ACLU Wins Right of Mentally Ill People to Sleep on the Streets And Remain Untreated
It’s now officially legal for the homeless to sleep on the streets in Los Angeles. You can thank a lawsuit brought by the ACLU.
It’s incredibly frustrating to watch groups like the ACLU fight for the “right” of mostly mentally ill people to sleep on the streets — since it is groups like the ACLU that are largely responsible for their plight to begin with. A tremendous percentage of the homeless population consists of mentally ill people who have no business being on their own. They need to be institutionalized and receive proper treatment for their mental diseases. But thanks in large part to the ACLU and related groups, the homeless were deinstitutionalized and tossed into the streets years ago.
Now they get to sleep there. What a tremendous step forward for them as people.
Congratulations, ACLU. You should be proud.
P.S. Deinstitutionalization is a principal topic of a fantastic book I read recently called Crazy, by Pete Earley. Earley has a mentally ill son, and spent a year examining the issue of the mentally ill and their treatment by the criminal justice system in Miami. I plan a review when I get a chance, but here’s the short version: buy it today.
I’ve heard others recommend the book as well. I’ll try to read it soon.
gotta say that my understanding has been that a major contributor to the homelessness situation for the mentally ill wasvast reduction in social services for them. And that “deinstitutionalization” was in large part a result of the Reagan administration slashing programs to help the mentally ill.
I’m not sure how the ACLU relates to it, so I’m interested in reading more. It does seem to me that in this case, the “instutions” that were going to “help” the mentally ill were, surprise surprise, the prison industry. The locked warehouses for the sick, which are basically all that conservatives provide as an alternative to being homeless.
I went through the whole miserable process with a client of mine whose’ son suffered a brain injury in a car accident. Surprise surprise, his health insurance actually excluded coverage for brain injuries, so his son couldn’t even get health care.
I’ve watched two years of tragedy as his son developed various problems until he finally was caught, just before killing himself, and ordered institutionalized for the protection of society.
The sad thing is, if he’d gotten proper care when his symptoms developed, he might have been able to lead a somewhat normal life. But there’s nothing, not a damn thing, available to help people like this until they’re so crazy we’re worried they could kill someone at any moment.
Phil (6d9f2f) — 10/11/2007 @ 6:50 amI would think that it is the Judge and not the ACLU
rwallis (008392) — 10/11/2007 @ 6:54 amLong before Reagan the ACLU (or similar group) “won” the same rights for the mentally ill in NYC. It wasn’t long before the train tracks by Grand Central were filled with helpless nut cases as were all other public facilities. The entire thing started with a bunch of “formerly” ill mental patients screaming about how Thorazine (administered orally against their will) was cruel an unusual. Total BS but this is still the mantra for ACLU types. As a former total maniac who was treated with Thorazine for nine months or so I can attest to the fact that Thorazine is very uncomfortable, mainly because it stops you from doing the things you “want to do” like raping women and killing men when enraged (rage is constant); these unconstitutional restraints are decidedly uncomfortable. I’d only observe that it is this “discomfort” that motivated me to get better, to conform with therapy (not conforming is a mental state of all the mentally ill), and consciously trying to get well enough to get off Thorazine. Does it work? Shit, it’s been at least a week since I wanted to kill someone.
Howard Veit (4ba8d4) — 10/11/2007 @ 7:02 amPhil,
I’ll have to consult the book again to make sure I have the story right. But from memory, there were horrible conditions in institutions and criminal defendants with mental illness weren’t being helped. Someone developed a novel theory that it was unconstitutional to have such inadequate facilities because defendants, without treatment, faced lifetimes of punishment fir minor offenses. The idea was to force states to improve conditions, but activist lawyers — ACLU types — seized control of the litigation with the goal of closing down the institutions. At the same time, if memory serves, the federal government told states they would be responsible for providing aid to the mentally ill through SSI. Facing the choice of costly improvements or letting the federal government handle matters, locals opted for the latter and dumped these folks on the streets. Since then the ACLU and other personal liberties activists have fought any efforts to empower relatives to involuntary commit mentally ill and even suicidal people. The result: an army of people with treatable illnesses, who medicate themselves with illegal drugs, while loved ones are powerless to help them — thanks to ACLU types.
