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Wednesday, September 9, 2020

What To Do With the Mentally Ill

      In the 1950's, more than half million people lived in U.S. mental institutions--one in 300 Americans. By the late 1970s, only 160,000 did, due to efforts by psychiatrists, philanthropists, and politicians to deinstitutionalize the mentally ill.

     Today there's one public psychiatric care bed for 7,100 Americans--the same ratio as in 1850. The motives behind this trend were varied. Emptying the asylums was going to save money. And who needed hospitals with all the antipsychotic drugs on the market? Deinstitutionalization was going to restore citizens' rights and protect them from deplorable conditions like those portrayed in movies like "One Flew Over the Cuckoo's Nest," conditions in which an insane person was unlikely to be cured. Wouldn't it be better if the mentally ill were treated at home, given support, therapy, and medication via community clinics? It sounded good, but the reality was quite different.

     In 1961, a joint commission of the American Medical and American Psychiatric Associations recommended integrating the mentally ill into society. This plan depended on the establishment of local facilities where mentally ill people could receive outpatient care. In 1963,Congress passed a law providing funding for these "community mental health centers". States, under pressure from the patients' rights movement, downsized their psychiatric hospitals faster than anyone had anticipated…

     As of 2006, 1.3 million of America's mentally ill were housed where they used to be until the late 1800s: in prisons. Between 1998 and 2006, the number of mentally ill people behind bars more than quadrupled. In some county jails, rates of inmates with mental illness have increased by nearly 50 percent in the past five years. It's not uncommon for individual jails to report that 25 to 30 percent of their inmates are mentally ill or that their mentally ill populations rises year after year…[Today, because politicians don't want the mentally ill in jail, tens of thousands of them live in squalor on the streets.]

Mac McClelland, "Schizophrenic Killer My Cousin," Reader's Digest, February 2014 

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