mosher, most deinstitutionalization in the USA took place after 1972, as a result of the availability of SSI, long after the antipsychotic drugs were used universally in state hospitals.

"The prevailing public arguments, time of onset, and pace of reforms varied by country. In the United States, class action lawsuits and the scrutiny of institutions through disability activism and antipsychiatry helped expose poor conditions and treatment. Sociologists and others argued that such institutions maintained or created dependency, passivity, exclusion, and disability, which caused people to remain institutionalised. Rosenhan's experiment in 1973 "accelerated the movement to reform mental institutions and to deinstitutionalize as many mental patients as possible."

ACLU

ACLU

ACLU

"From the mid-70s to mid-80s there was a strong 'patients rights' movement generated by the mental health advocate community. Although there were many facets to this movement, one of the primary elements was a re-examination of the criteria for institutionalizing patients.


The point of contention revolved around interpretations of what it meant for a patient to be able to 'take care of himself.' Prior to this the interpretation was rather strict; if a patient could not earn an income and provide shelter and food for himself (and if there were no family members able to care for him), then he would normally be institutionalized.

Begining in the late 70s, the advocacy groups began to demand a lower standard. As long as a patient could merely wash and dress himself, and could perform the mechanical tasks of shovelling food into his mouth, then every effort was made to force the institutions to release them.

Predictably, most of the newly discharged patients were unable to take care of themselves in any meaningful sense of the word, and became the homeless people on the street. It's no coincidence that the decline in California's mental health insitution population closely matched the sharp increase of homeless (in California, at least) during the same period. In fact, for about two years, my wife literally was on a first name basis with every homeless person we ran across in the Westwood/Santa Monica area. They were all former patients who had been 'sprung' from the VA by well meaning advocate groups who then simply walked away and left these guys hanging.

Reagan was not involved in this movement, nor was he a symptom or symbolic of it. Quite the contrary. The people who 'liberated' the inmates tended to be on the opposite end of the political spectum. In fact, it was the ACLU who provided legal representation to force the VA to release these patients."
 
2013-04-29 09:04:37 AM
I have been to several mental hospitals back when they were common (just visiting).  I'd rather take my chances on the street.
 
2013-04-29 09:19:51 AM

The Muthaship: I have been to several mental hospitals back when they were common (just visiting).  I'd rather take my chances on the street.


That's about the same level of logic and foresight that was applied when mental hospitals were shut down in the first place.
 
2013-04-29 09:21:04 AM

vartian: The Muthaship: I have been to several mental hospitals back when they were common (just visiting).  I'd rather take my chances on the street.

That's about the same level of logic and foresight that was applied when mental hospitals were shut down in the first place.


The sh*tty conditions did lead to them being closed more than what MJ would like to have you believe.
 
2013-04-29 09:24:55 AM
The Muthaship:The sh*tty conditions did lead to them being closed more than what MJ would like to have you believe.

I'll need a citation beyond "I saw a lot of them and they were bad" if you don't mind.
 
2013-04-29 09:30:57 AM

vartian: The Muthaship:The sh*tty conditions did lead to them being closed more than what MJ would like to have you believe.

I'll need a citation beyond "I saw a lot of them and they were bad" if you don't mind.


Quite a bit is already present in this very thread.  Clear your afternoon schedule and read away.
 
2013-04-29 09:59:59 AM

vartian: The Muthaship:The sh*tty conditions did lead to them being closed more than what MJ would like to have you believe.

I'll need a citation beyond "I saw a lot of them and they were bad" if you don't mind.


But we cut their funding, and all they did was get worse instead of better!
 
2013-04-29 10:00:15 AM
I see we have already started the traditional bullshiat of "Who is to blame" rather than "What can we do to fix the problem"

Because this is America, and it's more important to affix blame than solve something. And then pretend to be horrified and shocked when something terrible happens.
 
2013-04-29 11:13:17 AM

nekom: Well, it was complicated, spongy.  Dutch was trying to win a cold war and all



Nice. I tell you what.
 
vpb [TotalFark]
2013-04-29 11:21:25 AM
Marcus Aurelius:

But we cut their funding, and all they did was get worse instead of better!

