Defining Deviancy Down By Daniel Patrick Moynihan

Institutional care was condemned, as in many cases patients’ mental conditions deteriorated, and institutions were not able to treat the individual in a holistic manner. In many state institutions, patients numerously outnumbered the poorly trained staff. Many patients were boarded in these facilities for extensive periods of time without receiving any services. By 1963, the average stay for an individual with a diagnosis of schizophrenia was eleven years. As the media and newspapers publicized the inhumane conditions that existed in many psychiatric hospitals, awareness grew and there was much public pressure to create improved treatment options (Young Minds Advocacy, 2016). .

The article written by Daniel Patrick Moynihan, “Defining Deviancy Down”, illustrates the decline of social morals in the last 50 years within the United States. According to Moynihan, the amount of abnormal behavior being accepted into society is on the rise, if we don’t do something about this development the future generations will be impacted quite heavily. The abnormal behavior of society includes crime, mental illnesses, broken family structures and violence. He defines these terms by breaking them up into three different categories, the altruistic, the opportunistic, and the normalizing. These categories borrow ideas from people such as Emile Durkheim, Kai T. Erikson, Edwin Torres, and many others. Moynihan also uses articles and statistics in addition to the ideas of the people I mentioned to further develop his three categories. The first category, the altruistic, is illustrated by a movement that appeared in the 1950s known as the deinstitutionalization movement focusing on the mental health profession. The second category, the opportunistic, mainly portrayed

The four theories of deviance are The Learning Theory, The Strain Theory, The Social-Bond Theory and the Labeling Theory. These theories alone can explain the reasoning behind someone’s deviant behavior. But, in There Are No Children Here we see all of these theories being demonstrated. This lets us have an understanding of exactly why we are seeing the deviant behavior that we are.

With states closing many of its mental facilities in the communities, there were a lot of people in need of outpatient care who fell through the cracks of the system and ended up in prison. Prison is where many of them died from inadequate treatment. Prisons were suddenly receiving inmates with the following types of mental illnesses: Schizophrenia, bipolar, and deep depressions. These prisons just did not provide these inmates with any medication during their incarceration. Because the community based health services is lacking, and patients aren’t receiving sufficient outpatient care, it makes the effectiveness of deinstitutionalization a serious problem. Without the availability of 24/7 psychiatric services that are well structured, I believe that deinstitutionalization is what is accounting for the increase of the mentally ill inmates in the correctional facility.

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

The introduction of new psychotic drugs can provide better or more thorough care for the mentally ill. Creating options rather than one solution may have been believed to do greater good for the mentally ill community. Furthermore, the economic incentives involved as long term care was and continues to be at such a high cost. Community resources cost little to nothing for the federal Government to support. As well as releasing the mentally ill to their families, in any case those with minor illnesses. Additionally, a shift from treating chronic patients to treating acute ones would generate basic sense into the minds of many. This modification states through actions that

The community-based mental health programs are not only inadequate in relation to numbers, but also underfunded (Unite for Sight.org, 2013). According to Martin (1995), we live in a society that is increasingly becoming conscious of an excessive tax burden. Tax burden, on the other hand, provides for the realization of just how deinstitutionalization is directly related to politics and public policy. The pubic in America who account for the electorate, have a significant say in how policy is affected. To this extent the assumption in relation to deinstitutionalization is that due to increased public outcry in regards to taxation, the both federal and state governments have over the years been forced to cut down spending on some items in the recurring budget in order to free up additional funds. According to Treatment Advocacy Center (2011), the federal government in 1965 surgically excluded the payment of Medicaid for patients institutionalized in state psychiatric and other mental disorders institutions. The goals of this action, according to Treatment Advocacy Center (2011) was to foster deinstitutionalization, and the wading of care costs to sates, viewing them as largely responsible for mental care.

In early years of the last century, housing mentally individuals in local jails or prisons was seen as inhumane and a reform movement led by Dorothea Dix began. This led to the building of mental hospitals. It was once believed that mentally ill individuals deserved to be treated and not punished. However, deinstitutionalization happened which was the emptying of state mental hospitals due to overcrowding and deterioration as well as the introduction of effective anti-psychotic medications and increased funding for the establishment of mental health centers. By the early 1970’s, it was becoming evident that the emptying of the state mental hospitals turned many prisons throughout the U.S into institutions. Despite this clear evidence, deinstitutionalization continues even to this day. The mentally ill, left with few resources, largely turned to petty crime, ending up in prison because there were no other better alternatives.

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

The history of mental health in the United States show a robust movement towards the mental healthcare system we have today. Prior to the 19th century, individuals with mental health issues were widely considered to be demonically possessed, thus contributing to the stigmatization of mental illness and the proliferation of poor treatment conditions. However, in the 1800s, there was a dramatic change in mental healthcare in the U.S. The government took a proactive role in treating the mentally ill, leading to the dawn of state psychiatric facilities.

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

This was the first effective antipsychotic medication. Most of those who were deinstitutionalized were severely mentally ill. Between 50 and 60 percent of them were diagnosed with schizophrenia. Another 10 to 15 percent were diagnosed with manic-depressive illness and severe depression and an additional 10 to 15 percent were diagnosed with organic brain diseases, such as epilepsy, strokes, and Alzheimer's disease. Deinstitutionalization further worsened the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill. This situation continues up to the present. As a result, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment. Patients were kicked out with no choice. Many untreated mentally ill patients were incarcerated instead of being placed in asylums. The goal of deinstitutionalizing was that these patients should be treated in the least restrictive settings. But the settings ended up being on the streets or behind

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and

The homeless- found on city park benches, street corners, and subway grates. Where did all of these people come from? One third, to one half of the homeless suffer from a mental illness. A lot is said about the homeless-mentally ill, but what their plight says about us may be more significant. We still have not found a place for those who are both poor and insane. Once there was a place for them; the asylum fulfilled the basic needs of thousands for decades, but now these institutions lay empty and in ruin. Has the hope to heal the mentally ill also been abandoned? Is there once again a need for the asylum? The disbandment of the asylum was the first step in ending segregation for those