Patterico (f2294a) — 10/11/2007 @ 7:21 amOne of the reasons I dropped the LAT was their recycling of old ’60s theory in their Sunday mag. The article in question featured a psychiatrist who believes mental illness is just a reaction to the oppression of capitalism, patriarchy, blah blah. This goofball theory was first tried in the 60s in Germany, and the “freed” victims then were organized by their “doctor” into a virtual terrorist group. Most died in futile gun battles, which they provoked, with police or as a result of suicide, as a result of illness exacerbated by their being freed from their oppressive meds.
I guess the ACLU either doesn’t read history, or doesn’t care, or just needs more court ordered fees.
Patricia (4117a9) — 10/11/2007 @ 7:42 amPatterico, I agree with you that we need some re-institutionalization of the mentally ill, including involuntary commitments, but my recollection of the origin of the right-to-treatment is somewhat different. The most flagrant case was a woman who spent years in a mental institution because she could do nothing but babble. Of course, it was her mother tongue, some relatively uncommon (in the US) language like Georgian. And getting left out of your version of the story is the joy conservatives felt when they could zero out an expensive line item like mental hospitals from state and local budgets, which could then be used for tax cuts, the highest purpose of government.
Andrew J. Lazarus (7d46f9) — 10/11/2007 @ 7:56 amLazarus — Nasty folks, conservatives. Wanting to keep their money. How dare they?
Foxfier (f765f6) — 10/11/2007 @ 8:10 amI do think there needs to be some way to help the seriously mentally ill street folks– but we’ve gotten rid of the most of the ways.
Can anyone here picture the Gov’t actually letting religious groups take care of the mentally ill, like they did long ago?
I can’t.
Can any picture mandatory incarceration WITHOUT thousands of folks shrieking 1984 and going utterly nuts, no matter what safe guards there were?
Foxfier (f765f6) — 10/11/2007 @ 8:14 amI can’t.
The problem is that there are not sufficient facilities for voluntary commitment or community-based treatment. I have no problem with closing down the “snake pits”. It was a good thing. But we left few alternatives to either the street or prison. The few state facilities are populated mostly by people there for evaluation after being arrested for committing a crime. Sure, a mentally ill person can walk into a comprehensive emergency room and be seen by a doctor but he or she will be kicked out the next day if not the same day. We can and should do better.
nk (6e4f93) — 10/11/2007 @ 8:50 amThe title should read :
ACLU Wins Right of Mentally Ill People to Sleep on the Streets And Remain Untreated – Bush, NeoCons and Zionist lobby to blame. Women, Children, and Minorities hardest hit.
JD (55129f) — 10/11/2007 @ 11:29 amI second Howard Veit’s comment: I can tell you homelessness was a problem in NYC well before Reagan came along. But I was under the impression drugs like Thorazine and Haldol have by now been eclipsed by much more effective drugs that don’t in effect shut your brain down.
letmespellitoutforyou (dfb2fa) — 10/11/2007 @ 11:56 amHow dare the ACLU persuade judges that the Constitution supports their position! What’s a trifle like the Constitution compared to Patterico’s fundamental right not to have to look at homeless people?
Moops (444e9b) — 10/11/2007 @ 12:57 pmNK,
One problem is medicine doesn’t have answers for many mental illnesses, and I don’t mean this as a slam against medicine. If we knew what to do I feel sure that medicine, society, charities, etc., would have found ways to get treatment to the people that need it.
In other words, we’re upset about the delivery system when the real problem is we may not have anything to deliver.
DRJ (74c23b) — 10/11/2007 @ 1:00 pmMoop- please point out where the Constitution says we should leave sick folks out to hang.
Foxfier (f765f6) — 10/11/2007 @ 1:27 pmFoxfier, what an intellectually dishonest attack. Shame on you.
Christoph (92b8f7) — 10/11/2007 @ 1:30 pmPhil in #1,
Why didn’t your client pay for his son’s treatment from his own pocket? Reading your comment, it sounds as if your client may have had the money. If it’s my son, I would try to find a way. It just seems to me that our society wants the govt. to step in for everything. There must be a limit at some point.
