Prior to the deinstitutionalization movement, in the 1950’s and 60’s, care for those suffering from severe mental health issues fluctuated. It varied from non-existent to well intentioned but misguided or underfunded. The asylums were built with the best of intentions, but were not properly funded or supported, to meet the needs of those placed inside of them. Instead of being the treatment centers they were meant to be, they became the dumping grounds for those with psychological abnormalities. The introduction of chemical balancing drugs in the 50’s made notable progress with many patients. Along with a need to lighten the load on the hospitals as well as better the conditions within them, 90% of the hospitalized patients were discharged or placed in outpatient programs.

While many patients benefited from di-institutionalization, many others got lost in the system they needed help from. There weren’t enough outpatient programs to support the massive influx of new patients, enough properly trained medical personal to provide care, or funding to support them. Also, in the excitement of finding truly helpful drugs, doctors released patients that were not ready to be on their own. Many of these prematurely released patients were among those ‘lost in the system’, who subsequently ended up homeless or in the justice system, ever further from the proper help they needed. I believe, while well intentioned, the di-institutionalization process of the 50’s and 60’s was hasty, over optimistic, and thought through very poorly.

Shorter (1997) cites several cases in his book ‘A History of Psychiatry’, where many of the deviant, abnormal acts noted in patients institutionalized prior to the 1950’s, were directly caused by their poor treatment in the hospitals. When they were treated more decently, their behavior became more socially acceptable. It is obvious that a change was desperately needed for many reasons. However, the way the change was made caused a new, unintended harm. More thorough release evaluations should have been used, and a more stable outpatient support system should have been established, before releasing most of the hospitalized patients. But like they say, ‘the damage has been done’, so what of it now? Public awareness needs to be dealt with for starters, and while it has been progressing, it is slow going. When the public does not properly understand something, they are far less willing to contribute to it’s cause. With better funding and understanding, the proper balance between inpatient and outpatient facilities could be reached and staffed. While we may be a far cry from cutting holes in skulls to release the evil within, we are also a far cry from having the absolute answer we seek, regarding abnormal psychology and it’s treatment. A financially crippled system can be on the correct path, but is also at risk of being dismantled, for appearing ineffective.

Gateways Hospital and Mental Health Center (2002), founded in 1953 in Los Angeles, is dedicated to providing quality mental health care to patients who could otherwise not afford it. They have several locations today, but space is still limited. Gateways provides help to children, adults, the homeless, those in the justice system, and the families of their patients. They work with outpatient clients as well as those requiring hospitalization and long term care. They even have a residential center for adult patients to live at while in transition towards outpatient status, or who are not stable enough to join society without the added support. Along with treatment, they also help patients learn how to live productive lives on their own, by teaching life skills and providing job training. The majority of their funding is provided by “the Los Angeles County Department of Mental Health, the State Department of Mental Health’s Conditional Release Program and the Federal Bureau of Prisons Community Corrections Council programs” (Gateways Hospital and Mental Health Center, 2002). As well as, the Jewish Federation of Greater Los Angeles and volunteers.

Self help groups can encourage independence, build self confidence, and help aid in patient treatment, among other benefits. However, like most things, there are concerns that come along with self help practices. Over confidence in ones ability to deal with some problems on ones own, can result in patients not seeking help when they need it, or before it’s to late. Because there is not a therapists present, guidance for participants is reliant upon other participants in the groups. Research indicates that there are anywhere from 500,000 to 3 million self help groups in our nation, if we have such a vague grasp on how many groups there are, how can we know what amount of help or harm they are providing.

Overall, the mental health facilities are tangled up in a flawed system and are in need of help and proper structure. They are better now then they were in the past, but until proper understanding of abnormal mental states is more prevalent than misunderstandings, the needed funding is going to remain low which will continue to cripple it’s progress.

Works Cited

Gateways Hospital & Mental Health Center. 2002. Web. 28 Jan. 2012. <http://gatewayshospital.org/>.

Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons, 1997. Print.

Jocelyn Johnson