I've always heard that Reagan eliminated mental health care in the USA

[Coventina]

Here's an article about how that happened:

https://www.salon.com/2013/09/29/ronald_reagans_shameful_legacy_violence_the_homeless_mental_illness/

***snip***

President Reagan never understood mental illness. Like Richard Nixon, he was a product of the Southern California culture that associated psychiatry with Communism. Two months after taking office, Reagan was shot by John Hinckley, a young man with untreated schizophrenia. Two years later, Reagan called Dr. Roger Peele, then director of St. Elizabeths Hospital, where Hinckley was being treated, and tried to arrange to meet with Hinckley, so that Reagan could forgive him. Peele tactfully told the president that this was not a good idea. Reagan was also exposed to the consequences of untreated mental illness through the two sons of Roy Miller, his personal tax advisor. Both sons developed schizophrenia; one committed suicide in 1981, and the other killed his mother in 1983. Despite such personal exposure, Reagan never exhibited any interest in the need for research or better treatment for serious mental illness.

***snip***

In the 1980s, this all changed. Deinstitutionalization became, for the first time, a topic of national concern. The beginning of the discussion was heralded by a 1981 editorial in the New York Times that labeled deinstitutionalization “a cruel embarrassment, a reform gone terribly wrong.” Three years later, the paper added: “The policy that led to the release of most of the nation’s mentally ill patients from the hospital to the community is now widely regarded as a major failure.” During the following decade, there were increasing concerns publicly expressed about mentally ill individuals in nursing homes, board-and-care homes, and jails and prisons. There were also periodic headlines announcing additional high-profile homicides committed by individuals who were clearly psychotic. But the one issue that took center stage in the 1980s, and directed public attention to deinstitutionalization, was the problem of mentally ill homeless persons.

During the 1980s, an additional 40,000 beds in state mental hospitals were shut down. The patients being sent to community facilities were no longer those who were moderately well-functioning or elderly; rather, they included the more difficult, chronic patients from the hospitals’ back wards. These patients were often younger than patients previously discharged, less likely to respond to medication, and less likely to be aware of their need for medication. In 1988 the National Institute of Mental Health (NIMH) issued estimates of where patients with chronic mental illness were living. Approximately 120,000 were said to be still hospitalized; 381,000 were in nursing homes; between 175,000 and 300,000 were living in board-and-care homes; and between 125,000 and 300,000 were thought to be homeless. These broad estimates for those living in board-and-care homes and on the streets suggested that neither NIMH nor anyone else really knew how many there were.

***snip***

Despite the claims of homeless advocates, media attention directed to homeless persons made it increasingly clear that many of them were, in fact, seriously mentally ill. In 1981, Life magazine ran a story titled “Emptying the Madhouse: The Mentally Ill Have Become Our Cities’ Lost Souls.” In 1982, Rebecca Smith froze to death in a cardboard box on the streets of New York; the media focused on her death because it was said that she had been valedictorian of her college class before becoming mentally ill. In 1983, the media covered the story of Lionel Aldridge, the former all-pro linebacker for the Green Bay Packers; after developing schizophrenia, he had been homeless for several years on the streets of Milwaukee. In 1984, a study from Boston reported that 38% of homeless persons in Boston were seriously mentally ill. The report was titled “Is Homelessness a Mental Health Problem?” and confirmed what people were increasingly beginning to suspect—that many homeless persons had previously been patients in the state mental hospitals.

***snip***

By the end of the 1980s, the origins of the increasing number of mentally ill homeless persons had become abundantly clear. A study of 187 patients discharged from Metropolitan State Hospital in Massachusetts reported that 27% had become homeless. A study of 132 patients discharged from Columbus State Hospital in Ohio reported that 36% had become homeless. In 1989, when a San Francisco television station wished to advertise its series on homelessness, it put up posters around the city saying, “You are now walking though America’s newest mental institution.” Psychiatrist Richard Lamb added: “Probably nothing more graphically illustrates the problems of deinstitutionalization than the shameful and incredible phenomenon of the homeless mentally ill.”

on edit: typo

[underpants]

1. 👀

Thanks. Reading later. Reagan basically read his lines and tried not to bump into the furniture.

[Hekate]

16. He was still very much in his right mind when he was elected governor of California

[tblue37]

2. K&R for visibility. nt

[Elessar Zappa]

3. Yes.

Severe mentally ill people are now often on the streets or in prison. The shuttering of mental health hospitals was a national disaster. Yes, there were problems with the hospitals but the answer wasn’t to close them but to reform them.

[I_UndergroundPanther]

4. Reagan was a fascist asshole

Look at what he caused not what he said.
He is the one that killed the fairness doctrine that has paved the way for stations like faux news. He was racist when he trotted out that stupid trope about welfare queens driving cadillacs.He was wanting this shit to happen and he enabled fascism.

[Ex Lurker]

8. That was over 40 years ago

Time enough to have done something about it. The fact is there are people who can't live on their own in society, and community based outpatient solutions don't work for them. People who won't take their meds or are too damaged for meds to help, have to be in institutions. There have to be institution for them and legal means to get them there and keep them there. Civil liberties activists who advocate for complete personal autonomy do neither the mentally ill nor society in general any favors.

