The real, nuanced truth about mental illness, violence and the role of treatment, this book shows, doesn't align neatly with any of the highly polarized arguments.
the legislation—signed into law in December 2016—now aims to improve coordination of 112 different federal mental health programs with a new assistant secretary of the Department of Health and Human Services (HHS); expand access to crisis inpatient care; and promote early prevention and screening.
The hype surrounding the original antipsychotic drugs helped lead to the closing of many mental hospitals, leaving hundreds of thousands of severely mentally ill people out on the streets, without any better or meaningful alternatives. These trends were further fueled both by scandals about squalid mental hospitals and new legislation in the 1960s—which included Medicaid and President Kennedy's mental health act—that spurred the closing of state and county mental hospitals. In the mid-1950s, there were close to 560,000 public psychiatric beds available and by 2016, there were less than 40,000 such beds. When all public and private psychiatric beds are counted, that still amounts to less than 70,000 beds—even though nearly 400,000 seriously mentally ill people are incarcerated in jails and
nearly 400,000 seriously mentally ill people are incarcerated in jails and prisons on any given day. Essentially, then, ten times more mentally ill people are inmates than are patients in public hospitals. At other times, they may join the ranks of the people with severe mental illness who make up a third of the nation's 550,000 homeless counted on a single night in January 2016. Others are confined with nearly 700,000 or more mentally ill people in poorly monitored nursing homes and assisted living facilities (ALFs). Nearly once a month, The Miami Herald reported in 2011, mentally ill and elderly residents were killed through abuse and neglect in the state's ALFS while law enforcement and state regulators looked the other way. Outside of some facilities closed following media investigations, most states have done little to crack down on these homes.
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Mental illness is the largest single cause of disability, across all categories of injury, brain disorders and illness. The most serious mental illnesses (including schizophrenia, bipolar disorder and long-term major depression) play a major role in driving more than 40,000 Americans to kill themselves each year—more than the total number of car crash fatalities and well over twice the number of homicides. Overall, the nation's suicide rate across virtually all age groups has soared to its highest level in thirty years, especially among middle-aged men and teenage girls. At its very worst, the system is so bad that roughly two million people with serious mental illness go to jail each year, cycling in and out of local jail systems that hold nearly 11 million people annually. As Miami-Dade County Judge Steven Leifman, who has pioneered model community-based alternatives to jail, points out, "Because no comprehensive and competent community mental health treatment system was ever developed, jails and prisons once again function as de facto mental health institutions for people with severe and disabling mental illnesses"—the "New Asylums."
The largest psychiatric facility in the country is actually the Los Angeles County Jail. Over 20 percent of its 17,000 inmates each year suffer from serious mental illnesses—worsened by guard beatings, neglect and cover-ups that have led to the convictions of over 20 current and former Los Angeles County Sheriffs Department (LASD) officials on violence-related charges. "
the legislation—signed into law in December 2016—now aims to improve coordination of 112 different federal mental health programs with a new assistant secretary of the Department of Health and Human Services (HHS); expand access to crisis inpatient care; and promote early prevention and screening.
The hype surrounding the original antipsychotic drugs helped lead to the closing of many mental hospitals, leaving hundreds of thousands of severely mentally ill people out on the streets, without any better or meaningful alternatives. These trends were further fueled both by scandals about squalid mental hospitals and new legislation in the 1960s—which included Medicaid and President Kennedy's mental health act—that spurred the closing of state and county mental hospitals. In the mid-1950s, there were close to 560,000 public psychiatric beds available and by 2016, there were less than 40,000 such beds. When all public and private psychiatric beds are counted, that still amounts to less than 70,000 beds—even though nearly 400,000 seriously mentally ill people are incarcerated in jails and
nearly 400,000 seriously mentally ill people are incarcerated in jails and prisons on any given day. Essentially, then, ten times more mentally ill people are inmates than are patients in public hospitals. At other times, they may join the ranks of the people with severe mental illness who make up a third of the nation's 550,000 homeless counted on a single night in January 2016. Others are confined with nearly 700,000 or more mentally ill people in poorly monitored nursing homes and assisted living facilities (ALFs). Nearly once a month, The Miami Herald reported in 2011, mentally ill and elderly residents were killed through abuse and neglect in the state's ALFS while law enforcement and state regulators looked the other way. Outside of some facilities closed following media investigations, most states have done little to crack down on these homes.
"
Mental illness is the largest single cause of disability, across all categories of injury, brain disorders and illness. The most serious mental illnesses (including schizophrenia, bipolar disorder and long-term major depression) play a major role in driving more than 40,000 Americans to kill themselves each year—more than the total number of car crash fatalities and well over twice the number of homicides. Overall, the nation's suicide rate across virtually all age groups has soared to its highest level in thirty years, especially among middle-aged men and teenage girls. At its very worst, the system is so bad that roughly two million people with serious mental illness go to jail each year, cycling in and out of local jail systems that hold nearly 11 million people annually. As Miami-Dade County Judge Steven Leifman, who has pioneered model community-based alternatives to jail, points out, "Because no comprehensive and competent community mental health treatment system was ever developed, jails and prisons once again function as de facto mental health institutions for people with severe and disabling mental illnesses"—the "New Asylums."
The largest psychiatric facility in the country is actually the Los Angeles County Jail. Over 20 percent of its 17,000 inmates each year suffer from serious mental illnesses—worsened by guard beatings, neglect and cover-ups that have led to the convictions of over 20 current and former Los Angeles County Sheriffs Department (LASD) officials on violence-related charges. "
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