DEINSTITUTIONALIZATION Tish Lyne
Institutionalization • “Use of public institutions for the care of people who are physically or mentally disabled, criminally delinquent, or incapable of independent living .” • Dark, Dreary, Unsanitary Prisons • Many forms of treatment including • Shock therapy, Lobotomy, drugs • In 1955, some 560,000 Americans were being treated in state hospitals for mental problems
Deinstitutionalization “the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability .”
Video: John Oliver • https://www.youtube.com/watch?v=NGY6DqB1HX8 • Start @4:15 • End @ 7:50
Or Was it????
Shockingly, No It was really…
Deinstitutionalization • The first wave began in the 1950s and targeted people with mental illness. • Put into effect by the JFK administration • Do you think this had anything to do with sister, Rose Kennedy and her mental illness?
What led to Deinstitutionalization: • Numerous social forces led to a move for deinstitutionalization; • researchers give credit to six main factors: • criticisms of public mental hospitals • incorporation of mind-altering drugs in treatment • support from President Kennedy for federal policy changes • shifts to community-based care • changes in public perception • individual states' desires to reduce costs from mental hospital • The second wave began roughly 15 years later and focused on individuals who had been diagnosed with a developmental disability. • Deinstitutionalization continues today, though the movements are growing smaller as fewer people are sent to institutions.
Consequences: • JFK Assassination • Funding Cut • Housing and community help did not happen • Increasingly difficult for people who suffer from severe mental illness to receive treatment in a facility • Expensive • Could not be forced into treatment • Adults, had rights, even if mentally incompetent • Many mentally ill individuals were left homeless after Deinstitutionalization, making up one-third of the homeless population in the US
Consequences cont.: • Today the most prominent treatment for the severely mentally ill is incarceration in a correctional facility, where mentally ill individuals are not receiving adequate care for their disorder • More than 300,000 MI are in jails and prisons today • Half a million MI are on court-ordered probation • The largest public mental health facility in America is not a hospital. It’s the Los Angeles County jail. On any given day, it houses 3,000 mentally disturbed inmates
Crazy (2006) • Pete Earley • Bestselling author. • When he is not spending time with his family, he tours the globe advocating for mental health reform. • Former reporter for The Washington Post, • Pete uses his journalistic background to take a fair-minded approach to the story all while weaving an interesting tale for the reader • Mentally ill son • Story focuses on his son Mike’s struggle with mental illness and the “mental health” system today • Recommend all to read
Crazy • Major Characters • Mike Early – Pete’s Son, Bipolar disorder • Alice Ann Collyer – Schizophrenia • April Hernandez – Schizoaffective • Ted Jackson – Bipolar disorder • Judge Steven Leifman – Judicial Reformer • Tom Mullen – Director of treatment programs • Dr. Joseph Poitier – Miami Jail Psychiatrist • Judy Robinson – Advocate • Deidra Sanbourne – Schizoaffective
Crazy • Pete’s Son’s Story “Mike” • Normal kid, went college, hoping to graduate, planning on a career • Things went down hill • First Mental Breakdown Senior Year • Many signs: • Feeding Homeless McDonalds • Mike was unsure if this was real • In Love with Jen • Parents used this to get him to a hospital • Admitted multiple times but insurance wouldn’t pay
• Diagnosis • Saw multiple Mental Health Professionals • Bipolar disorder, showed early stages of schizophrenia, schizo- affective disorder • Final diagnosis of bipolar disorder • a mental disorder marked by alternating periods of elation and depression • Multiple different therapies tried • Mike thought the drugs were poison • Pete couldn’t do anything; Mike was an adult & had “rights” Could not be forced into treatment if he was not a danger to himself or others • Pete was told to say Mike was threatening him to get treatment • Led to arguments and family disruptions (Common) •
Crazy • Mike’s Crime • Broke into a home • Turned on the radio • Rummaged through the kitchen cabinets • Turned on all the faucets in the bathrooms • Took a bubble bath • Attacked by the canine unit, took 5 officers to restrain Mike • Officer suggested that Pete tell medics that Mike had threatened his life • Pete did and Mike was admitted • Still could not force Mike to take drugs, he had “rights”
Mike’s Crime Cont. • Homeowners pressed charges, • Wanted Mike in Jail • Two Felony Charges • Five years in Prison • $10,000 in fines • Still could be prosecuted even though he was Mentally Ill • Pete took Mike to be booked • Routine, Like it happened all the time
Crazy • Pete’s Search through Prisons • Miami- Dade County jail • Unrestricted Access • What he found • Dr. Joseph Poitier • 9 th floor
Miami – Dade County Jail • 9 th Floor • Housed the mentally ill inmates • Was thought to be the “Better” environment of the jail • Was “Safer” than general population • Thought to give better treatment • WRONG! • Overcrowded • Dark and Dreary • Stuffy • Inmates like to remove clothes and masturbate • Correctional Officers like to “attack” the inmates • Generally the Psychiatrists & Nurses were told to “leave”
Miami – Dade County Jail • In Jail Awaiting trial for whatever wrong doing • Incompetent to stand trial • Becoming “Competent” • “Riding the Bus” • Endless Cycle • Sent to the Hospital to become competent • Competency achieved sent back to jail • Deteriorate • At jail meds where changed to the cheaper route • Sent back to the Hospital • Cycle continued • Never Stand Trial • Better than being on the streets or sentenced to a federal prison
The Miami – Dade County Jail • Inmate Goes Unnoticed • Pete learns of inmate that was never booked • Housed in Jail • Goes unnoticed (overcrowding), about 20 some days • Can’t keep him in Jail, Never Booked • Jail has 33 days to file charges • Officer went on vacation, never filed charges • Officer came back on the 32 nd day and filed • Do you think the inmate should have been released because he was never booked at the beginning? Should Jails have this 33 days to file charges?
The Miami – Dade County Jail • Plea Bargins • Terry Chavez & Bart Armstrong • Decided who got into treatment programs & which went to prison • Depended on insurance • Sam Konell • “Court Liaison and forensic program director” • “Patient broker” • Only Picked those with insurance to allow into programs • Promised personal responsibility to get inmates into his programs and healed • The Condition? • They must use the Westchester network
Types of therapy offered to mentally ill in prisons • Cannot be forced • Still had “rights” • Sent to be “Made” competent • Riding the bus • Switched to cheaper meds • Even if they new a certain med was working, they switched
Not In Institutions, Not In Prisons, Where? • The Streets! • Homeless • 0ne-third of the homeless population in the US • Alcohol and Substance Abuse • Petty Crimes
???Discussion Questions??? • How can we, as the next generation of mental health providers and criminal justice professionals, provide safe housing and medical attention to the mentally ill without infringing their rights to refuse treatment? • If President Kennedy had not been assonated would the funding been cut as exponentially as it had? Would the “safe houses” been an improvement? • Do you think the Mentally Ill should be sent to jail to await trial and should they be “made” competent? • Should there be lesser punishments/sentences for those who plead guilty by reason of insanity? • Should plea bargains be based on insurance and if you do not have good insurance should you still get the opportunity?
Sources • “Crazy” by Pete Earley • http://www.peteearley.com/ • http://sometimes-interesting.com/2013/03/01/manteno-state-hospital/
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