Mental Illness After The Deinstitutionalization Movement

This paper will give a description of the Disability Insurance Policy with a focus on the mentally disabled, giving rise to the Community Mental Health Act of 1963. It will describe the problems that made it necessary to create the CMHA policy, giving the pros and cons of deinstitutionalization. It will give a historical account of the policy and finally will give an analysis of the policy.

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). .

In the video, “The New Asylums”, it demonstrated how deinstitutionalization has left thousands of mentally ill patients in the hands of the prison system. As the mental health hospitals closed down, the police department and prison system has become responsible for the mentally ill people that are on the streets. There was a firm point made about the release of mentally ill patients- “When hundreds of thousands of mentally ill are released, they do not magically become healthy. They went to the streets, became homeless, and turned to a system that cannot say no.” The video also stated that today, there are nearly 500,000 mentally ill people being held in jails and prisons throughout the country. Furthermore, there was no safety net for those

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.

In addition to the historical aspect, confusion about mental health is another reason leading to the perception of the mentally ill. The Surgeon General's Report on Mental Health, (1999), dispels any confusion by making detailed analogies and information. Mental health and mental illness are not opposites; they are like two points on a continuum. The value of mental health is

Deinstitutionalization further exacerbated the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill, and this situation continues up to the present.

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 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.

There are many people in the United States that have a mental illness that is either not

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

Jails have been described as “de facto mental hospitals” because they have filled the void created when state psychiatric hospitals began closing in the early 1960s through a process known as deinstitutionalization. Supporters of deinstitutionalization thought the process would help individuals suffering from a mental illness live more self-reliantly while being treated by community mental health programs. However, the federal government did not provide the necessary funding to meet the mounting demand for these programs, leaving numerous untreated. Individuals with serious mental illnesses are often poor or homeless and are likely to have substance abuse problems. Therefore, when they are left untreated, they are more likely to commit minor crimes that have been the focus of law enforcement in recent years (H. Richard Lamb and Linda Weinberger).

(Biasotti et. al., 2014, p. 11) Which yet again, led to finding a new solution for what to do with individuals who have a mental illness and need assistance appearing to our societal expectations of being normal. The answer: a new form of institutionalization known as

During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical

Erving Goffman is a Canadian-born sociologist who was considered the most influential American sociologist of the 20th century. One of Goffman’s most renowned work is his book Asylums (1961). Asylums focuses on the issue of deinstitutionalization. This specific book is one of the first sociological work that examines the social situation of mental patients in hospitals. The book goes into detail about Goffman’s theory of the “total institution” and he suggests that any institutions have the feature of “guard” and “captor” in order to properly function. This ensures them that both the “guard” and “captor” know their functions and social role. In other words, this is a method of “institutionalizing” them. On the other hand, around the same time,