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Inpatient mental hospitals used to be in every state. They housed not only the mentally ill but also the chronically homeless and other outcasts. As the advent

Inpatient mental hospitals used to be in every state. They housed not only the mentally ill but also the chronically homeless and other outcasts. As the advent of antipsychotics and antidepressants reduced their population, these hospitals were an obvious target for budget cuts throughout the 80s and 90s. They money for the community health centers that were supposed to replace them never materialized, and thousands of patients were left without access to their medication. Some estimate that over 50% of the homeless population is mentally ill. Ironically prison systems now provide these services (and sometimes paying more for them!!), but in a much worse environment for the patients. https://www.pbs.org/wgbh/frontline/film/showsasylums/ https://www.pbs.org/wgbh/frontline/film/showsasylums/

arrosenberg 6y ago
I'll never forget this fact because there is a King of the Hill episode (10:13) where a mentally-ill, homeless man named Spongy exclaims "Ronald Reagan kicked me out of my mental hospital!" and Hank bashfully tries to justify it as part of winning the cold war.
- Sn0wCoder 6y ago
  I remember that episode, seen them all at least twice. I was just a kid when they all were closing but thinking back it seemed like a good thing. I do wonder now where people thought all those people in there would go. I think a lot of people believed they did not need to be there and were getting a free ride as strange as that sounds.
  - jrumbut 6y ago
    Hard to source this claim exactly but after many discussions on the topic, my view is that people across the political spectrum believed that there were adequate outpatient mental health resources for the newly released individuals. Either they imagined it was already available or that the money saved on running the institutions would instantly create it (with some left over). There was a massive underestimation of the scope of the problem.
stevecalifornia 6y ago
I would add that you are missing a major component for why mental hospitals went away-- public opinion changed. The public was made aware of abuses and such abuses were also dramatized in One Flew Over The Cuckoos Nest. There was pressure to shut these down. Separately, I will add that we need these hospitals back desperately. I don't know who will sign up for this tough job, but we need a place for the mentally ill to reside that is not the middle of the street.
- worik 6y ago
  True. The abuses are worse now, distributed rather than institutional, which makes the abuse harder to combat and easier to ignore. I am not in the USA, and we have a significant problem too.
- ALittleLight 6y ago
  Odd that "One Flew Over the Cuckoos Nest" could have such an effect, but we have all kinds of movies and TV shows now depicting how terrible prison is and that doesn't seem to have a similar (but opposite) effect.
  - munificent 6y ago
    "One Flew Over the Cuckoo's Nest" is about how forcing someone into a mental hospital just because they don't fit into society is evil and dehumanizing. There's lots of movies and shows that take place in prisons, but th prison itself is usually just the setting. The film is rarely making a statement about incarceration itself. Also, we have a much more fragmented high volume media culture, so it's not clear that film and TV can effect cultural change like they used to be able to.
- frankydp 6y ago
  Pennhurst and Bridgewater State Hospitals and the resulting exposes on these facilities were the start of the abandonment of most state run mental health services and facilities. Search for "Suffer the Children" from 1968, by NBC10. added: https://www.youtube.com/watch?v=YG33HvIKOgQ&feature=emb_logo https://www.youtube.com/watch?v=YG33HvIKOgQ&feature=emb_logo added: Also search "Titicut Follies" for temporal context Those calls to action lead to defunding and closing of many facilities on mass regardless of the services they provided or the conditions. From orphanages up to mental health institutions. That period was followed up by a small influential group of individuals that lobbied very hard to have state schools for the handicapped and severe development delays closed in preference of services provided by local schools culminating in Title 1, which was eventually federally mandated regardless of the level of care and support a child might need. Both of these large changes led to significant changes in the cultural acceptance of institutionalization of any individual young or old, even to the detriment of those individuals in some cases.
bko 6y ago
> As the advent of antipsychotics and antidepressants reduced their population, these hospitals were an obvious target for budget cuts throughout the 80s and 90s Do you have a source that shows that public funding for hospitals and treatments for mental health declined during this time period? From a quick search is seems it has risen considerably throughout the 80s to today. https://www.statista.com/statistics/252393/total-us-expenditure-for-mental-health-services/ https://www.statista.com/statistics/252393/total-us-expendit...
- anonAndOn 6y ago
  Trump stomping on his predecessor's sand castle is not a new phenomenon. Patients be damned, Jimmy Carter giveth and The Gipper taketh away.[0] [0]https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1980 https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...
  - bko 6y ago
    From your link: > the Mental Health Systems Act supported and financed community mental health support systems I'm missing something here.

