Continued madness

As J-P mentioned in comments to the "Mad" post, mad pride doesn't help those who have been deinstitutionalized. According to the Treatment Advocacy Center, of the 744,000 people who are homeless (according to 2005 statistics), one-third have untreated psychiatric illnesses.

TAO reports that the DOJ's 2005 data reveal that of the 2.2 million prisoners in local, state, and federal jails and prisons, approximately 10% have severe psychiatric illnesses. TAO says, "There are now more severely mentally ill individuals in the Los Angeles County Jail, Chicago's Cook County Jail, or New York's Riker's Island Jail than there are in any single psychiatric hospital in the nation." Many of these inmates committed crimes at least in part because of their mental impairments (e.g., disordered thinking, hallucination, delusions). 

We don't adequately support people with severe mental illness, many of whom refuse to admit or don't know they are sick. The process of deinstitutionalization began in the 1950s and continues, even though the number of people who need treatment is increasing.

I'm not saying that inpatient treatment is the way to go. Having been a patient in a private facility, I can only imagine what the state-run facilities are like. Even at Bridgeway, staff focused on keeping patients "calm" (or more accurately, sedated) and the facility's making money, not treating patients. That's another story for another time, though. 

What may work is assisted outpatient treatment, in which people with mental illness receive mandatory treatment but continue to live in the community. AOT laws typically provide support for finding housing and coping with tasks of daily living. Although I'm uncomfortable with the paternalistic air of AOT, it may be that we as a nation bear the responsibility for helping people with serious mental illnesses who cannot help themselves, just as we must help those who cannot afford to feed their families.

The civil rights questions surrounding AOT go right to the heart of how the government should view individuals who cannot for whatever reason abide by its laws. To what extent can individuals be required to take psychotropic medication? Should the focus be on protecting the public or rehabilitating/treating the individual? Who gets to make decisions about an adult's wellbeing, and how are those decisions made? I'm still thinking about the answers to these questions and more. Stay tuned.