Deinstitutionalization- a term popularized in the mid fifties to early seventies, was an experiment involving the release of some 830,000 mental patients. By reducing state mental hospitals by 60%, this ideology was found very appealing by Liberals due to mental patients receiving their freedom (Website 1). It was also liked by conservatives because of the large amount of money that would be saved by cutting the mental health budget. A very debatable question arises when analyzing this, and the upsurge of homelessness.
Is the increase of homelessness due to deinstitutionalization? I believe that homelessness is not a result of deinstitutionalization, but rather in the way it has been implemented. Approximately 20-25% of the single adult homeless population suffers from some form of severe and persistent mental illness (Website 2). According to the Federal Task Force on Homelessness and Severe Mental Illness, only 5-7% of the mentally ill homeless need to be institutionalized (Website 2). A majority of mentally ill can live within the community with the appropriate supportive housing options (Website 2). That is where the problem lies.
The mentally ill individuals, who have been dependent on all aspects of an institution, are being thrown into a community with little help or guidance. The importance of the distribution of psychoactive medication and financial support were perceived, but the significance of helping to create a community status role for the mentally ill was overlooked. Once this became apparent, community mental health centers were very resistant to providing services for them. States were also extremely reluctant to distribute funds for these community-based services (Website 3).
There are also several aspects of institutionalism that were not recognized in the early stages of deinstitutionalization. First, observations of patients that spend a substantial amount of time in a hospital prove that one develops institutionalism. This is a syndrome characterized by lack of initiative, apathy, withdrawal, submissiveness to authority, and excessive dependence on the institution (Website 3). It has also been found that some of these reactions caused by external stimulation are qualities of the disease itself. One of the most important factors, that was disregarded by the simple minded individuals who helped bring about deinstitutionalization, is what left these mentally ill people unable to work, support themselves, cope with community, and ideally make them feel somewhat like a member of the community. These findings definitely support the drift theory, which states that upper class mentally ill will drift downward into lower class neighborhoods.
This class transition then increases the rate of mental illness in that neighborhood. Once released from an institution a mentally ill person, without the support of the community and much needed medication, might find themselves feeling very scared and threatened by interactions with the community. This leads us to another problem, which is crime and the mentally ill. About one thousand people in the U.S. are murdered by severely mentally ill people who are not receiving treatment. These killings are about 5% of all homicides nationwide, and help show once again how important it is to follow all the steps of deinstitutionalization.
How do you charge someone with a crime that suffers from a severe mental illness? The insanity defense refers to that branch of the concept of insanity, which defines the extent to which men accused of crimes may be excused of criminal responsibility because of their mental illness. The final decision on whether an individual is mentally ill or not rests solely on the jury, who gets their information drawn from the testimony of expert witnesses. These are usually professionals in the field of psychology. The result of such a decision is what places these individuals in a mental facility, incarceration, or a release.Due to these factors above, there a many problems that arise by the existence of the insanity defense. Problems such as the possibility of determining mental illness, justifiable placement of judged mentally ill offenders, and the overall usefulness of such a defense.
Insanity is a legal definition, not one of medical origin. In other words insanity and mental illness are not synonymous. Only some mental illness constitutes insanity. Because of this, there are problems in applying a medical theory to a legal matter.
One test used to establish insanity is the Durham Rule. It is based on the contention that insanity represents many personality factors, all of which may be present in every case (Website 5). Judge David Bazelon brought about this rule during the case of Durham vs. U.S.
He rejected the M’Naghten Rule and stated that the accused is no criminally responsible if the unlawful act was the product of mental disease of defect. The major problem with this rule again lies in its meaning. Once again it is impossible for us to define mental disease or defect, and product does not give the jury a reliable standard by which to base a decision. In Texas, there is a man on death row who had been diagnosed with paranoid schizophrenia at the age of 21. Having been adopted, the family really didn’t know what was wrong with him during his adolescence. This case is a prime example of deinstituitionalization because after his diagnosis he kept being turned away because he wasn’t violent and the hospital needed a bed (Website 6).
Knowing of his need of medication and counseling, institutions kept admitting him for about thirty days and then letting him go because of the non violence factor. His first and only act of violence was killing five people. Larry is now on death row and even after records were dug up showing five other biological relatives with this same disease he will not be given a sanity hearing. I have found a lot of information about community shelters and treatment centers, but after all this research it doesn’t sound like their doing their job very well or they don’t have the funds to do so. I believe that some mentally ill need to reside in a long-term facility.
Some individuals will never adapt to society and are not capable of functioning as a member of the community on their own, on a daily basis. For those who are I believe that the whole process of deinstitutionalization needs to be rethought. The emergency homeless shelters and the short lived institution visits just aren’t working. These individuals need to be embraced by the community not shunned because a difference they have no control over. With the right amount of financial support, guidance, and medication I believe we would see more somewhat dependent mentally ill individuals.
Bibliography:Bibliography(Website1). http://csf.colorado.edu/mail/homeless/feb99/0037.html(Website2). http://nch.ari.net/causes.html(Website3). http://wwwlinteractivist.net/housing/deinstitutionalization_1.html(Website4).
http://www.psych-health.com/madness1.htm(Website5). /Encarta.msn.com/find/concise.asp?ti=008F600(Website6). http://www.flashl.net/rwcarlso/larry.htm