MENTAL HEALTH AWARENESS SERIES

Deinstitutionalization — The Exodus of the Severely Mentally Ill to the Streets and Prisons

10th day of May— a different point of view for the homeless and prisoner

DEMOLITION OF A MENTAL HOSPITAL

My graduation from the university happened in the spring and it should have been a proud moment in my life, but there was no celebration or kudos for my accomplishment.

That summer, a job opportunity in Honolulu took me overseas to paradise for four months. This turned out to be a place of huge flying insects and a bicycle wreck that almost ruined my face and definitely destroyed my glasses.

That fall, as a dog returns to its vomit, I moved back to The Dalles, the very place I didn’t ever want to live again. The very place of bad memories and emotional turmoil.

I found a place to live with a friend from high school and began to look for work. It was spring again when I took a job on a demolition crew to destroy the old mental hospital on the hill by the park. They gave us hammers and a dump truck. I was there five months and then moved on to something else, as was usual in my restless life.

Why were they using a minimal crew with less than adequate tools to knock down walls? I’m not sure of the answer to that question. All that I knew was that the hospital had been there ever since I could remember, and now they were shutting it down. Where had all the inpatients gone? Were they now on the streets of The Dalles? Again, I don’t know, but maybe the process of years of deinstitutionalization had something to do with its closure.

DEINSTITUTIONALIZATION

Beginning in the 1950s, there was a shift in public opinion and the traditional psychiatric hospitals were shut down and the inpatients were sent somewhere. Where did they go? Was this the start of our current mental health crisis, homelessness, and overcrowded prisons? There was an exodus, so to speak, of the severely ill mental patients. The hospitals were shut down, and they had nowhere to go but the streets or to prison.

But don’t take my word for it, take a look at this next article that describes this horrific decision that has had far-reaching consequences in our own lives.

The following excerpt is drawn from Chapters 1, 3 and the Appendix of: Out of the Shadows: Confronting America’s Mental Illness Crisis by E. Fuller Torrey, M.D. Source: Frontline — Deinstitutionalization: A Psychiatric Titanic

Deinstitutionalization is the name given to the policy of moving severely mentally ill people out of large state institutions and then closing part or all of those institutions; it has been a major contributing factor to the mental illness crisis.

Deinstitutionalization began in 1955 with the widespread introduction of chlorpromazine, commonly known as Thorazine, the first effective antipsychotic medication, and received a major impetus 10 years later with the enactment of federal Medicaid and Medicare.

Deinstitutionalization has two parts: the moving of the severely mentally ill out of the state institutions, and the closing of part or all of those institutions.

Thus deinstitutionalization has helped create the mental illness crisis by discharging people from public psychiatric hospitals without ensuring that they received the medication and rehabilitation services necessary for them to live successfully in the community.

For a substantial minority, however, deinstitutionalization has been a psychiatric Titanic. Their lives are virtually devoid of “dignity” or “integrity of body, mind, and spirit.” “Self-determination” often means merely that the person has a choice of soup kitchens. The “least restrictive setting” frequently turns out to be a cardboard box, a jail cell, or a terror-filled existence plagued by both real and imaginary enemies.

Here’s another source to consider — the Atlantic magazine expounds on the crisis caused by deinstitutionalization.

Today, nearly half the people in U.S. jails and more than a third of those in U.S. prisons have been diagnosed with a mental illness, compared to about a fifth in the general population. May 25, 2021 from The Atlantic by Alisa Roth

There’s a complexity to this crisis of depth that I can’t explore in an article like this. Just being aware of the concept and tragedy of deinstitutionalization is a step in the right direction to understanding our current crises of homelessness, overcrowded prisons, and the abundance of mentally ill individuals.

And just maybe, possibly, hopefully, we can muster up a bit of compassion for the victims of deinstitutionalization.

Thank you for reading today’s Mental Health Awareness article. Stay tuned for another tomorrow, that is, if I can stop long enough to write one. And in case you missed the previous ones, you can find them here.

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