By Diane Gee, The Wild Wild Left
Mental health is an extremely touchy subject in the United States. We have made gains in some areas, but overall, our treatment of the mentally ill is a failure created by making it into an industry, rather than assisting them.We have come so far in taking away the stigma, being more politically correct in our terminology and in realizing that children born with handicaps are special, not a burden. Yet, adults with mental illness are still treated as pariahs, often cruelly demonized in the press.
There are lovely K-12 programs for children with all sorts of needs, from physical to developmental, yet mental illness is still marginalized. Still, in one area – our educational system – we have made great gains. Once 18, there are really no programs available for people with mental illness.
More controversial is the world of pharmaceuticals. This is the proverbial double edged sword. The industry has worked hard to sell their wares – so hard that we have one of the most over-medicated populations on Earth. They work to hard to convince us to be hypochondriacs, in need of mood lifters, sleep aids, and performance enhancers. While bringing legions of healthy people to the counter, purchasing what they shouldn’t need; the reverse effect has also come true. People who actually need medicine mistrust the industry so much, they refuse to take it. More on that later.
Ultimately, were either of these factors working… we would not have the mentally ill accounting for over 30% of our exploding homeless population. We would not have 20% of our prison population there because of their untreated mental illness.
Why in the world are they not getting the help they need?
According to the U.S. Conference of Mayors Hunger & Homelessness Survey for 2013, homelessness was up 52% in the majority of cities from the prior year. Other cities reported a decrease… unsurprisingly, cities that have policies that remove the homeless from within their city limits, or criminalize being poor. More notably, 30% of these people are mentally ill.12% of our homeless are Veterans The National Coalition for Homeless Veterans reports – counting male homeless only, that demographic goes up to 20%. Of these? HALF have serious mental illness.
Nearly 50,000 Iraq and Afghanistan veterans were either homeless or in a federal program aimed at keeping them off the streets during 2013, almost triple the number in 2011, according to numbers released by the Department of Veterans Affairs. The VA consistently makes it difficult to get treatment, denies PTSD claims while continuing to recycle our young men and women through repeated tours that would break even the strongest of minds.
We need to step back into the chronicles of history to fully understand this.
State run Mental Institutions have a long and ugly history of being abusive, horrific, some even going so far as to be places of torture. It was not uncommon in the past, for men to institutionalize their wives for being “frigid” – and doctors to rape them, to teach them to “experience pleasure.” Shock treatments, restraints, filth and horror – we have all seen the movies.
By the 70’s, President Carter had codified that only those deemed a “danger to themselves or others” could be involuntarily institutionalized. He created a commission to study what the needs of the mental health community were, and how they could be served better.
The final report of the commission to President Carter contained the recommendations upon which the Mental Health Systems Act of 1980 was based. Despite the methodological flaws of the earlier report, the act was considered a landmark in mental health care policy. The key to the proposals included an increase in funding for Community Mental Health Centers and continued federal government support for such programs. But this ran counter to the financial goals of the Reagan administration, these were of course to reduce federal spending, reduce social programs, and transfer responsibility of many if not most government functions to the individual states. So, the law signed by President Carter was rescinded by Ronald Reagan on August 13, 1981. In accordance with the New Federalism and the demands of capital, mental health policy was now in the hands of individual states.Source: http://www.sociology.org/conte…
But in California in that same period, another system had arisen. Reagan had been cutting funding to State facilities, and making privatized (read for-profit) facilities the norm.
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.Source: http://www.salon.com/2013/09/2…
Reaganomics saw one future: No funding for public institutions, and a proliferation of profiteering ones. He decreased mental health funding by over 30% – a number, while unrelated directly, that is now the percentage of the homeless who are mentally ill. A sad irony.
