http://www.salon.com/2013/09/29/ronald_reagans_shameful_legacy_violence_the_homeless_mental_illness/
One month prior to the election, President Carter had signed the Mental Health Systems Act, which had proposed to continue the federal community mental health centers program, although with some additional state involvement. Consistent with the report of the Carter Commission, the act also included a provision for federal grants “for projects for the prevention of mental illness and the promotion of positive mental health,” an indication of how little learning had taken place among the Carter Commission members and professionals at NIMH. With President Reagan and the Republicans taking over, the Mental Health Systems Act was discarded before the ink had dried and the CMHC funds were simply block granted to the states. The CMHC program had not only died but been buried as well. An autopsy could have listed the cause of death as naiveté complicated by grandiosity.
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By 1975 board-and-care homes had become big business in California. In Los Angeles alone, there were “approximately 11,000 ex-state-hospital patients living in board-and-care facilities.” Many of these homes were owned by for-profit chains, such as Beverly Enterprises, which owned 38 homes. Many homes were regarded by their owners “solely as a business, squeezing excessive profits out of it at the expense of residents.” Five members of Beverly Enterprises’ board of directors had ties to Governor Reagan; the chairman was vice chairman of a Reagan fundraising dinner, and “four others were either politically active in one or both of the Reagan [gubernatorial] campaigns and/or contributed large or undisclosed sums of money to the campaign.” Financial ties between the governor, who was emptying state hospitals, and business persons who were profiting from the process would also soon become apparent in other states.
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Similar communities were becoming visible in other California cities as well as in New York. In Long Beach on Long Island, old motels and hotels were filled with patients discharged from nearly Creedmore and Pilgrim State Hospitals. By 1973, community residents were complaining that their town was becoming a psychiatric ghetto; at the local Catholic church, patients were said to “have urinated on the floor during Mass and eaten the altar flowers.” The Long Beach City Council therefore passed an ordinance requiring patients to take their prescribed medication as a condition for living there. Predictably, the New York Civil Liberties Union immediately challenged the ordinance as being unconstitutional, and it was so ruled. By this time, there were about 5,000 board-and-care homes in New York City, some with as many as 285 beds and with up to 85% of their residents having been discharged from the state hospitals. As one New York psychiatrist summarized the situation: “The chronic mentally ill patient has had his locus of living and care transferred from a single lousy institution to multiple wretched ones.”
California was the first state to witness not only an increase in homelessness associated with deinstitutionalization but also an increase in incarceration and episodes of violence. In 1972 Marc Abramson, another young psychiatrist working for San Mateo County, published a landmark paper entitled “The Criminalization of Mentally Disordered Behavior.” Abramson claimed that because the new LPS statute made it difficult to get patients admitted to a psychiatric hospital, police “regard arrest and booking into jail as a more reliable way of securing involuntary detention of mentally disordered persons.” Abramson quoted a California prison psychiatrist who claimed to be “literally drowning in patients. . . . Many more men are being sent to prison who have serious mental problems.” Abramson’s paper was the first clear description of the increase of mentally ill persons in jails and prisons, an increase that would grow markedly in subsequent years.
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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.
There is much more on the link.
Thanks for the thread, Lady Freedom Returns.
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