Rockabilly community - people living like it's 1951

[MADem]

40. They locked a lot of those people up, involuntarily, in mental wards.

The burst of homelessness that happened in the Reagan era came on the heels of tossing mental patients out onto the streets, to no small extent.

1980s: THE PROBLEMS BECOME NATIONAL

Until the 1980s, most people in the United States were unaware that the deinstitutionalization of patients from state mental hospitals was going terribly wrong. Some were aware that homicides and other untoward things were happening in California, but such things were to be expected, because it was, after all, California. President Carter’s Commission on Mental Health issued its 1978 report and recommended doing more of the same things—more CMHCs, more prevention of mental illness, and more federal spending. The report gave no indication of a pending crisis. The majority of patients who had been discharged from state hospitals in the 1960s and 1970s had gone to their own homes, nursing homes, or board-and-care homes; they were, therefore, out of sight and out of mind.

In the 1980s, this all changed. Deinstitutionalization became, for the first time, a topic of national concern. The beginning of the discussion was heralded by a 1981 editorial in the New York Times that labeled deinstitutionalization “a cruel embarrassment, a reform gone terribly wrong.” Three years later, the paper added: “The policy that led to the release of most of the nation’s mentally ill patients from the hospital to the community is now widely regarded as a major failure.” During the following decade, there were increasing concerns publicly expressed about mentally ill individuals in nursing homes, board-and-care homes, and jails and prisons. There were also periodic headlines announcing additional high-profile homicides committed by individuals who were clearly psychotic. But the one issue that took center stage in the 1980s, and directed public attention to deinstitutionalization, was the problem of mentally ill homeless persons.

During the 1980s, an additional 40,000 beds in state mental hospitals were shut down. The patients being sent to community facilities were no longer those who were moderately well-functioning or elderly; rather, they included the more difficult, chronic patients from the hospitals’ back wards. These patients were often younger than patients previously discharged, less likely to respond to medication, and less likely to be aware of their need for medication. In 1988 the National Institute of Mental Health (NIMH) issued estimates of where patients with chronic mental illness were living. Approximately 120,000 were said to be still hospitalized; 381,000 were in nursing homes; between 175,000 and 300,000 were living in board-and-care homes; and between 125,000 and 300,000 were thought to be homeless. These broad estimates for those living in board-and-care homes and on the streets suggested that neither NIMH nor anyone else really knew how many there were....