Cuts in funding for mental health services continued throughout the 1980s, with the emphasis being on the provision of services via the private sector. Overall, the number of beds available to the mentally ill in public and private hospitals dropped over forty percent between 1970 and 1984 (Reamer, 1989). Most of this decline was due to cuts in public hospitals. During the 1980s, the number of beds provided by general hospitals in psychiatric wards and in private hospitals for the mentally ill increased. In 1970, there were 150 private psychiatric centers; in 1980, there were 184; by 1988, there were 450 in the United States. General hospitals offering psychiatric services increased from 1,259 in 1984 to over two thousand in 1988 (Reamer, 1989, 25; LaFond and Durham, 1992, 115-16). With such growth in the private sector, there were substantial profits to be made in mental illness, assuming that the patient had adequate health insurance. Those without medical insurance frequently did not receive adequate care.Source: http://www.sociology.org/conte…
State hospitals, without federal funding, began to close by the droves. Worse? Reagan made it infinitely hard for mental illness to be cause for getting disability compensation.
Then came Ronald Reagan. Within a month, the Office of Management Budget announced it would curtail the budget of the National Institute of Mental Health (NIMH), phase out training of clinicians, interrupt research, and eliminate services. Cutbacks to staff followed; chaos ensued. Experienced people left, others remained in government service but were forced into menial jobs. Trained professionals were reassigned to labs to dissect dead rats; science writers were reassigned to typing pools. The Mental Health Systems Act would be disappear. Instead, the Omnibus Budget Reconciliation Act (1982) would merge money for mental health programs into block grants, and with fewer dollars going to the states. They had the discretion to use them however they saw fit, often to perpetuate programs already deemed problematic. The pretense for all this was the president’s concept of a “new federalism.””Many of our dreams were gone,” wrote Rosalynn Carter in Helping Someone with Mental Illness. “It was a bitter loss.”
This could have been enough, but it was not. Pres. Reagan attempted to restrict criteria for determining eligibility for SSI, thought to be a safety-net. Nearly 2.6 million people were receiving insurance because their disability prevented them from working. New evaluations for eligibility led to widespread terminations. Of those who were terminated, about half appealed, and in two-thirds of the cases, administrative law judges reversed the decision. The process took nearly a year, during which time they, and their families, were deprived of promised help.
http://www.miwatch.org/2011/02…
The end result of this, is simple. I’ll let this item speak for itself:
This brings me full circle to the concept of medication. There is a self-imposed stigma many feel for having to take medication when their body does not produce the correct chemicals for a normally functioning brain. This is a ridiculous concept… do people feel guilt or failure when their bodies do not produce insulin? No. There are people that are bipolar, or have severe depression that absolutely cannot function without taking the replacement chemicals their body does not produce.
The backlash to the pervasive pharma-ad panacea has been brutal. I personally have seen good friends take themselves off their meds, because of rants on social media that all meds are poison, convincing them if they “ate healthier” or tried “this herb” they would be fine. One ended in a violent clash with the police, another an attempted suicide, another an actual suicide… One of my best friend’s brother took himself off, and after years of living a successful, happy life – hung himself from a tree outside of his grandmother’s home on Thanksgiving.. never even entering the house to let anyone know he had arrived there. The less extreme has happened as well. Men that become stalkers, convinced I had a secret relationship with them; threats of violence against me and my son when their unrequited love was not returned by me. A few weeks back on their meds, the apology comes… “I am so sorry, I would never do that to you. I don’t know what I was thinking. When I go off my medications I get crazy.”
This anti-medication campaign has also fueled the anti-vaxxer movement, another paranoid rejection of science. Medical science is not evil. Polio was eradicated for a reason. And people with a clinical need should absolutely take what has been prescribed for them, working with their Doctors to find the right balance for them.
That said? We should not medicate conditions we do not have. Grief, for one, is a natural process – you should not throw pills at it to dull the pain. Natural exuberance, or being very quick thinking is not a handicap to be medicated into dullness by teachers or parents who cannot cope with a personality type. When I was young, the Nuns pressed my Mom once, to consider putting me on Ritalin – the new trend of the era. “She finishes her work way ahead of the class, then whispers and giggles with her friends, distracting the class.” My Mom was a force of nature in her own right, “I will not medicate her for being smarter than average. I pay you good money to teach her. Give her more to do.” There forward, I would happily do worksheets from the grade ahead of mine, after my own work was completed. Being emotional is not an illness either. Medicating an overly sensitive child, who cries easily, is hurt easily, or feels anger and has not been taught yet how to channel it is criminal.