But we got the government off of their back.
 
2013-04-29 11:35:26 AM
Indiana is the first of more than 30 states to enact a compulsory sterilization law, allowing the state to "prevent procreation of confirmed criminals, idiots, imbeciles and rapists." By 1940, 18,552 mentally ill people are surgically sterilized considering running for public office.
 
2013-04-29 11:47:01 AM

Marcus Aurelius: Much cheaper that way


imgs.xkcd.com


What's the cost ratio?
 
2013-04-29 11:47:34 AM
25.media.tumblr.com
 
2013-04-29 11:52:55 AM

Actual Farking: [25.media.tumblr.com image 449x720]


HA!
 
2013-04-29 12:57:47 PM
In the wake of the Newtown shootings, I remember listening to a father on NPR who was desperately trying to get help for his mentally ill son. Everyone agreed the son was a danger to society, but there were no beds open in the state of Virginia by a long shot for the son until he did real harm.

I felt more sorry for that dad than very many people I've met, as he was just trying to do the right thing for everyone but just plain could not.

/not very CSB
 
2013-04-29 01:01:37 PM
Unfortunately the GOP preyed upon the negative images of inpatient mental health care facilities depicted in Cuckoos Nest and threw out the baby with the bathwater.
 
2013-04-29 01:01:51 PM
i586.photobucket.com
 
2013-04-29 01:06:06 PM
Well, the timeline is mostly accurate. Some of the public reasons are BS, though.

Yes, the mental health system back then was in poor shape. However, by the 70's, reforms were coming so fast they were piling up. Clinics were just showing up encouraging more outpatient treatment instead of being institutionalized, education programs were being presented to the average population to undue the nasty image of mental illness spawned by Hollywood and by records of actual, poorly run institutions.

The Waverly Mental Institution -- abandoned in the late 70's or early 80's due to cuts in funding, was essentially a self contained city. It's currently used by Hollywood for horror movies and the new owner runs tours through the vast place -- repairing it just enough to keep the scare factor while not letting it fall in on itself.

Progress was catching up to the old, huge institutions and major changes were sweeping through in patients rights, therapies and conditions.
Then, the funds were cut, most of the major institutions closed and several hundred thousand mentally ill folks, barely able to care for themselves, were released into the national homeless communities.

Now, you factor in the cost of the soaring demand for social services, the impact thousands of homeless had on the already booming homeless communities, the cost to cities and states which found their crime rates soaring, the cost of camps vandalizing assorted areas, like parks, then abandoned buildings and the increased number of the mentally ill winding up in prison, plus the increased drain on charities and the increase in people requiring medical care with no income and you'll come up with a financial figure greater than what it cost to keep the institutions open.

You also need to consider the deaths. The mentally ill died by the handful on the streets -- often killed by other mentally ill homeless or dying of exposure. Without guidance or a controlled environment, many did not get the care they needed to recover. Many did not get regular supplies of medication.

Prisons took in many, kept them for a time with minimal treatment, then released them with 3 days worth of pills, a prescription for more, the address of a clinic and no means to support themselves or even find shelter.

That plan didn't work out too well.

During this time, moneys sucked from the Mental Health budget vanished into special interest groups.

There were no gains by closing the major institutions.

This also spawned a mass of for profit Mental Clinics -- where if you had the money, you got treatment. If not, then go be crazy somewhere else. Most remaining clinics had to rely on State funds -- but with those funds came archaic regulations which undid many of the great advances prior to the budget cuts.

So, by now the majority of the self contained, major mental institutions which were closed down have either been sold and turned into condos or shops or are in such a poor state of repair, that it will cost billions to make them habitable again.

I worked in psychiatrics. I saw the changes hit when the budgets were cut. It used to infuriate me when cities would easily get funds to make public parks, redecorate public buildings, make beaches more pleasing to the eye and turn piles of rubble into historic land marks.

