4.5 million Americans suffer from severe mental illness, of which 1.8 million are receiving no treatment on any given day. The results? Homelessness, incarceration and a high level of violence (schizophrenics and manic-depressives commit 1000 murders every year).
When de-institutionalization began in the U.S in 1955 the States were responsible for the mentally ill, most of whom were in purpose-built institutions. Then Medicaid and Medicare were introduced and the States saw a brilliant way of reducing costs by closing the old hospitals and letting the Feds look after the mentally ill (90% of all the old mental hospitals are now closed). There then followed a tussle as to who should look after these poor people. The Federal government maintained that traditionally the States looked after the sick. The result was that schizophrenics and manic-depressives were dumped into either general hospitals or into poorly financed nursing homes. In both the standard of care is generally poor and if a patient is very badly sick hospitals refuse to admit them. There is little or no rehabilitation. By the mid-80s 23% (348,000) people with mental disorders lived in nursing homes (maybe a fair warning to the rest of us).
The current situation is that 200,000 schizophrenics and manic-depressives are homeless (a third of the homeless population). 300,000 are in jail and only 20,000 are in proper psychiatric hospitals getting proper treatment. Sufferers can be violent and suffer violence, in jail or outside it. Since jails are now run for profit it is safe to assume that treatment is minimal and little is done to assist sufferers back into the community when released.
Is there any one prepared to comment on this post and explain how a modern, civilized country can justify this treatment?
In no part of the world do people enjoy paying tax, but in America the dislike of this pastime reaches near-pathological dimensions. It would not cost that much to have the mentally sick properly treated. It is a sign of a nation’s honor and decency as to whether it looks after the halt, the sick and the maim. The excuse is that the churches do the job. This is untrue, or if they do they hardly do an adequate job.
As a former psychiatric nurse before going into psychology, I am prepared to comment, but only from the English perspective.
The reason for closing down mental hospitals here was because the nature of these places was considered to be inhumane. And in many cases they were. People were housed in large Dickensian Victorian mansions with few modern amenities and a cold atmosphere – psychologically and physically. Institutionalisation set in very early with the patients (note that word – they were considered sick and weird and not welcome in ‘society’ – I am not exaggerating. And they are still not welcome in society by and large). Most of the nurses did their best to provide care but the ambiance was more like a strictly regimented boarding school than a ‘hospital’. There was also abuse and and the incarceration of people who had no reason to be there. For instance I looked after an old lady who had been put there because she had become pregnant as a teenager 50 years ago, and was then deemed to be ‘mad’. Apparently this happened a great deal years ago. The whole set up was not conducive to their wellbeing, and in order to keep everyone manageable, major tranquillizers were given.
However….
The government closed the hospitals and probably felt very pleased with themselves, but HAD NO FURTHER PROPER PLANS for the care of the mentally ill. Care in the community they call it. There is very little of it and I actually see one of my erstwhile patients wandering round my town where he is given cups of tea by various people who know him to be harmless.
Churches are not trained to care for the mentally ill, but I do know of several Christian organisations who do their best to provide day centres . The government have made a real mess of the care of the mentally ill. Sounds like yours has too.
The government closed the hospitals and probably felt very pleased with themselves, but *HAD NO FURTHER PROPER PLANS* for the care of the
*Does this ring a bell?? !!