In the 1960s, the ACLU and other human rights organizations examined the state of mental health care in the US and came to the conclusion that it was ineffective and possibly unconstitutional.
Two seminal events cause the eventual reduction and almost total elimination of mental health facilities in the US. The first was the Community Mental Health Act of 1963, signed by President Kennedy. It was aimed at providing better in-house treatment for those with mental illness. It was also meant to promote treatment for out-patient care using the newest pharmaceuticals.
The CMHA resulted in the shuttering of a number of hospitals across the country. The immediate impact was that some in-patient treatment was terminated in favor of out-patient treatment. One of the weaknesses in the CMHA was the lack of any mandate to force medical treatment of the most seriously mentally affected patients. Instead, they were released from institutions and given prescriptions for pharmaceuticals… which they often did not take.
After the SCOTUS ruled in O’Connor v. Donaldson that it was unconstitutional to force “non-dangerous” patients to take medication as a condition of their release from institutions, many institutions were shut down for financial and other reasons. The term “non-dangerous” was never fully defined. Care of the mentally ill took a deep downturn, especially in some larger cities.
To make a long story short, the US had decided – through the courts and the efforts of JFK – that using new emerging psychiatric drugs would be more cost-effective and “better in the long run” than paying the high costs to maintain mental health institutions.
They closed the institutions.
The worst of the psychotics were let out onto the streets without any supervision at all.
Rather than understanding that mental health facilities were necessary to maintain a safe society, we decided that the most violent psychologically affected inmates deserved to be released and allowed to take medications – but only if they wished to.
We expected those who suffered from delusions, paranoia, and schizophrenia to treat themselves.
Mental illness is not the same as the flu or a cold. It affects the reality of those who are afflicted.
Many did not wish to take these new medications, claiming that they “dulled” their senses and made them feel like robots. Others were unwilling to take the medications, opting instead for life on the street than in an institution. And others refuse to seek non-pharmaceutical help from psychologists and psychiatrists who might help the afflicted better understand their affliction.
In the belief that we were “doing what was right”, we were wrong.
We, as society, condemned ourselves to live under the threat of people whose psychosis ranged from simple bipolar afflictions to full-blown paranoia and schizophrenia. And let’s not fool ourselves: even those who may at first seem gentle and suffer from mild dysphoria can – and may indeed – attack those who they perceive as a threat, even if there is no threat.
Looking at the latest spate of shootings, we must acknowledge that a high percentage are committed by individuals who should be under some kind of treatment, from simple consultations to medications – but are not.
Until we as a society decide that some mentally ill individuals are too sick to be allowed to roam the streets unmedicated, we will continue to see an unfortunate level of crime that could be prevented by institutionalizing the most dangerous among us.
Society has a responsibility to care for those who cannot care for themselves. This includes newborn infants, those who suffer from congenital diseases, and those whose minds are so unbalanced that they are a danger to both themselves and others.