Yet, the funds for Mental Health would be increased one year, then slashed the next, destabilizing the sector.

I'm going to pull figures out of my ass here, just as an example: Prior to Mental Health Budget Cuts, states probably spend 2 billion on the care of patients. After the cuts and the subsequent problems caused, their costs went up to around four billion, more when you factor in the long term results.

So who the f**k won? Who benefited?

We went from being one of the top 5 nations on the globe in mental health care to one of the lowest 20.

Of course, in the interval, we developed about 200 new billionaires, popped up with CEOs making more money than ever before, over turned the Federal limits on loan and credit card interest rates and medical care simply exploded in cost.

The majority of your Mental Health Professionals are going into private practice, since the funding for State run mental care is so unreliable.

Currently your government is pushing many billions of bucks into the development of a better Tank for the military. The Military keeps telling them not to -- wanting to develop other programs -- but the Congressmen pushing hard on this bill represent areas where most of the tank components are built.

If there is a drastic drop in employment in the Tank building companies, the congressmen might not be re-elected.

Some of those same billions could be channeled to the Mental Health Services.
 
2013-04-29 01:06:36 PM
We should let churches and charities run mental asylums.

encrypted-tbn0.gstatic.com

Right?


encrypted-tbn0.gstatic.com
 
2013-04-29 01:09:01 PM
Why should I have to pay for other people's mental health problems???  It's the Republican way!
 
2013-04-29 01:12:29 PM

Andromeda: In the wake of the Newtown shootings, I remember listening to a father on NPR who was desperately trying to get help for his mentally ill son. Everyone agreed the son was a danger to society, but there were no beds open in the state of Virginia by a long shot for the son until he did real harm.

I felt more sorry for that dad than very many people I've met, as he was just trying to do the right thing for everyone but just plain could not.

/not very CSB


I heard the same story.  Better mental healthcare would do far, far more to reduce gun violence than increased gun control.  Although they don't have to be mutually exclusive.
 
2013-04-29 01:21:17 PM

hasty ambush: Begining in the late 70s, the advocacy groups began to demand a lower standard. As long as a patient could merely wash and dress himself, and could perform the mechanical tasks of shovelling food into his mouth, then every effort was made to force the institutions to release them.


Looks like Reagan had access to Obama's time machine.
 
2013-04-29 01:23:09 PM
<a data-cke-saved-href="<a href=" href="<a href=" http:="" www.motherjones.com="" files="" reagan.jpg"="" target="_blank">www.motherjones.com
Caused more mass shootings that all the bushmasters combined.  Thanks to him I long ago gave up on humanity and wish it would just get wiped the ufark out already for the good of the planet.  We dont deserve a mercy killing, god keeps this country alive because he is petty and cruel.  God sends republicans like Reagun to punish us and remind us how much he hates us.

/suffering is our only right as citizens, its guaranteed for the 99%.
 
2013-04-29 01:24:02 PM
Utica, NY has a pretty badass old mental hospital, where they invented the Utica Crib (basically a cage that fit over beds to immobilize patients), and they produced The American Journal of Insanity there as well.

/alienist is one of my favorite archaic job titles
 
2013-04-29 01:24:35 PM

Rik01: If there is a drastic drop in employment in the Tank building companies


Analogy fails. There is only one tank building company in the US-Gerneral Dynamics and they run the only US tank factory - Lima Army Tank Plant and they have not built a new tank in years. Currently they only refurb and modify existing vehicles.

The Army's Future Combat Systems Program which among other things would have developed a new tank has been cancelled.

Better to point out that we spend about $1 trillion (combined Federal and State) on means tested welfare in this country (to include mental health care) and only 30% of it reaches the intended recipients. The remaining 70% goes toward administration and regulation, along with the normal waste, fraud and abuse in government operations.

As normal it is not about how much we are spending but how we are spending it
 
2013-04-29 01:24:50 PM
Oh, also, Cropsey was halfway decent.
 