Tregg Wright (489b30) — 10/11/2007 @ 2:09 pmTregg, I’m not a fan of having the governnment pay for everything either. The thing is, with the mentally ill, if they aren’t treated, ultimately they end up in jail anyway, or institutionalized, so society pays.
What makes no sense to me is that our criminal system treats the mentally ill and non-mentally ill almost exactly the same way. And the result is very different; most mentally ill people aren’t going to learn from jail, it’s going to turn them into human wreckage.
My client thought he had great health insurance coverage. Then his son (age 18) got in a car accident. When he woke up out of a several-day coma he had lost his ability to exercise any sort of judgment. And the insurance wouldn’t pay for treatment of his “mental illness.”
After acting in various irrational ways, the youth was arrested for assault. A condition of his not going to jail was that he be given 24-hour-a-day inpatient care – not an option the state provides facilities for.
Imagine having to choose between paying $1,000 per day (that’s the going rate for a 24-hour private inpatient facility) and having your son go to jail (where he’ll get slaughtered because he can’t control his impulses).
My client paid close to a hundred grand out of pocket, all told, before the money ran out (although son is now in his 20s, his dad has to step in and save him from jail).
Client’s son eventually ended up in a halfway house, where he was caught trying to kill himself, and finally put in one of the rare insitutional setting still available in my state.
Phil (6d9f2f) — 10/11/2007 @ 2:48 pmThe statement: “deinstitutionalization” was in large part a result of the Reagan administration slashing programs to help the mentally ill.” is a typical example of bad history and left wing politics. Maybe they aren’t your politics, Phil, but that’s where they came from. Somebody mentioned “Snake Pit” and that movie, with Oliva DeHavilland, had a lot to do with the deinstitutionalization in the 60s. The movie that really knocked the mental health system for a loop was “One Flew Over the Cuckoo’s Nest.” Once people saw that movie, they knew that psychosis was not real; those people were just “different” and should be left alone. The result was disaster.
Yes, Reagan had a hand in it but as governor, not president. All the governors, and I don’t blame them a bit, said; “OK. If you don’t want us to spend $200 million a year on clean hospitals and would rather have the mentally ill sleep in the street. OK”
It wasn’t quite that simple. There was an effort at converting to outpatient treatment; in California this was called the Short-Doyle Act. The trouble was that psychosis includes the conviction that you do not need any treatment. With paranoid delusions, pretty common, it goes beyond that. Psychologists and therapists are warned never to get between a paranoid psychotic and the door. A therapist got killed in Santa Monica a few years ago because she forgot that rule.
The Thorazine family of drugs had just come out and I was working in the VA psych hospital in Westwood the summer of 1962. The change the drugs had brought about was amazing. The trouble was that those changes convinced some people that hospitalization was no longer necessary. The result was calamitous, especially for the mentally ill. There is more history in my chapter on Psychiatry but that is the story in a nutshell. The ACLU, of course, never learns but we knew that.
Mike K (6d4fc3) — 10/11/2007 @ 3:09 pmYour book looks interesting, Mike K. I’ve added it to my Amazon shopping list and I’ll buy it next time I shop. Thanks.
DRJ (74c23b) — 10/11/2007 @ 3:26 pmThe ACLU acted with malicious intent to make society worse in order to advance the cause of revolution. They are all socialists/communists and always have been.
Alan P (03b341) — 10/11/2007 @ 3:33 pmEither that or they have a different viewpoint.
Christoph (92b8f7) — 10/11/2007 @ 3:36 pmI thought if you were going to have a conversation about mental health it should stick to the facts. This summary is courtesy of the Hogg Foundation at the University of Texas at Austin:
Jim Montague (b47e6a) — 10/11/2007 @ 4:41 pm1700 – A series of local mental health acts that created local responsibility for the mentally ill.
1800 — State policies began an era of rapid development of state hospitals, with 84 percent of the states following this trend. Between 1800-1850 over 300 state hospitals were constructed.
