Nearly 60 Years After Congress Killed Off Mental Hospitals, Complete Breakdown of the System Has Lawmakers Attempting to Bring Them Back
What people think is compassion sometimes brings bad results.
Fail to confront the slacking employee and other workers have to carry more of a load. Be a pal to your children and then be frustrated by their disrespect. Lavish welfare and then wonder why unappreciative people won’t work.
And then there’s the running away from obligations to protect the mentally ill from themselves and from society.
Perhaps you’ve had the same thoughts as I — the grand experiment in mental health care of the past half-century or so has failed.
Just witness the aggressiveness of babbling panhandlers, the general filth of helpless people living on the sidewalks, the destruction of cities such as San Francisco.
Believe it or not, the left-leaning Politico published an article Monday that gave a nod in the direction of some kind of return to the involuntary commitment of some mentally ill people.
Just a nod, mind you, but its general direction reflected an overall thoughtfulness, as in pointing out growing numbers of health professionals favoring a return to stricter controls on mental issues.
Bills favoring involuntary commitments are making progress in both the U.S. House and Senate, of which Politico writer Carmen Paun said, “Republicans in Congress agree. Democrats are divided.”
The fact that some Democrats are willing to go along with a Republican push for involuntary commitment would seem shocking, but remember it’s Democrat-run cities and states that are suffering the most from homelessness based on mental illness.
And the Democrats are beginning to see political pushback to their laissez-faire attitudes toward sick street people.
Which means even lefties like New York Mayor Eric Adams and California Gov. Gavin Newsom are promoting some forms of mandatory incarceration, according to Politico.
In the background is fear of the old-fashioned large-scale mental health institutions where sometimes thousands were housed — warehoused, perhaps — and subject to abuse and starvation in formidable prison-like facilities, as outlined in a 1946 Life magazine article.
“One Flew Over a Cuckoo’s Nest,” the famed 1962 Ken Kesey novel that became a celebrated 1975 movie starring Jack Nicholson, made a mark in portrayals of the traditional mental health facilities, which themselves reflected 19th-century compassion in removing mentally ill from prisons, according to Politico.
Republican Sen. Bill Cassidy of Louisiana, who advocates the return of some dimensions of involuntary treatment, said, “It does not have to become a warehouse, you know.”
“‘One Flew Over a Cuckoo’s Nest’ — absolutely not,” said Cassidy, who is a gastroenterologist. “That’s wrong. It should not happen.”
Undercutting the original large mental health operations was the 1965 prohibition against using Medicaid for treating patients there. That followed advocacy in 1963 by then-President John F. Kennedy to replace the big hospitals with community-based mental health centers.
The new rules prohibited Medicaid from mental health facilities larger than 16 beds.
But now, with many urban streets awash with people seriously debilitated by mental illness and addictions, there are calls on many sides for reform.
The first step is rescinding the rule against larger mental health facilities. A measure to do that was approved by the House on Dec. 12 and by the Senate Finance Committee in November, and prospects for passage are considered good, according to Politico.
New Jersey Democratic Rep. Frank Pallone initially resisted the House bill. “We know that one of the best ways to help people in recovery is to ensure they have access to care in their communities,” he said.
But he came around to supporting it following Republican pledges to increase Medicaid for incarcerated individuals with substance abuse problems.
Republican Rep. Michael Burgess of Texas is a physician and sponsor of the House bill. “It is no longer the 1960s, and there is no longer the same stigma against the treatment of mental health,” he said.
My bill to lift the IMD exclusion, as part of the SUPPORT Act, passed the House in December. This legislation aims to modernize Medicaid coverage of addiction treatment in Institutes for Mental Diseases and directly addresses the fentanyl crisis in the US, which is linked to…
— Michael Burgess, MD (@michaelcburgess) January 2, 2024
Proof of the old adage that politics makes for strange bedfellows, a co-sponsor is Democratic Rep. Richie Torres, who represents New York City’s poverty-stricken South Bronx and who personally has been hospitalized for mental health issues.
🚨My bipartisan legislation with @michaelcburgess to improve mental health and drug treatment just overwhelmingly passed the House in a package by a vote of 386-37. pic.twitter.com/YIA2srip2i
— Rep. Ritchie Torres (@RepRitchie) December 12, 2023
Other supporters include the Treatment Advocacy Center and the National Alliance on Mental Illness, along with state-level directors of Medicaid, Politico reported.
Nevertheless, there are those who fear that steps toward change might slip mental health treatment back to the bad old days of warehousing.
In the end, the question is, who is willing to care for the mentally ill?
They’ve been neglected in the old-time hospital-prisons, and few care for them while they’re on the street.
Money can help in addressing such issues, but ultimately, these people need other people who have the training and the care to help them in their dark days.
Which brings each of us to the question, what personally do I do? Because the issue is more than just getting the mentally ill off the streets.
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