2013-04-29 01:25:35 PM

orclover: Thanks to him I long ago gave up on humanity and wish it would just get wiped the ufark out already for the good of the planet.


Show us what a leader looks like.
 
2013-04-29 01:26:41 PM
We don't need new gun laws, just stronger mental health services for the at-risk.

Oh, and, we have the best healthcare system in the world, don't need to make any changes to it.

Ergo, mental healthcare is fine as is and we don't need any new gun laws.

Damn, that was easy.
 
2013-04-29 01:27:14 PM
i actually think i kinda prefer the free-range crazies. maybe some kind of tether compromise is in order.
 
2013-04-29 01:28:00 PM

I_Am_Weasel: Indiana is the first of more than 30 states to enact a compulsory sterilization law, allowing the state to "prevent procreation of confirmed criminals, idiots, imbeciles and rapists."


Now if we could only implement this here.
 
2013-04-29 01:28:52 PM

hasty ambush: only 30% of it reaches the intended recipients. The remaining 70% goes toward administration and regulation, along with the normal waste, fraud and abuse in government operations.


Cite?
 
2013-04-29 01:29:04 PM

GoldSpider: orclover: Thanks to him I long ago gave up on humanity and wish it would just get wiped the ufark out already for the good of the planet.

Show us what a leader looks like.


upload.wikimedia.org
We have no leaders.  Only wardens.
 
2013-04-29 01:30:21 PM

hasty ambush: The point of contention revolved around interpretations of what it meant for a patient to be able to 'take care of himself.' Prior to this the interpretation was rather strict; if a patient could not earn an income and provide shelter and food for himself (and if there were no family members able to care for him), then he would normally be institutionalized.

Begining in the late 70s, the advocacy groups began to demand a lower standard. As long as a patient could merely wash and dress himself, and could perform the mechanical tasks of shovelling food into his mouth, then every effort was made to force the institutions to release them.


I was coming in here to call bullshiat on this whole article.  It is unbelievably difficult to institutionalize the homeless because of efforts by the left to make sure they aren't institutionalized.  I could see how they chose this path.  In the 70's, when I was a teen in San Fran, cops would sweep up homeless people and put them in hospitals willy-nilly.

The left saw this as police overreach and began to demand stricter thresholds for institutionalization.  They succeeded, but like almost every movement started with good intentions, went too far.  Now there's a bunch of whackadoos walking around and nobody can do anything with them.  Thanks Obama.
 
2013-04-29 01:30:59 PM

orclover: GoldSpider: orclover: Thanks to him I long ago gave up on humanity and wish it would just get wiped the ufark out already for the good of the planet.

Show us what a leader looks like.

[upload.wikimedia.org image 318x300]
We have no leaders.  Only wardens.


That guy didn't lead anyone.  He just sat down and didn't move for fear of inducing a heart attack.  Like if Chris Christie decided to sit under a tree and no one helped him up.
 
2013-04-29 01:34:12 PM

Testiclaw: Damn, that was easy


Oh yes, absolutely agreed.  Now just give it all to every single person who is breathing air on United States territory free of charge at gunpoint if necessary.  No exclusions and no denial of services allowed for any reason for anyone.  Dont like it? Get out.  Like it? Here's your guns.

Never happen, enjoy the weekly shootings.  Pray for a meteor the size alaska to end the suffering.
 
2013-04-29 01:35:13 PM
The upshot of de-institutionalization is that all those empty facilities provide great settings for today's horror movies.
 
2013-04-29 01:37:42 PM

insano: The upshot of de-institutionalization is that all those empty facilities provide great settings for today's horror movies.



One of the bigger ones in California, The Camarillio State Hospital, is a CSU now.
 
