In the late sixties and early seventies, an amazing thing happened. It was like a warm, feel-good tsunami that spread across all 48 contiguous states.
The eerie, ghost-filled state mental hospitals were all being shuttered and the patients were set to return to live in their own communities and treated as outpatients at community mental health centers. They were scheduled to see psychiatrists and therapists to help them adjust to life outside a hospital and to live normal productive lives. Being locked up and treated like a “crazy person” was to be a thing of the past.
Well, it all started out great. The cities and states were given huge amounts of federal funds to rehabilitate facilities, hire doctors and therapists, and close down the state hospitals. Three years later when I finished my psychiatric residency and went into private practice, I got a part-time job at a community mental health center outside of Philadelphia. It was a charming rehabilitated private home with a staff of about a dozen professionals. We treated hundreds of patients, made home visits and helped a lot of mentally ill people.
Fast forward fifty years.
The government decided to save money and reduce mental health funding. Whoops. Someone forgot that we no longer have state hospitals. Whoops again. No one took the time to predict where this would lead.
Well, it led to chaos. There are now over 40,000 homeless people in Los Angeles County alone. At least 15,000 of them are mentally ill.
Once a week, a large hazmat crew dressed in white protective gear, disinfects large areas of the Venice ocean walk and other popular mentally ill habitats in and around LA. The streets smell of waste material and everyone is placed in jeopardy from infections. Think 50 states and think of the thousands of mentally ill who roam in our midst. Many of these people are treatable…
The warm tsunami has turned into a cold, bacterial filled avalanche. Now it will take billions of dollars to house and treat these people, who by no fault of their own are mentally ill.
The good news is that a tax bill just passed designating billions of dollars to solve this problem. The bad news is that communities understandably don’t want the mentally ill housed in THEIR neighborhoods.
The answer… Build new state hospitals on the VA grounds that will combine the old and the new — a safe place to treat the mentally ill using our new medications and newly developed methods to teach social skills. This would be in an environment filled with warmth and loving feelings. Then, when patients are more capable and mentally stable, they can be moved to a more independent facility (Also on the VA grounds). That’s where job training and the possibility of eventual treatment in a community mental health center will become available.
Full circle from the seventies, but this time, each stage of mental illness will be carefully delineated and supported.
I’d donate my time and efforts to a place like this…
If you enjoyed reading, Inside the Mind of a Psychiatrist, you might also enjoy Dr. Smukler’s novels, Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks. Also, please visit Inside the Mind of a Psychiatrist — mystery and romance meets psychology.