As a psychologist who began practicing nearly 40 years ago, I’ve seen a significant shift in the care of the mentally ill since the mid-1980s — and it hasn’t been for the better.
After the deinstitutionalization movement began in California in the 1960s, many state mental health hospitals closed, forcing many folks who needed a lot of care onto the streets.
Without those facilities, many mentally ill people ended up in jails and prisons which are not set up to provide safe, compassionate care for brain illnesses. But in 1981, when President d Reagan deinstitutionalized the mentally ill and emptied the psychiatric hospitals into so-called “community” clinics, the problem got worse.
Most of those who were deinstitutionalized from the nation’s public psychiatric hospitals were severely mentally ill. Between 50 percent and 60 percent were diagnosed with schizophrenia. The fact that many of these people struggled with various forms of brain dysfunction was not recognized back then. With so many advances in brain science, experts now know that we need to be able to coordinate care in residential facilities, especially if we are housing people at $4,000 per day in a local medical hospital.
People with severe mental illness need to be supported every step of the way. They need to be housed with compassion and supplied with medications, state of the art brain health therapies, nutritious food that supports brain health and extracurricular activities that give them a chance to live meaningful lives. They need to receive quality care with programs like art and music therapy, equestrian therapy, job training and volunteer opportunities to become actively engaged members of society.