2013-04-29 01:38:42 PM

radioshack: I was coming in here to call bullshiat on this whole article.  It is unbelievably difficult to institutionalize the homeless because of efforts by the left to make sure they aren't institutionalized.  I could see how they chose this path.  In the 70's, when I was a teen in San Fran, cops would sweep up homeless people and put them in hospitals willy-nilly.


exactly - people tend to forget that when you create a circumstance that allows for a) profit and b) social winnowing, you aren't going to get a result that's sunshine and lollipops. hell, the number of people that were institutionalized for being gay gives you a hint towards how the idea works in practice.

in other words, given the two options, i'm still in the free-range crazy camp. i'm not saying there's never cause for institutionalization against ones will, but expanding it from where it stands now carries risks i'm not liking compared to the reward.

tangential, but it kinda highlights the lack of anything good in the way of options when any conversation on national mental health eventually revolves around institutionalization.
 
2013-04-29 01:39:23 PM

I_C_Weener: Like if Chris Christie decided to sit under a tree and no one helped him up.


Two terms.  shiat I would campaign for him if he did that.  Sit there, do nothing, dont break anything and just talk about peace and preach tolerance while choking down krispy kremes.  I would chisel his asscheeks in 14-1 scale on Mt Rushmore myself.
 
2013-04-29 01:44:40 PM
On the plus side, deinstitutionalization left us with more available redheads.
 
2013-04-29 01:44:44 PM
How many of them became members of Congress?
 
2013-04-29 01:45:05 PM
NuttierThanEver:
Unfortunately the GOP preyed upon the negative images of inpatient mental health care facilities depicted in Cuckoos Nest and threw out the baby with the bathwater.

I'm sorry, but the people who were using movies like Cuckoo's Nest were the Democrats and "progressives" of the time.

There wasn't a lot of budget-busting talk about mental institutions then - most of the bigger and more successful ones were largely self-supporting (with on-site farms and fees paid by well-off relatives of some patients).

The big issue was "it's inhumane to lock people up, now that we have all of these Cool New Drugs to treat things like psychosis."

The big reason for all of the budget cuts for mental hospitals in the 1980s was the drastic drop in occupancy - they were being shut down at a pretty brisk rate, since so many of the patients were being kicked out to "outpatient facilities" (AKA drug dispensaries). Part of the justification - by Democrats - for kicking the mentally ill out of the asylums was that they could save money and spend it elsewhere.

I know it's a left-wing mental issue to blame pretty much any Bad Thing on the Republicans - but the de-institutionalization of mental patients in the 1970s and 1980s is squarely in the lap of the left/Progressive wing.

Of course, the original plan to institutionalize them in the first place was Progressive-era work at its finest... but it wasn't to protect the mentally ill. It was to take the mentally ill out of society and put them in places where they wouldn't bother the productive citizens. It was accompanied by mandatory sterilization, as part of the then-popular Progressive eugenics philosophy. That caught on much more in Europe in the 1940s than in the US - but it was popularized here first.
 
2013-04-29 01:45:30 PM

Aarontology: I see we have already started the traditional bullshiat of "Who is to blame" rather than "What can we do to fix the problem"

Because this is America, and it's more important to affix blame than solve something. And then pretend to be horrified and shocked when something terrible happens.



Blame is important, as this is another neoliberal failure, so stop voting for neoliberals.

Not that I see this happening anytime soon.  People still want to believe they can do whatever they want and voting with your dollars is more effective than sound policy making.  So when Jon Stewart shiats all over the science behind limiting portion sizes in the name of his right to buy shiat, the exact same reasoning leads to crazy people having the freedom to be homeless or locked up in a private prison somewhere.  Because public needs and market demands are not the same things.
 
2013-04-29 01:56:35 PM
This is the real cost of conservatism......cutting spending often creates unintended expenditures elsewhere. Very seldom is it a net gain.
 
2013-04-29 01:57:39 PM

cirby: but the de-institutionalization of mental patients in the 1970s and 1980s is squarely in the lap of the left/Progressive wing.


Are you farking serious? Way to rewrite history.
 
2013-04-29 02:04:16 PM

physt: cirby: but the de-institutionalization of mental patients in the 1970s and 1980s is squarely in the lap of the left/Progressive wing.

Are you farking serious? Way to rewrite history.


Cirby is a very dedicated right wing themed troll / shrill.
 
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