So, to be clear, I am not speaking of the “invented” mental illnesses here, I am speaking to real illness.
In September of 2011, a conservative estimate claimed 350,000 of the incarcerated were mentally ill. NPR reported:
When the government began closing state-run hospitals in the 1980s, people with mental illness had nowhere to turn; many ended up in jail. Leifman saw the problem first-hand decades ago in the courtroom. When individuals suffering from mental illness came before him accused of petty crimes, he didn’t have many options.(snip)
“They’d walk out the door, they were ill, they’d act out, because [the jail] is next to the courthouse there are several officers out there, and they’d get re-arrested,” he says.
Not only was the system inefficient, it was costly as well. When Leifman asked the University of South Florida to look at who the highest users of criminal justice and mental health services in Miami-Dade County, researchers found the prime users were 97 people, individuals diagnosed primarily with schizophrenia.
“Over a five-year period, these 97 individuals were arrested almost 2,200 times and spent 27,000 days in the Miami-Dade Jail,” Leifman says. “It cost the tax payers $13 million.”
Source: http://www.npr.org/2011/09/04/…
Unable to afford care from private facilities, with no public funding for mental health subsidies in hospitals – more patients receive mental health treatment IN PRISON than out of prison. What does that say about us as a society?
There are 10 times more mentally ill Americans in prisons and jails than in state psychiatric hospitals, a report published Tuesday found – adding that those individuals’ conditions often deteriorate while they are incarcerated.Source: http://america.aljazeera.com/a…
There is a feedback loop present. If you are unable to get treatment, you cannot find work, and without work, cannot afford insurance or to pay out of pocket for treatment, to get a job….
Obamacare will only double down this problem. It is forced purchase of a private commodity, not health CARE.
There are some very admirable programs available to children who suffer from mental illness, or other unrelated handicaps they may have. They are mainstreamed into the schools, stigma and isolation removed. This has worked well for most, though it works poorly for some kids with autism, (which I am not equating with mental illness btw) where the noise and crowding is so over-stimulating as to be painful for them. The lack of publicly funded special schools means most parents of children with those issues have no option but to home-school; something challenging under the best of conditions.
The stigma needs to be removed, period. There is no shame in needing help. There is nothing frightening about people who may be different than you. But there is danger in shoving untreated people out onto the street – both for them, and others. It is a travesty that people are freezing to death on our streets from untreated mental illness; it is another that they are maltreated as “criminals” when their behaviour is borne of illness not deviancy.
What good are the gains we have made in language and perception when once a human reaches the age of 18, there is nothing in place to help them if they are not rich? We have allowed their illness to become a commodity for enriching the very few. And as a Capitalist enterprise, those who can afford care are warehoused, with as little treatment as possible given, to generate more profit per bed.
We are failing these people, our people.
As the wealthiest in our nation vie for ever larger pieces of our national wealth, leaving more and more of us homeless, depressed and struggling – these pressures are felt exponentially by those already at the bottom, our mentally ill. Untreated, the most ill can become ticking time bombs – as the 70’s California crime statistics showed – and recent events have reported almost weekly.
We are humans, not an Industry. It is our Social responsibility to make sure that our ill receive the very best care, at any time, in any corner of our nation, absolutely free. We need Socialized medicine, not Privatized profiteering.
We would be much the richer for it.
Dedicated to my dear friend Kim, who suggested I research this and write this article.
ABOUT THE AUTHOR
Diane Gee is the founding editor of The Wild Wild Left as well as Links for the Wildly Left, one of Facebook’s major political (progressive—not liberal!) groups.