[Hekate]

17. People forget he was California governor from 1967-1975. That was when he closed down ...

..the state mental hospitals. So, a very long time ago.

I agree with you that there are people who need institutional care — and that making jails the default organization to take them in is heinous.

Reagan was aided and abetted all the way by the far right, which was becoming ascendent. Dems keep trying to repair the damage done by the RW — then another GOP president is elected, another GOP Congress or Senate comes in.

[MichMan]

22. Why hasn't California reopened them all in the 45 years since Reagan was governor

It doesn't really matter what Republicans do

[Hekate]

26. Why do you think?

[Mr.Bill]

28. Probably because since then we've had

three two-term republican governors and we didn't hold the super-majority we have now to over-ride vetoes. California hasn't always been as blue as it its now.

[paleotn]

30. Exactly.

[MichMan]

32. They have one now, correct?

And a big budget surplus.

Tired of not having the political will to undo something that occured way back in the 70's

[Mr.Bill]

33. Yes, and legislation has been passed recently

on plans to get homeless people with mental issues the help they need. I'm not familiar with all the details but I believe it allows adjudication to place people with mental health issues in facilities. It's a start.

Yes, we do have a huge budget surplus, but many problems that need addressing. And literally and figuratively many fires to put out.

[I_UndergroundPanther]

38. Im mentally ill

And I agree.

However you cannot put narcissists,sociopaths or psychopaths in group settings with trauma,manic depression ect.

The sociopath will hurt them.
It takes just one sociopath/ narcissist to fuck up any group setting,put patients in danger and sociopaths suck all the oxygen out of a psych unit so staff are occupied with the sociopath at the detriment to everyone else.

Sociopaths arent mentally ill its who they are it is like downs syndrome it never improves. Sociopaths need jail.

Psychiatry has to look at this problem honestly.

[Docreed2003]

5. K&R

[Farmer-Rick]

6. The GOP sold it as a way to get patients closer to their homes

What the con was, that yeah, they were going to close the large mental health facilities and psychiatric hospitals. But they were going to create and fund local mental health facilities to compensate for it.

But guess what? They never funded the local mental health clinics. I think about 10% if the funding went out. Then everyone just ignored it.

[Ex Lurker]

10. You're right about that. The other part that's often unsaid is

there are people who need more supervision than local mental health facilities would provide. So that alone wouldn't solve the problem of the severely mentally ill homeless.

[pamdb]

7. mentally ill

As a retired public librarian in a fairly large urban library, I an tell you were a lot o them went.
To your public library.

[Coventina]

9. As a user of public libraries, I am well aware.

Thank you for your service!

[paleotn]

31. You are 100% correct.

Then again, where else are they going to go? A national tragedy few ever talk about.

[The_Casual_Observer]

11. At that time Los Angeles was buying one way bus tickets to

Riverside for those that were put out on the street. The bus terminal and surrounding area - an area that was in deep decline at that time was filled with these souls wandering around. It was heartbreaking to witness.

[mnhtnbb]

12. Gov Reagan was connected to the businesses making $$ from closing state psych hospitals

From the article:

California has traditionally been on the cutting edge of American cultural developments...

This was also true in the exodus of patients from state psychiatric hospitals. Beginning in the late 1950s, California became the national leader in aggressively moving patients from state hospitals to nursing homes and board-and-care homes, known in other states by names such as group homes, boarding homes, adult care homes, family care homes, assisted living facilities, community residential facilities, adult foster homes, transitional living facilities, and residential care facilities. Hospital wards closed as the patients left. By the time Ronald Reagan assumed the governorship in 1967, California had already deinstitutionalized more than half of its state hospital patients. That same year, California passed the landmark Lanterman-Petris-Short (LPS) Act, which virtually abolished involuntary hospitalization except in extreme cases. Thus, by the early 1970s California had moved most mentally ill patients out of its state hospitals and, by passing LPS, had made it very difficult to get them back into a hospital if they relapsed and needed additional care. California thus became a canary in the coal mine of deinstitutionalization.

snip

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.

My husband was a resident in Psychiatry at UCLA when this was all going on in the mid to late 60's (before he had to give two years to Uncle Sam in the USAF (Berry Plan) for Vietnam). He watched it from the inside. Many years later a very prominent psychiatrist who was heavily involved in the process of setting up this new practice of releasing state psych patients to community settings told him he really regretted having been involved. He felt taken. The concept had been sold with the idea of funding going to community centers--instead of residential state facilities--and, of course, the corporate owners swooped in with their for-profit goals, and eventually the funding dried up so that many of the patients ended up homeless.

Privatizing. Republican wet dream. It's why they want to get their hands on Social Security and it's what they are currently doing with Medicare Advantage plans in place of original Medicare. Greedy f'ing Republicans.

[Coventina]

13. I wish I could rec your post!

Thanks for the inside, personal knowledge!

