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Isn't this usually attributed to the Reagan administration's repeal of Mental Health Systems Act? Not that the situtation was necessarily all that great before

Isn't this usually attributed to the Reagan administration's repeal of Mental Health Systems Act? Not that the situtation was necessarily all that great before it was repealed, but my understanding is that the federal government making this change ended up putting a lot of people on the street. https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1980 https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...

KLexpat 6y ago
Yeah they did, we have had similar problems in Australia The thing is, it's still a lot better than the mid-century horror stories of institutions; electrotherapy, lobotomy, people being drugged into a permanent fugue state, sexual abuse, etc. Those concerns are what drove these changes to the system.
- bobthepanda 6y ago
  The Carter Administration had funded a transition to community-based outpatient mental health. Then the Reagan administration proceeded to pull the rug out by repealing the MHSA and leaving it to the states. https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1980 https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...
- CaptainZapp 6y ago
  > The thing is, it's still a lot better than the mid-century horror stories of institutions; electrotherapy, lobotomy ECT[1] (Electroshock Therapy) has an extremely bad rap (One Flew over the Cukoo's Nest didn't help), but there's quite an important use for it in modern psychiatry. Notably severe depression, where normal meds don't help, or where there's an urgency to do something immediately (psychiatric meds usually take a few weeks to work and finding the right medication and dosage can be very difficult) ECT may be the last viable option for a patient. Nowadays an anesthetic is applied before the treatment and (except in very rare cases) informed consent by the patient is required. There's no doubt that it was massively abused in the past (and let's not even get started on lobotomy) and I'm pretty sure it's still abused in countries run by totalitarian regimes. But it can be really the last hope for a patient with severe depression, despite the fact that it still has a very bad image. [1] https://en.wikipedia.org/wiki/Electroconvulsive_therapy https://en.wikipedia.org/wiki/Electroconvulsive_therapy E: clarifications
lotsofpulp 6y ago
There was also a few court cases in the 70s and 80s that made it very difficult to involuntarily commit someone to a mental institution. Some of them are: https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson https://en.wikipedia.org/wiki/Addington_v._Texas https://en.wikipedia.org/wiki/Addington_v._Texas If a mentally ill person doesn’t want to stay in a mental institution, authorities basically have to wait until they cause significant harm to be classified as dangerous before being able to do anything.

KLexpat 6y ago

Yeah they did, we have had similar problems in Australia The thing is, it's still a lot better than the mid-century horror stories of institutions; electrotherapy, lobotomy, people being drugged into a permanent fugue state, sexual abuse, etc. Those concerns are what drove these changes to the system.

bobthepanda 6y ago
The Carter Administration had funded a transition to community-based outpatient mental health. Then the Reagan administration proceeded to pull the rug out by repealing the MHSA and leaving it to the states. https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1980 https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...
CaptainZapp 6y ago
> The thing is, it's still a lot better than the mid-century horror stories of institutions; electrotherapy, lobotomy ECT[1] (Electroshock Therapy) has an extremely bad rap (One Flew over the Cukoo's Nest didn't help), but there's quite an important use for it in modern psychiatry. Notably severe depression, where normal meds don't help, or where there's an urgency to do something immediately (psychiatric meds usually take a few weeks to work and finding the right medication and dosage can be very difficult) ECT may be the last viable option for a patient. Nowadays an anesthetic is applied before the treatment and (except in very rare cases) informed consent by the patient is required. There's no doubt that it was massively abused in the past (and let's not even get started on lobotomy) and I'm pretty sure it's still abused in countries run by totalitarian regimes. But it can be really the last hope for a patient with severe depression, despite the fact that it still has a very bad image. [1] https://en.wikipedia.org/wiki/Electroconvulsive_therapy https://en.wikipedia.org/wiki/Electroconvulsive_therapy E: clarifications

lotsofpulp 6y ago

There was also a few court cases in the 70s and 80s that made it very difficult to involuntarily commit someone to a mental institution. Some of them are: https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson https://en.wikipedia.org/wiki/Addington_v._Texas https://en.wikipedia.org/wiki/Addington_v._Texas If a mentally ill person doesn’t want to stay in a mental institution, authorities basically have to wait until they cause significant harm to be classified as dangerous before being able to do anything.