Rod Thomson

Some of the highest profile ills poisoning American society have the same root cause: closing state mental institutions in favor of out-patient community health centers — not shocking to many people, this is rooted in “reforms” that began in the 1960s.

The state mental institutions certainly had some real problems. But perhaps the biggest public blot against them was the popular book, play and later movie One Flew Over The Cuckoo’s Nest — all of which were quality entertainment. But they were not real. One Flew Over The Cuckoo’s Nest was not a documentary, nor were the dozens of movies following that depicted mental institutions as horror houses with depraved wardens.

Unfortunately, it’s possible that, combined with President Kennedy’s mentally ill sister, Congress decided to make permanent national policy based on fiction. It wouldn’t be the first time. And it’s not surprising that it turned out badly.

The politicized closing of state mental institutions in favor of out-patient community health centers in the 1960s has had unforeseen and tragic consequences across a range of American society — but not least of which on the stubborn homeless problem and on mass shootings. Many people in both of these categories would have been lodged in state mental institutions previous to the “reforms” of the 1960s — possibly including the Parkland shooter, and shooters at Sandy Hook, U.S. Naval Yards, Aurora, Colorado and others, along with perhaps half of the homeless people on American streets today.

Author and research director for the Minnesota Department of Corrections Grant Duwe, and Michael Rocque, a professor of sociology at Bates College write in the Los Angeles Times: “There is a clear relationship between mental illness and mass public shootings.”

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They write: “At the broadest level, peer-reviewed research has shown that individuals with major mental disorders (those that substantially interfere with life activities) are more likely to commit violent acts, especially if they abuse drugs. When we focus more narrowly on mass public shootings…we see a relatively high rate of mental illness.”

Their research puts it at 69 percent of mass killings. Mother Jones also put the rate at 61 percent of known and potential mental illness among mass shooters when the magazine examined 62 cases in 2012.

Unfortunately, any link between mental illness and mass killings, is immediately attacked by NPR, the New York Times, Time, the Atlantic, PBS — you get the idea. That is done because it is seen by those gun-control advocates as being a diversion. But it’s not.

But it is just historical fact that the state mental hospitals closed and that caused a cascading effect. Homelessness is maybe the biggest, but there is no denying that the deinstitutionalization has impacted mass killings in the United States, also.

The impact of closing mental hospitals

This impact is spelled out in the meticulously researched 2013 book American Psychosis: How The Federal Government Destroyed The Mental Illness Treatment System by the esteemed psychiatrist and schizophrenia researcher E. Fuller Torrey.

Relying on a deep trough of data and citations, Fuller Torrey argues that transferring responsibility for serious mental illnesses from state to the federal government destroyed the mental illness treatment system. This deinstitutionalization precipitated a disastrous change in how the mentally ill continue to be treated today.

Fuller Torrey does not dispute that the state mental hospital system had serious flaws. But he said it was a system to be fixed, rather than jettisoned. Because for too many of the seriously mentally ill, it was replaced with nothing. Part of the failing of the plan in the first place, beyond poor conception, was that none of the experts the federal government called in to create this change had any experience with mental hospitals. Again, all well cited.

Fuller Torrey writes that: “Unfortunately, the mental health centers legislation passed by Congress was fatally flawed. It encouraged the closing of state mental hospitals without any realistic plan regarding what would happen to the discharged patients, especially those who refused to take medication they needed to remain well. It included no plan for the future funding of the mental health centers. It focused resources on prevention when nobody understood enough about mental illnesses to know how to prevent them.”

His work on this topic has been difficult to dispute.

Elin Weiss writes of Fuller Torrey’s research in Metapsychology Online: “It also makes it difficult to argue with Fuller Torrey because the reader is almost overwhelmed by evidence of how the shift in responsibility has damaged the care of individuals with mental illness.”

Why they were closed

This is both interesting and telling of how things happen when the federal government has too much power.

In 1963 President John F. Kennedy spoke to Congress on “Mental Illness and Mental Retardation.” He proposed a new program where the federal government would create hundreds of community health centers to ultimately replace old, dated state mental institutions.

This was all very personal for Kennedy as he had a younger sister who was put in a state mental institution and the family was very upset over it. So, the federal government spent about $20 billion — a lot of money, but even more then — and created some 800 community health centers in the following decade.

At the same time, the number of patients in the state mental hospitals fell from 500,000 to 130,000. But there was a big problem.

These local, federally funded community mental health centers were not taking in the serious cases of mental illness being discharged from the shuttered state mental institutions. Instead, they took the easier cases of people, often those who had not been in the state mental institutions, and cared for them while taking the federal reimbursements.

What happened to more serious and too often dangerous people that had been discharged? Not coincidentally, right around this time America began experiencing its homeless problem, something that grew up precisely at the same time all of the state mental institutions were closed down.

With the advent of Supplemental Security Income, and Medicaid and Medicare, essentially all of the funding for the mentally ill is now through the federal government, at an annual cost of more than $100 billion. That means the distant, inefficient, sometimes corrupt gargantuan government in Washington runs mental health in every corner of the nation. No wonder there are so many problems with the system.

It’s not like there weren’t real and true problems with state mental hospitals. But instead of improving those conditions and creating institutions where the mentally ill could thrive under conditions of conscientious care, they were closed down and what was supposed to replace them did not. Further, in following years laws were passed making it more difficult to commit people who were a threat to themselves and sometimes others.

There was and is apparently no long-term, systemic method and place to commit people who really are not capable of living on their own. So they end up on the streets or in prison. This has now been going on for generations of mentally ill.

Because of the lack of any good way to institutionalize the chronically and dangerously mentally ill, there was no place to put the Parkland shooter or previous mass shooters — or perhaps future mass shooters.

This can be fixed. But it would require real leadership in Congress and at the state level to change laws. An honest and fair media would help, but that seems lost.

Congress could decentralize mental health care, return to allowing states to run modernized mental health institutions and provide guarded authority with reviews to institutionalize those who are a threat to themselves and others. This is a discussion that should take place totally separate from gun control, because it affects other parts of society.

Rod Thomson is an author, TV talking head and former journalist, and is Founder of The Revolutionary Act. Rod is co-host of Right Talk America With Julio and Rod on the Salem Radio Network.

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