How is Reagan responsible for decisions made at a state and local level? Mental asylums had already lost their credibility as news of medical abuse was document

How is Reagan responsible for decisions made at a state and local level? Mental asylums had already lost their credibility as news of medical abuse was documented in the 60s. O'Connor vs Donaldson had rendered involuntary commitment as a violation of personal liberty. By the time Reagan became President, it was quite clear asylums were little more than medical prisons.