arrosenberg 6y ago

I'll never forget this fact because there is a King of the Hill episode (10:13) where a mentally-ill, homeless man named Spongy exclaims "Ronald Reagan kicked me out of my mental hospital!" and Hank bashfully tries to justify it as part of winning the cold war.

Sn0wCoder 6y ago
I remember that episode, seen them all at least twice. I was just a kid when they all were closing but thinking back it seemed like a good thing. I do wonder now where people thought all those people in there would go. I think a lot of people believed they did not need to be there and were getting a free ride as strange as that sounds.
- jrumbut 6y ago
  Hard to source this claim exactly but after many discussions on the topic, my view is that people across the political spectrum believed that there were adequate outpatient mental health resources for the newly released individuals. Either they imagined it was already available or that the money saved on running the institutions would instantly create it (with some left over). There was a massive underestimation of the scope of the problem.

stevecalifornia 6y ago

I would add that you are missing a major component for why mental hospitals went away-- public opinion changed. The public was made aware of abuses and such abuses were also dramatized in One Flew Over The Cuckoos Nest. There was pressure to shut these down. Separately, I will add that we need these hospitals back desperately. I don't know who will sign up for this tough job, but we need a place for the mentally ill to reside that is not the middle of the street.

worik 6y ago
True. The abuses are worse now, distributed rather than institutional, which makes the abuse harder to combat and easier to ignore. I am not in the USA, and we have a significant problem too.
ALittleLight 6y ago
Odd that "One Flew Over the Cuckoos Nest" could have such an effect, but we have all kinds of movies and TV shows now depicting how terrible prison is and that doesn't seem to have a similar (but opposite) effect.
- munificent 6y ago
  "One Flew Over the Cuckoo's Nest" is about how forcing someone into a mental hospital just because they don't fit into society is evil and dehumanizing. There's lots of movies and shows that take place in prisons, but th prison itself is usually just the setting. The film is rarely making a statement about incarceration itself. Also, we have a much more fragmented high volume media culture, so it's not clear that film and TV can effect cultural change like they used to be able to.
frankydp 6y ago
Pennhurst and Bridgewater State Hospitals and the resulting exposes on these facilities were the start of the abandonment of most state run mental health services and facilities. Search for "Suffer the Children" from 1968, by NBC10. added: https://www.youtube.com/watch?v=YG33HvIKOgQ&feature=emb_logo https://www.youtube.com/watch?v=YG33HvIKOgQ&feature=emb_logo added: Also search "Titicut Follies" for temporal context Those calls to action lead to defunding and closing of many facilities on mass regardless of the services they provided or the conditions. From orphanages up to mental health institutions. That period was followed up by a small influential group of individuals that lobbied very hard to have state schools for the handicapped and severe development delays closed in preference of services provided by local schools culminating in Title 1, which was eventually federally mandated regardless of the level of care and support a child might need. Both of these large changes led to significant changes in the cultural acceptance of institutionalization of any individual young or old, even to the detriment of those individuals in some cases.

bko 6y ago

> As the advent of antipsychotics and antidepressants reduced their population, these hospitals were an obvious target for budget cuts throughout the 80s and 90s Do you have a source that shows that public funding for hospitals and treatments for mental health declined during this time period? From a quick search is seems it has risen considerably throughout the 80s to today. https://www.statista.com/statistics/252393/total-us-expenditure-for-mental-health-services/ https://www.statista.com/statistics/252393/total-us-expendit...

anonAndOn 6y ago
Trump stomping on his predecessor's sand castle is not a new phenomenon. Patients be damned, Jimmy Carter giveth and The Gipper taketh away.[0] [0]https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1980 https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...
- bko 6y ago
  From your link: > the Mental Health Systems Act supported and financed community mental health support systems I'm missing something here.