Mental Health
Dec. 18th, 2012 09:47 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
chris_gerribAdam Lanza, the man who shot up the school in Connecticut, was crazy. The guy who shot up the theater in Colorado is crazy. The guy who shot Gabrielle Giffords in Arizona is crazy. Does anybody see a pattern here? The question then becomes, why weren't these crazy people locked up somewhere?
The answer is deinstitutionalization. This is a policy, going back to the 1970s, of emptying and then closing mental health facilities, AKA asylums. There were several reasons this policy was adopted. One is that, frankly, running an asylum is expensive, usually only paid for by governments, and has few political advocates. So as we got on the "small government" kick, asylums went away.
There are other reasons as well. For most of human history, "treatment" for mental illness consisted of warehousing the mentally ill. Then, starting in the 1960s, modern medicine came up with psychotropic drugs. To oversimplify, a madman could take a pill and be sane. This seemed to mean you could give them a prescription and send them home.
Yet another reason was the abuse of the asylum system. Barbra Streisand notably played an adult woman whose parents were trying to have her committed because she was a hooker. This type of stuff happened (albeit rarely) but more common was the locking up of teenagers because their parents though they were gay.
One end result of deinstitutionalization was an increase in homelessness. Basically, some number of the mentally ill can't or won't take their meds or otherwise function in society. The other end result was that it is very difficult to commit an adult, and even if you do get them committed, there may not be a place for them to go. If we're going to undertake meaningful action about nuts shooting up public places, we need to fix this problem.
ETA: An interesting discussion of the problem from a psychiatrist.
The answer is deinstitutionalization. This is a policy, going back to the 1970s, of emptying and then closing mental health facilities, AKA asylums. There were several reasons this policy was adopted. One is that, frankly, running an asylum is expensive, usually only paid for by governments, and has few political advocates. So as we got on the "small government" kick, asylums went away.
There are other reasons as well. For most of human history, "treatment" for mental illness consisted of warehousing the mentally ill. Then, starting in the 1960s, modern medicine came up with psychotropic drugs. To oversimplify, a madman could take a pill and be sane. This seemed to mean you could give them a prescription and send them home.
Yet another reason was the abuse of the asylum system. Barbra Streisand notably played an adult woman whose parents were trying to have her committed because she was a hooker. This type of stuff happened (albeit rarely) but more common was the locking up of teenagers because their parents though they were gay.
One end result of deinstitutionalization was an increase in homelessness. Basically, some number of the mentally ill can't or won't take their meds or otherwise function in society. The other end result was that it is very difficult to commit an adult, and even if you do get them committed, there may not be a place for them to go. If we're going to undertake meaningful action about nuts shooting up public places, we need to fix this problem.
ETA: An interesting discussion of the problem from a psychiatrist.
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no subject
Date: 2012-12-18 04:29 pm (UTC)He went on to run a community home which he never did feel met the needs of mental health care in the same way.
But, as you say, it was much cheaper, and politicians, even Margaret Thatcher were able to use stories of abuse of the system to make it look like they cared.
In reality, care in the community as we called it in the UK was the complete opposite of what happened.
no subject
Date: 2012-12-18 07:02 pm (UTC)I'm with you on this one - but on both sides. It was a bad, sad solution to a chilling - and growing - problem. Remember that the Soviet Union was a “Worker's Paradise” - the government said so, and if you thought otherwise, you were obviously crazy! Clang! Incarcerated without trial or appeal for “anti-socialist deviationism.”
It wouldn't have taken much longer in this country. Only the labels would have changed.
“We treat racism and homophobia as delusional disorders (http://drhelen.blogspot.com/2005/12/should-bias-be-mental-illness.html),” said Shama Chaiken, who later became a divisional chief psychologist for the California Department of Corrections, at a meeting of the American Psychiatric Association. “Treatment with antipsychotics does work to reduce these prejudices.”
The word is, thoughtcrime. Maybe “deinstitutionalism” happened just in time!
no subject
Date: 2012-12-18 08:06 pm (UTC)