Mental Health Issues

What the U.S.A. really needs is improvement and support of inpatient mental health facilities.  Every time there is a shooting many people start crying for gun control.  The problem with that mentality is that you only make it harder for law-abiding citizens to obtain firearms, you'll never, I repeat, NEVER get the guns out of the hands of the criminal elements of society.  One of the REAL problems is the deinstitutionalization of the mentally ill.  For example, in the Gabrielle Giffords shooting in Tucson, AZ, the shooter's family actually attempted to get help for their son - but until he actually DID something to prove he was a danger to society, the institutions would not take him.  Rather than getting him help and having him prove himself safe, he got no help and ended up proving himself quite unsafe.

Under President Kennedy, may he rest in peace, there were attempts to bring attention and support to the needs of the mentally ill.  Eunice Shriver went on to found the Special Olympics, which to this day does a lot of good for that community.(1)  However, the funds and attention contributed more toward deinstitutionalization.  Funds raised went to institutions which cared for the mentally ill - but primarily to those which did outpatient treatment. 

Reducing costs (2)
As hospitalisation costs increased, both the federal and state governments were motivated to find less expensive alternatives to hospitalisation. The 1965 amendments to Social Security shifted about 50% of the mental health care costs from states to the federal government, motivating the government to promote deinstitutionalisation.

The increase in homelessness was seen as related to deinstitutionalisation. Studies from the late 1980s indicated that one-third to one-half of homeless people had severe psychiatric disorders, often co-occurring with substance abuse. (3)(4)(5)

A process of indirect cost-shifting may have led to a form of "re-institutionalisation" through the increased use of jail detention for those with mental disorders deemed unmanageable and noncompliant. When laws were enacted requiring communities to take more responsibility for mental health care, necessary funding was often absent, and jail became the default option, being cheaper than psychiatric care.

In summer 2009, author and columnist Heather Mac Donald stated in City Journal, "jails have become society's primary mental institutions, though few have the funding or expertise to carry out that role properly... at Rikers, 28 percent of the inmates require mental health services, a number that rises each year."(6)

So, what we really need is better funding for the mentally ill - which would help with the homeless situation as well as potentially heading off some of the violent incidents previously discussed. 


(1) http://www.jfklibrary.org/JFK/JFK-in-History/JFK-and-People-with-Intellectual-Disabilities.aspx and http://www.presidency.ucsb.edu/ws/?pid=9546

(2) http://en.wikipedia.org/wiki/Deinstitutionalisation

(3) Rubin, Lillian B. (Fall 2007). "Sand Castles and Snake Pits: Homelessness, Public Policy, and the Law of Unintended Consequences". Dissent. 

(4) Friedman, Michael B. (8 August 2003). "Keeping The Promise of Community Mental Health". The Journal News.

(5) McQuistion, Hunter L.; Finnerty, Molly; Hirschowitz, Jack; Susser, Ezra S. (May 2003). "Challenges for psychiatry in serving homeless people with psychiatric disorders". Psychiatric Services 54 (5): 669–76. doi:10.1176/appi.ps.54.5.669. PMID 12719496.

(6) Mac Donald, Heather. "The Jail Inferno". City Journal. Retrieved 27 July 2009.