MENTAL HOSPITALS EMPTIED
I want to avoid overstating the obvious. However, aspects of today’s homelessness situation were predictable nearly fifty years ago. I recall a conversation with my older brother lawyer about a case that arose in our hometown that made its way to the US Supreme Court. The case was part of a change in the historic manner of mental health commitments by the courts. Due process rules akin to criminal law cases were established before an individual could be involuntarily committed for treatment.
A local lady diagnosed with schizophrenia was well know for repetitive phone calls (i. e. 100’s in a day), oration at common council meetings and ongoing disputes with past employers/attorneys/ and police. When the police came to transport her to a hospital she claimed they were “Nixon Goons” sent to kill her. There was no question that the poor woman needed mental health treatment. However, short of an official court commitment she refused treatment. Her successful case led to a re-writing of the state’s laws on involuntary commitment. What my brother and I discussed those many years ago is that her case also led to reducing/closing much of the county’s mental health facilities; including out-patients funding. Politicians could then re-direct those funds to other sectors. The question thereafter was whether a suitable treatment alternative to commitments was to be set up. The local lady involved lived a long and presumably chaotic life. Homeless at times she often slept on buses and had scores of emergency detentions. It was later reported that she once asked for admission to a psychiatric hospital for treatment but she was refused because she did not meet the admission criteria established by her case in the 1970’s. (No room in the inn.)
When one walks the downtown streets it is common to see segments of the homeless who rant and rave. It cannot be determined if the individual is a danger to themselves or others but treatment is clearly needed. Layer in addictions and there are many on the street who do not get adequate treatment. I see little dignity in their freedom/plight. Politically, it allows for a great deal of lip service to compassion and talk of addressing “complex” issues. A legislative will to enact required treatment, and pay for it, short of mental institutions for the non-dangerous doesn’t appear to exist.
One constant for folks brought in for a hearing after an emergency detention is the refusal to take medication. In a past life Papa was appointed to represent various clients on mental health holds. Most of the individuals stated they’d refuse medication. A quick hearing and they’d be back on the streets. One man in particular insisted he’d not be examined, sealed his lips and would take no medicine. He said words to the effect that they will have to release me. He was. Two months later the newspaper reported that he died after being struck by a vehicle on a snowy night while he was running naked in the center of the road yelling at the passing traffic.
In 1948 there was a movie, “The Snake Pit” that highlighted the sordid side of mental institutions. It went a long way in promoting change in the laws concrning involutary housing of mental patients. The eventual constitutional rights case my brother and I discussed followed that evolutionary path. “Enlightenment” at the time meant that not all mental patients belonged in asylums; especially on an involuntary basis. Sadly, all the good intentions are worthless if mental health treatment is not only not available in the commun ity but also cannot be made mandatory. Ranting and raving, living hand to mouth on the streets, being subject to abuse and spiraling into deeper mental illness is the opposite extreme to the Snake Pit. There is a need for the money and effort to treat and protect the vulnerable. There is a need to bolster mental health laws that not only protects against wrongful admission to institutions but insures “no ifs ands or buts” treatment. Some might argue that it is not mean/cruel to ban living on the street and put some teeth in mandated treament for mental patients in need.