The re-institutionalization and criminalization of people labeled with ‘mentally illness’

The Sacramento Bee has started a disturbing opinion piece series, coupled with a forum, in The Conversation: A Journey Into Darkness. The editorializing of this article focuses on one specific case of a young man labeled with “mental illness”, and his families alarm over the situation this young man has created for himself. From this specific case the opinion piece then proceeds to generalize about all cases without reference to any other specific cases.

I personally favor deductive reasoning over such inductive methods. As we haven’t made this case the rule simply by treating it as such, it is always possible that it could be exceptional.

The father of this young man has taken to lobbying the state for more draconian mental health laws. He is trying to get a law enacted to force psychiatric drugs on people who have no desire to take such drugs.

I didn’t like him as a Governor (I was in California for a small amount of time back then), and I liked him even less as a President, but Ronald Reagan may be deserving of a little praise for some of the things he did while he was around.

In the 1960s, California had 14 state hospitals that housed 36,000 patients. Gov. Ronald Reagan pushed to empty the facilities, and found allies among conservatives who saw a chance to save money, and liberals who saw abuses and sought to grant patients greater rights. They emptied the hospitals, but never sent money to counties to fund community care.

Okay, and excluding the possibility that perhaps Ronald Reagan has been given much undue credit…

The state hospital population fell to 3,410 patients by 1995. The pendulum is swinging. The population under the care of the California Department of Mental Health is expected to reach 6,324 next year.

Subtract 3,410 patients from 36,000 patients, and you get 32,599 patients who were no longer held in the state hospitals. This isn’t magic. They didn’t need to be there in the first place. Subtract 6,324 patients from 36,000 patients, and you get 29,676 patients. Either way, this represents a vast improvement over the 1960s.

We’ve now come to the scary part of the equation.

However, the mix is very different. Twenty years ago, half the people in the few remaining state hospitals had committed no crime. Now, 92 percent of the patients are in for Penal Code violations. Many thousands more severely mentally ill people are housed in state prisons.

When 92 % of the patients in California psychiatric institutions are now forensic patients, the authorities must be using criminal law, petty or otherwise, with more frequency than ever before to detain people in the mental health system.

Many ex-patient advocates will tell you that they were once labeled “severely mentally ill” themselves. The line between the person with a “major mental illness” label and the person with a “minor mental illness” label is not as broad as some people may imagine it to be. People recover from “serious mental illness” labels, they join the ranks of the mentally well, and they get on with their lives. More funding for community mental health programs might help, provided those programs were effective. Such is not always the case. This matter is actually about intolerance and criminalization, and those are the issues that should be addressed in any discussion of this sort.

5 Responses

  1. The article points out an extreme case and any lawyer will pop up and tell you extreme cases do not make for good law. You’re right to argue that it’s wrong to paint with a broad brush and to suggest the facts of this case can be applied to all other cases.

    One of the things that makes it an extreme case is that this kid’s parents were very well-connected and very powerful in the state. I can’t prove it, but I’ll bet some of the kid’s current situation can be laid at their doorstep. They pulled strings to keep him out of trouble, and they had every means at their disposal to force him to get help. And none of the help was helpful. I find it bizarre that they’re now trying to blame the laws for his problems.

    Another thing that makes it an extreme case is that this kid is a rather violent cookie. Mental health apologists try to equate lack of treatment with violence. This has been proven time and time not to be the case. However, this kid was violent and I get the feeling the mental health professionals tried to avoid him because they knew full well there was nothing they or the drugs could do about that violent streak, unless he actually wanted to do something about it.

    The poor kid’s at Napa State Hospital. One of Napa State’s former inmates commented in the forums and left his website. His website reports that:

    …Inside NSH marijuana and methamphetamine are the drug choices of the day which can be purchased from staff. Inside NSH alcohol is also brought onto the hospital grounds and sold to patients.

    Patients have bought sex from female staff.

    According to Wayne Morin Jr the black-market, prostitution, trafficking of drugs, sale of alcohol and loan sharking are happening this very day at Napa State Hospital and hospital staff is well aware of what is going on, and not only do they turn a blind eye, they are participating in these very illegal activities

    You know if I’d been locked up at this place, they would have never kicked me out. I’d still be there partyin’. I’m sure it’s a wonderful environment if you’re an attractive, young drug user

    This place is no better than or different from a prison. But because it’s run by psychiatrists it’s considered far more humane. lol

    • It looks like Napa State Hospital could use an investigation.

      This case has not been put in context. Putting it in context would be a matter of comparing it with other cases. It would be a matter of looking at the statistics. There are not a lot statistics in this article on violence and mental health issues, and there should be. Generalizing on the basis of one disturbed individual you’re going to get more misses than hits.

      Another problem is this matter of what was referred to as “trans-institutalization”, or the relationship between the criminal justice system and mental health issues. Here one is given the false impression that criminal justice institutions today are serving as mental hospitals. This is a gross over simplification. We don’t have any information on the background of the prisoners, nor whether they substantially differ from the population that actually are receiving mental health treatment. This begs the question of whether, in some instances, conditions in jails and prisons might cause inmates the inordinate distress that can lead to “mental illness” labels being applied to them. You’ve also got the fact that “insanity” is used for a legal defense, and this alone would give any number of prisoners motive to fake a “mental illness”.

  2. The reality is about 80 percent of those on the streets are mentally-ill. Those numbers have continued to increase despite the billions of dollars spent by homeless advocates and more thrown at the homeless initiates from the government. Add in the cost of medical care, prison costs and cost in terms of crimes and the amount the mentally ill are costing tax-payers is astronomical. The out-patient system has been broken for years; the outpatients refuse to comply with taking their med as required because they’re not supervised. What that leaves is taxpayer-sponsors bedlam. I hope everyone against institutionalization is happy. Your insanity continues to hold the citizenry of this country hostage to a segment of society who are a danger to themselves and others. Letting people wallow in filth on the street is the opposite of compassion; its cruel.

    • People use the streets. Okay. Saying that 80 % of the people “on the streets” are “mentally ill” is nonsense. Are you referring to the so called homeless? If so, you should say so. 80 % of the people who use the streets are not “mentally ill”. Involuntarily institutionalizing 80 % of the people who use the streets would be a very absurd measure to take. Say what you will, most people know better. Tolerance works both ways. Locking up people for being people is just not the thing to do, now or ever. “Wallowing in filth on the street” beats rotting in a mental institution, a polite way of saying psychiatric prison, that only provides custodial care, any day of the week. Given that there are approaching 400 “mental disorders” listed in the psychiatric bible, the DSM, it’s awfully easy for the sidewalk to become filled with people alleged to have one or another of them. I suggest that you get used to living with them.

      • Not too worry. At the rate things are going, the compassionate folks like you will ensure most major cities and taxpayers will be burdened with a ragged homeless population equal to that of Victorian England. Yes, that’s a lovely way to treat folks. Leave them on the streets; let them fend for themselves like sewer rats. I bet you think you’re very progressive don’t you? You seem oblivious to government regulations which prevent the very abuse you imagine. The fact is, many of the street homeless you defend will and do engage in petty crimes in order to get arrested. That’s how good they themselves consider the very incarceration you so abhor. To them ANY option is better than street life — except for the schizophrenics, who really have no clue, and have a very high morality rate. Streets are a death-sentence, and those who advocate for them over compassionate institutional care, are just executioners masquerading as advocates..

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