In the 1960's, tens of thousands of mentally ill people were taken out of institutions and dumped into communities across America. They filtered downward from voluntary programs of community based treatment, to lives of vagrancy on the streets. Law enforcement has now become the primary solution for dealing with these mentally ill ( and often violent) people on the streets. America's solution for the mentally ill is clear: throw them out on the street.
This movement began in the 1960's with humane intentions. There was an increased recognition of the rights of the mentally ill to have due process. In 1975, the Supreme court made a ruling determining the rights of civilly committed patients in the case of O”Connor v. Donaldson (422, U.S. 563, 1975). This case was an attempt to define a standard for involuntary hospitalization; the court ruled that the state cannot detain a non-dangerous psychiatric patient who is capable of surviving in the community-either on their own or with the help of friends and family.
Suzuki v. Quisenbery (411 E Supp. 11 13, 1976) further expanded the survival standard by developing a two-pronged test for civil commitment: First, a person cannot be hospitalized simply for being mentally ill; and second, only those individuals who were proven substantially dangerous to themselves or others could be involuntarily hospitalized.
In the 1960's, there was a growing belief that the mentally ill should be appropriated back into the community - rather than mental institutions. Psychiatric drugs were offered as another solution. These Drugs were just beginning to hit the market back in the 1960's. There was a prevailing theory that community health centers and psychiatric drugs would meet the needs of the deinstitutionalized population. The Kennedy administration even boasted that the days of long term institution were past. Mental health made a drastic shift from inpatient treatment, to outpatient treatment. In 1955, 75% of psychiatric treatment was handled on an inpatient basis. Today, 75% percent of treatment is handled on an outpatient basis (The Effects of Psychiatric Deinstitutionalization on Community Policing).
However, the assumptions that community centers and psychiatric drugs would create a safety net for the mass of deinstitutionalized mentally ill was grossly inaccurate. Of the tens of thousands of mentally ill persons who were thrown onto the streets, many became homeless. According to the National Coalition for the Homeless, approximately 20-25% of the homeless population suffers from a severe and persistent mental illness (NCH Statistics on Homelessness).
Not only has the deinstitutionalization of the mentally ill contributed to America's significant homeless population, but it could also be a factor in the drastic rise in violent crime America has experienced since the 1970's. There has been a dramatic increase in the number of mass public shootings; the kind where people go into public places and murder complete strangers. It has been found that at least half of these mass murderers have a history of mental illness. It also has been shown that 13 - 18% of prisoners are mentally ill (Madness, Deinstitutionalization and Murder).
America clearly needs a more comprehensive and sane approach for the mentally ill. This is a crisis in both public safety and health.
THE DEINSTITUTIONALIZATION OF THE VIOLENT, MENTALLY ILL
What Is Deinstitutionalization? (Wikipedia)
Deinstitutionalization (Encylopedia Of Mental Disorders)
Madness, Deinstitutionalization & Murder (The Federalist Society)
The Effects of Psychiatric Deinstitutionalization on Community Policing (Emotional Survival)
Deinstitutionalization of the Mentally Ill: (Clayton Cramer)