I found this to be a very interesting read:
Wall Street Journal (paywall)
Another thing discussed in the article is how, to the extent the persons once institutionalized are living on the streets, prisons have mostly picked up the load. When you consider the statistic in bold, above, where we've reduced mental health beds by over 550,000, with the fact that prison population has increased over that same time period, from 185,000 to 1,900,000, it seems to me that there is a pretty direct correlation.
In talking about alternatives, they also discuss a new 320 bed in-patient facility built in Massachusetts which is more like a rehab facility, but the cost per resident is almost four times the cost to house a prisoner in Massachusetts (which is $55,00 per annum), so finding the money for that kind of approach doesn't seem realistic.
Wall Street Journal (paywall)
The article goes on to talk about how, in the 1950s, psychiatry began to see drugs (in particular, Thorazine) as an alternative to institutionalization, and how the Community Mental Health Act signed by JFK in 1963 intended to replace asylums with 1,500 local clinics where patients could receive drugs and therapy on an outpatient basis -- but few of which were ever built.Quote:
The ongoing saga of the severely mentally ill in America is stirring attention again in a sadly familiar way. In Los Angeles in early 2022, a 70-year-old nurse was murdered while waiting for a bus, and two days later a young graduate student was stabbed to death in an upscale furniture store where she worked. That same week in New York City, a 40-year-old financial analyst was pushed onto the subway tracks as a train was arriving, killing her instantly.
All three assaults, random and unprovoked, were committed by unsheltered homeless men with violent pasts and long histories of mental illness. In New York, the perpetrator had warned a psychiatrist during one of his many hospitalizations of his intention to commit that very crime.
Then came the chance encounter this May that led to the death of Jordan Neely on a Manhattan-bound subway car. Homeless and schizophrenic, Neely had spent most of his adult life in and out of emergency rooms, psychiatric wards and prison. He had 42 prior arrests, mostly for nuisance crimes, but also for assault. He'd recently pleaded guilty to punching an elderly woman in the face, fracturing her eye socket.
What happened in the moments leading up to his death is still in dispute. While a jury will decide whether another passenger's chokehold on Neely was second-degree manslaughter or an act of self-defense, the attention the incident received speaks volumes about the public's fear of the aggressive and sometimes violent behavior of the mentally ill. Most of all, Neely's death highlights the failures of a mental health system that allows profoundly disturbed people to slip through the cracks.
On an average night, according to the U.S. Department of Housing and Urban Development, close to 600,000 people in the country will be homelessa figure seen by many as an undercount. More than 40% will be "unsheltered," or "living in places not suitable for human habitation," and about 20% will be dealing with severe mental illness.
Experts sharply disagree about the contribution of homelessness to rising crime rates. Some emphasize that the most of these crimes are low-level victimless offenses, such as loitering or public urination. But others note the disproportionately high level of all crimes, including assaults and homicides, committed by those battling homelessness and mental issues simultaneously.
Had Jordan Neely and the others been born a generation or two earlier, they probably would not have wound up on the streets. There was an alternative back then: state psychiatric hospitals, popularly known as asylums. Massive, architecturally imposing, and set on bucolic acreage, they housed close to 600,000 patients by the 1950s, totaling half the nation's hospital population. Today, that number is 45,000 and falling.
Another thing discussed in the article is how, to the extent the persons once institutionalized are living on the streets, prisons have mostly picked up the load. When you consider the statistic in bold, above, where we've reduced mental health beds by over 550,000, with the fact that prison population has increased over that same time period, from 185,000 to 1,900,000, it seems to me that there is a pretty direct correlation.
In talking about alternatives, they also discuss a new 320 bed in-patient facility built in Massachusetts which is more like a rehab facility, but the cost per resident is almost four times the cost to house a prisoner in Massachusetts (which is $55,00 per annum), so finding the money for that kind of approach doesn't seem realistic.