[appalachiablue]

37. ++

[progressoid]

42. +1

[Aristus]

14. I've talked to right-wingers before about the best way to improve the homeless situation

in the United States, and that it includes reversing a lot of what Ronald Reagan did. They don't want to hear it, though, because they worship at the altar of St. Ronald.

Every. Single. Day. I have patients who fall into one or another of the categories listed in the article. If anyone ever tells you that homeless people "choose" to be homeless, just tell them that some people find living on the streets preferable to the horrific conditions found in many of these for-profit mental health nursing facilities.

[I_UndergroundPanther]

39. They need to put sociopaths

In jail. They bully,threaten , hurt and traumatize patients.

I bet sociopathy is partly why hospitals are so awful.

I got raped on a psych ward and I had cptsd and dissociative disorder before that happened. Sociopaths cannot be mixed in with other patients period.

[Hekate]

15. You know this "nostalgia" for the 1950s? Part of it is this: there were no beggars in the streets....

No homeless. No people looking visibly unhinged.

I was a child, to be sure. But I was aware that part of our narrative about the wonderfulness of America was that other countries had these problems, but that we had left behind these tragic images when the Great Depression ended.

And then Ronald Reagan was elected governor. His brilliant money-saving idea — aided, it is true, by civil libertarians pointing out how much progress had been made on the medication front — was not accompanied by any substantive change in the infrastructure of mental health care. The really seriously ill were at perfect liberty to stop taking their meds and go live under a bridge with the voices in their heads for company.

I watched it happen. That was the first wave of homeless beggars. Just the first wave. After that, look to the economy. But my gods.

[demosincebirth]

18. He did in CA.

[Kaleva]

19. Before, it was much easier to have someone committed

[Coventina]

20. And, perhaps it was too easy.

However, the answer is not to make it nearly impossible.

[Kaleva]

24. The issue now is that the mentally ill are in charge of their treatment

Unless they pose an actual threat to themselves or others, it is they who decide.

[I_UndergroundPanther]

40. The evidence based care

Is a joke,they expect you to rate complex feelings on a number scale its so stupid.
Dont get me started on the new age indoctrination and positive think that is so in vogue now.

Shrinks can heap the cause on a patients and if that patient cant mindful their symptoms away they feel hopeless

There is a social culture reason mental illness is so common.

Therapists got to consider that maybe this profit at all cost capitalist work all day and never even be comfortable enough to survive type culture is harming people

[Hekate]

25. Exactly. I have 2 different friends who each had an adolescent that suffered a psychotic break...

This happened about a decade apart in the 1990s. In both cases, the parents’ hands were tied as soon as their child turned 18. You want insane? That is insane.

In my naïveté I thought lack of family money was a contributing factor, but the second kid had a father who was a trust fund baby, so to speak, and his hands were just as tied as the moneyless woman’s.

One story ultimately ended well, because the young woman had enough personal insight to seek out appropriate treatment on her own.

The other story ended with the young man hacking his stepmother to death in the yard of their home — while his dad was out interviewing yet another potential resource for help.

It shouldn’t be impossible. And the prison system shouldn’t be our default insane asylum.

[Chainfire]

21. The shuttered mental hospitals because they wasted money on sick people.

Money better spent on business handouts.

[Kaleva]

27. ACLU fought against confining people against their will and won

People who hadn't shown to be a threat to themselves or others and could reasonably care for themselves.

[former9thward]

23. Since I have often read this charge, I was waiting to read how Reagan did it.

Which was the second line of the OP. I did not read anything about that.

Reagan did not lead the "de institutional" movement, the ACLU did as they proudly relate on their website. Beginning in the mid-1970s the ACLU filed a series of lawsuits against mental health hospitals for involuntarily holding patients.

The ACLU's most important Supreme Court case involving the rights of people with mental illness was filed on behalf of Kenneth Donaldson, who had been involuntarily confined in a Florida State Hospital for 15 years. He was not dangerous and had received no medical treatment. In a landmark decision for mental health law in 1975, a unanimous Supreme Court ruled that states cannot confine a non-dangerous individual who can survive on his own, or with help from family and friends.


https://www.aclu.org/other/aclu-history-mental-institutions

Almost all mental health is dealt with (or not dealt with) by the states, not the Federal government.

[hardluck]

36. It would be nice if more people read your post

Than parroted the simplistic idea that Reagan shut down the state mental institutions. There is is a history here that we could learn from if we seek to reform mental health in the US.

[BigmanPigman]

29. My mother still rants about this to this day.

[MichMan]

34. Somehow Reagan did it with a Democratic House for his entire two terms

Really tired of people powerless to undo something that occured 35 years ago. I was in college then and now I am eligible for Medicare. How long does it take?

[Coventina]

35. It's a lot more difficult to build something than to tear something down.

Especially when it involves a population that many feel are worthless to begin with.

[JudyM]

41. This was exactly what awakened me politically. Total clarity about the difference between D & R.

My dad was an ardent political conservative, even though compassionate. I wasn’t interested in politics as a teen, just doing my own thing. Then this happened and the light went on for me.