[lbo-talk] Asylum

[Mark Bennett]

The assumption did not seem as hopelessly naive at the time as it does now.
The major problem was how to fund the complex, community-based mental health
infrastructure that was being proposed.  California didn't get the minimum
necessary funding for the Short-Doyle proposals until the early 70s, and
soon thereafter Prop 13 put paid to the Golden State.  Prop 63 was enacted
in 2004, adding a 1% to state income taxes on incomes over a million dollars
for the purpose of  finally funding the necessary community mental health
organizations; but it has been largely ineffective, and the money raised is
being diverted to other, more politically expedient projects.  I know
several people who work in county crisis houses, and the resources they have
to work with are pitiful.  That they manage to help anyone at all is little
short of a miracle, and is a testament to their dedication and compassion.
The current system is much like it was in the 19th century, with the
mentally ill being cycled through dilapidated hospitals and the jails, and
back onto the street. With the addition of psychotropic drugs, of course.

On Wed, Dec 29, 2010 at 8:08 AM, <123hop at comcast.net> wrote:


> I'm sure it's long, and sad, and complicated.
>
> But the fatal assumption seems to be that there would be a "community" for
> these patients to go back to. Because in reality, community would mean
> either well-coordinated and supported half-way houses or the sidewalk. For a
> lot of people it meant the sidewalk.
>
> Thanks for the link.
>
> Joanna
>
> ----- Original Message -----
> From: "Mark Bennett" <bennett.mab at gmail.com>
> To: lbo-talk at lbo-talk.org
> Sent: Wednesday, December 29, 2010 12:32:04 AM
> Subject: Re: [lbo-talk] Asylum
>
> Your research would have to start here:
> http://www.questia.com/PM.qst?a=o&d=100859113.  Some of the AFMH
> recommendations were:
>
> *"No further State hospitals of more than 1000 beds should be built,
> and not one patient should be added to any existing mental hospital
> already housing 1000 or more patients. It is further recommended
> that all existing State hospitals of more than 1000 beds be gradually
> and progressively converted into centers for the long-term and com-
> bined care of chronic diseases, including mental illness. This conver-
> sion should be undertaken in the next ten years.*
>
> *Special techniques are available for the care of the chronically ill
> and these techniques of socialization, relearning, group living, and
> gradual rehabilitation or social improvement should be expanded
> and extended to more people, including the aged who are sick and
> in need of care, through conversion of State mental hospitals into
> combined chronic disease centers."*
>
>
> *"The objective of modern treatment of persons with major mental
> illness is to enable the patient to maintain himself in the community
> in a normal manner. To do so, it is necessary (I) to save the patient
> from the debilitating effects of institutionalization as much as pos-
> sible, (2) if the patient requires hospitalization, to return him to
> home and community life as soon as possible, and (3) thereafter to
> maintain him in the community as long as possible. Therefore, after-
> care and rehabilitation are essential parts of all service to mental
> patients, and the various methods of achieving rehabilitation should
> be integrated in all forms of services, among them day hospitals,
> night hospitals, aftercare clinics, public health nursing services, foster
> family care, convalescent nursing homes, rehabilitation centers, work
> services, and ex-patient groups. We recommend that demonstration
> programs for day and night hospitals and the more flexible use of
> mental hospital facilities, in the treatment of both the acute and the
> chronic patient, be encouraged and augmented through institutional,
> program, and project grants*."
>
> All this seemed reasonable, but most states found themselves ill-equipped
> to
> deal with the complexities of such a system.   California had actually
> anticipated the federal proposals with the passage of the Short-Doyle Act
> of
> 1957, which provided state funds of up to 50% of the cost of establishing
> community-based mental health facilities.  Before that, California had a
> population of more than 36,000 patients in only 14 psychiatric hospitals
> throughout the state, and many of these patients had been judicially
> committed for indefinite periods for dubious reasons. The
> Lanterman-Petris-Short
> Act of 1968 was enacted to address many of the abuses in involuntary
> commitments, but the road to hell being paved with good intentions, it
> exacerbated many problems dealing with the treatment of the seriously
> mentally ill.  It's a long, sad, complicated story.
>
> On Tue, Dec 28, 2010 at 11:07 PM, <123hop at comcast.net> wrote:
>
> > I don't think it was Foucault. Though he certainly didn't help.
> >
> > There is no question that there were abuses at these institutions. But
> what
> > really makes me wonder is whether the ability of the mentally ill to care
> > for one another and to create a working communal life did not strike some
> as
> > setting a bad example. The possible success of that therapy through work
> and
> > socialization would then be weighed against the success of popping a
> pill.
> > What would be more profitable? Having a sizable population bound for all
> > life to psychotropic drugs? Or having that same population achieve some
> kind
> > of balance or even sanity through cooperative work and living? There are
> > financial and political consequences to each of these options.
> >
> > It's kind of like: were unions destroyed because they were corrupt? or
> > because they were unions?
> >
> > Joanna
> >
> > ----- Original Message -----
> > From: "Dennis Claxton" <ddclaxton at earthlink.net>
> > To: lbo-talk at lbo-talk.org, "lbo-talk" <lbo-talk at lbo-talk.org>
> > Sent: Tuesday, December 28, 2010 11:25:45 AM
> > Subject: Re: [lbo-talk] Asylum
> >
> > At 09:24 AM 12/28/2010, 123hop at comcast.net wrote:
> >
> >
> > >Sacks' introduction makes me want to know a lot more about why and
> > >how these institutions were destroyed.
> >
> >
> > It was Foucault's fault.
> >
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