Virginia Bola, PsyD

Recycling The Mentally Ill

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30 years ago, California, later followed by other states,
decided to virtually close down the State Mental Hospitals.

There had been multiple exposures of abuse throughout the
Nation's systems such as over-medicated individuals kept on
back wards for years without clinical justification.
However, the primary force leading to the widespread
closures was economic. Providing free room, board,
medication and psychiatric care to the chronic and seriously
impaired mental health population was expensive and failed
to result in any positive financial or political benefits.

Theoretically, these marginally functional individuals would
now be cared for by a network of community service agencies
that would spring up on a local basis. Unfortunately, such a
network never existed and failed to develop for the same
economic challenges the State Institutions had faced.
Counties continued to provide outpatient services, with
occasional brief local hospitalizations for those who became
unstable, and nonprofit organizations were founded, and
often financially foundered, to provide services.

With few resources and the cognitive and emotional inability
to connect with the few programs available, the mentally ill
started to drift into the streets where they often self-
medicated with illegal drugs. Within 10 years, police and
social service agencies estimated that possibly one third of
the growing homeless population had mental disabilities.

An increase in street crime, the resentment of business
owners who lost customers who would not cross the crowds of
homeless on the sidewalks, and the disgust of working
citizens who resented the litter and potential dangers of
large numbers of people living on the streets, led to a
political decision to crackdown on the homeless. Sweeps of
targeted areas moved the homeless away - to other areas
where the resentment was just as great. Petty street crimes
to enable the penniless to live, and drug use, provided the
excuse for more draconian measures. The homeless started
moving again, this time into the prisons.

It is now estimated that the penal system is the largest
provider of mental health services in the nation. Apart from
those Institutions designed for those who have been legally
determined to be "criminally insane," the system houses
mentally ill individuals who may make up a third or more of
the total prison population.

Building more prisons and hiring more guards is politically
positive: voters want to keep their communities clean and
safe and willingly pay for the fight against crime. While
the murderers and rapists are held up as examples of those
who need to be contained at all costs, the fact remains that
a majority of the enormous and growing prison population are
serving their time for drug-related activities or victimless
crimes.

The mentally ill have finally been fully recycled. They are
still invisible but instead of vegetating in State Mental
Wards, they are caught within a system which robs them of
their dignity, provides less than optimal treatment, and
costs far more to the taxpayers than would well-organized
and efficiently run hospitals and clinics.

This is progress?

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