Around the time that Maxine was beginning her struggle with mental illness, President Kennedy signed the Community Mental Health Care Act. On October 31, 1963, just a few weeks before he was assassinated, the President focused on creating a system of mental health clinics to serve the mentally ill in the communities in which they lived. The purpose was to liberate the mentally ill from the abuse of long-term hospitalization and return them to the community with adequate treatment. The idea was that if people were treated, they would be able to return to the community as a productive member. Very admirable goal. However, this goal was never reached. We can only look at what we are currently dealing with in terms of mental illness and treatment to realize that. Here is the article that gave me the information that I will be sharing with you: http://bit.ly/1a66zX4
Let's look at the actual results of the law. In terms of the goal of decreasing inpatient hospitalization for the mentally ill, it appears to have worked. The article quotes Paul Applebaum, a Columbia University Psychiatry Professor, who says that approximately 90% of the beds in inpatient mental health hospitals were eliminated by the act. Unfortunately, the other part of the goal, creating mental health centers to take up the slack didn't happen. Because the federal government didn't totally fund the effort, the centers didn't get created. Therein lies the problem, beds were taken away from the severely mentally ill. The replacement resources for treatment were never created. So, that left the mentally ill untreated and out in the community. That pretty much sums the problem up and explains the problems that we are experiencing today.
What can we learn from this? First of all, we can't put only half of a solution in place and expect it to solve the entire problem. This should be obvious. What did we create by closing inpatient options without having alternatives? A huge number of homeless mentally ill who didn't have treatment available. Increased involvement of the mentally ill in the criminal justice system. And the continued stigma and fear of the mentally ill partially due to the number of high profile violent incidences that have become common today.
Second, we can learn that solutions have to be multi-pronged. In other words, eliminating beds alone is not a solution. What that actually accomplished is that we eliminated treatment for the most severely mentally ill. When unable to obtain care, the severely mentally ill are most likely to end up on the streets, as they exhaust family energy and resources. We have to have a continuum of care...many solutions for many different needs. From treatment to supportive services. From assistance regarding finances to opportunities to create support systems. From jobs training to placement in jobs. From housing to case management. A system of services to provide for the needs that the mentally ill and their families are likely to have. Sounds kind of costly, doesn't it?
I would suggest that the true cost is in avoiding this. Without looking at the problem in a holistic way, we are setting ourselves up for even higher costs in the long run. The results of violence, homelessness, and crime seem to be too high a price to pay for ignoring the needs of the mentally ill. We have a choice here. We can go back to the basics...the spirit of The Community Mental Health Care act of 50 years ago. We can create a society in which the mentally ill really have the support to reintegrate into the community as productive citizens. We can solve the problems created when we eliminated beds and ignored the needs for other services. The solution is in our hands.
Let's look at the actual results of the law. In terms of the goal of decreasing inpatient hospitalization for the mentally ill, it appears to have worked. The article quotes Paul Applebaum, a Columbia University Psychiatry Professor, who says that approximately 90% of the beds in inpatient mental health hospitals were eliminated by the act. Unfortunately, the other part of the goal, creating mental health centers to take up the slack didn't happen. Because the federal government didn't totally fund the effort, the centers didn't get created. Therein lies the problem, beds were taken away from the severely mentally ill. The replacement resources for treatment were never created. So, that left the mentally ill untreated and out in the community. That pretty much sums the problem up and explains the problems that we are experiencing today.
What can we learn from this? First of all, we can't put only half of a solution in place and expect it to solve the entire problem. This should be obvious. What did we create by closing inpatient options without having alternatives? A huge number of homeless mentally ill who didn't have treatment available. Increased involvement of the mentally ill in the criminal justice system. And the continued stigma and fear of the mentally ill partially due to the number of high profile violent incidences that have become common today.
Second, we can learn that solutions have to be multi-pronged. In other words, eliminating beds alone is not a solution. What that actually accomplished is that we eliminated treatment for the most severely mentally ill. When unable to obtain care, the severely mentally ill are most likely to end up on the streets, as they exhaust family energy and resources. We have to have a continuum of care...many solutions for many different needs. From treatment to supportive services. From assistance regarding finances to opportunities to create support systems. From jobs training to placement in jobs. From housing to case management. A system of services to provide for the needs that the mentally ill and their families are likely to have. Sounds kind of costly, doesn't it?
I would suggest that the true cost is in avoiding this. Without looking at the problem in a holistic way, we are setting ourselves up for even higher costs in the long run. The results of violence, homelessness, and crime seem to be too high a price to pay for ignoring the needs of the mentally ill. We have a choice here. We can go back to the basics...the spirit of The Community Mental Health Care act of 50 years ago. We can create a society in which the mentally ill really have the support to reintegrate into the community as productive citizens. We can solve the problems created when we eliminated beds and ignored the needs for other services. The solution is in our hands.
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