Deinstitutionalization- a term popularized in the mid fifties to early seventies, was an experiment involving the release of some 830,000 mental patients. By reducing state mental hospitals by 60%, this ideology was found very appealing by Liberals due to mental patients receiving their freedom (Website 1). It was also liked by conservatives because of the large amount of money that would be saved by cutting the mental health budget.
A very debatable question arises when analyzing this, and the upsurge of homelessness. Is the increase of homelessness due to deinstitutionalization? I believe that homelessness is not a result of deinstitutionalization, but rather in the way it has been implemented.
Approximately 20-25% of the single adult homeless population suffers from some form of severe and persistent mental illness (Website 2). According to the Federal Task Force on Homelessness and Severe Mental Illness, only 5-7% of the mentally ill homeless need to be institutionalized (Website 2). A majority of mentally ill can live within the community with the appropriate supportive housing options (Website 2). That is where the problem lies. The mentally ill individuals, who have been dependent on all aspects of an institution, are being thrown into a community with little help or guidance. The importance of the distribution of psychoactive medication and financial support were perceived, but the significance of helping to create a community status role for the mentally ill was overlooked.
Once this became apparent, community mental health centers were very resistant to providing services for them. States were also extremely reluctant to distribute funds for these community-based services (Website 3).
There are also several aspects of institutionalism that were not recognized in the early stages of deinstitutionalization. First, observations of patients that spend a substantial amount of time in a hospital prove that one develops institutionalism. This is a syndrome characterized by lack of initiative, apathy, withdrawal, submissiveness to authority, and excessive dependence on the institution (Website 3). It has also been found that some of these reactions caused by external stimulation are qualities of the disease itself.
One of the most important factors, that was disregarded by the simple minded individuals who helped bring about deinstitutionalization, is what left these mentally ill people unable to work, support themselves, cope with community, and ideally make them feel somewhat like a member of the community. These findings definitely support the drift theory, which states that upper class mentally ill will drift downward into lower class neighborhoods. This class transition then increases the rate of mental illness in that neighborhood.
Once released from an institution a mentally ill person, without the support of the community and much needed medication, might find themselves feeling very scared and threatened by interactions with the community. This leads us to another problem, which is crime and the mentally ill. About one thousand people in the U.
S. are murdered by severely mentally ill people who are not receiving treatment. These killings are about 5% of all homicides nationwide, and help show once again how important it is to follow all the steps of deinstitutionalization. How do you charge someone with a crime that suffers from a severe mental illness?
The insanity defense refers to that branch of the concept of insanity, which defines the extent to which men accused of crimes may be excused of criminal responsibility because of their mental illness. The final decision on whether an individual is mentally ill or not rests solely on the jury, who gets their information drawn from the testimony of expert witnesses. These are usually professionals in the field of psychology.
The result of such a decision is what places these individuals in a mental facility, incarceration, or a release. Due to these factors above, there a many problems that arise by the existence of the insanity defense. Problems such as the possibility of determining mental illness, justifiable placement of judged mentally ill offenders, and the overall usefulness of such a defense. Insanity is a legal definition, not one of medical origin. In other words insanity and mental illness are not synonymous. Only some mental illness constitutes insanity.
Because of this, there are problems in applying a medical theory to a legal matter. One test .