1853 — President Franklin Pierce vetoed a bill that would have involved the federal government in the provision of mental health care at the state level.
1930 – Federal statute creating a division of mental health within the Public Health Service. This division was the forerunner of the National Institute of Mental Health (NIMH).
1946 – Congress passed legislation (PL 79-487) creating NIMH and asked each state to designate a single state agency to be responsible for mental health care. This law was in response to the high proportion of males found mentally unfit to serve in WWII and to the number of psychiatric causalities.
1947 – The Supreme Court ruled that national health insurance was constitutional.
1955 – Congress passed legislation (PL 84-142) creating the President’s Commission on Mental Illness. The Commission identified 600,000 individuals in state hospitals in the United States in poor conditions in state hospitals. The report of the Commission (Action for Mental Health) became the basis for the eventual development of the community mental health movement and law.
1963 – Congress passed and President John F. Kennedy signed (PL 88-164), the community mental health centers construction act, providing federal money to construct mental health centers that provided the five essential services. The Act bypassed the states and gave money directly to non-profit groups to provide alternative services to the state mental hospitals.
1964 – Congress passed amendments to the Social Security Act creating Medicaid and Medicare that provided graduated federal payment to the states to provide medical and inpatient psychiatric care outside state hospitals for the poor and aged. This Act enabled private psychiatric hospitals and general hospitals with psychiatric units, but not community mental health centers, to be paid for the inpatient care that they provided to the mentally ill.
1973 – Congress passed legislation (PL 93-45) extending the 1963 legislation for an additional year. Community mental health legislation and funding were strongly opposed by President Nixon and efforts were made by his administration to eliminate this legislation.
1980 – Congress proposed new legislation (PL 96-398) called the community mental health systems act (crafted by Ted Kennedy), but the program was ended by newly-elected President Ronald Reagan. This action ended the federal community mental health centers program and its funding.
1980 – Congress passed legislation (PL 96-416) tile Civil Rights of Institutionalized Persons Act (CRIPA) allowing the Justice Department to sue state governments if they violate the civil rights of the mentally ill or mentally retarded in their state hospitals (the Act was focused originally on prisons).
1981 – Congress passed legislation (PL 97-35) sought by Reagan, titled the Omnibus Reconciliation Act of 1981 that shifted funds to the states vial block grants. States had the option of using their funds to continue to support mental health centers.
1987 – Congress passed new legislation (PL 99-319) developing rules for the protection and advocacy for the mentally ill and offered dollars to the states to set up human rights agencies and regulations to insure rights of the mentally disabled.
1987 – Congress passed new legislation (PL 99-660) requiring that for states to receive block grant monies for mental health and substance abuse, the states had to develop plans for how they would care for the mentally ill who were released from state hospitals and the staff who needed to be retrained.
1987 – Congress passed new legislation (PL 100-77) called the Stewart B. McKinney Homeless Assistance Act, to assist the states in providing housing for the homeless who are mentally ill.
1989 – Congress passed legislation (PL 100-336) titled the Americans with Disabilities Act, designed to prohibit discrimination against individuals with physical or mental disabilities.
1990 – Newly elected President Clinton proposes a national health reform act that will provide mental health and substance abuse services in the coverage (Hillary Rodham-Clinton was chairperson).
1992 – A newly elected Republican congress endorses managed care as the policy for controlling costs and services in health care in the United States.
I don’t ming – As long as the mentally ill sleep on the streets in front of the homes of ACLU members. Then the ACLU members can interact with inevitable panhandling, dumpster diving, and going to the bathroom on their doorstep.
Perfect Sense (b6ec8c) — 10/11/2007 @ 5:03 pmHere in Massachusetts, “deinstitutionalization” was one of those perfect-storm brainwaves that unites both political tendencies.
Liberals loved the idea that the old, forbidding Victorian “State Hospitals” would be closed. The propaganda around the issue was that the ill and substance abusers would be returned to “the community,” and I don’t think anyone pictured it quite the way it turned out. There was a lot of fluffy-bunny talk about how the end of institutionalization would empower these people.
Conservatimes, as some have mentioned, were cool with the idea of not squandering money on a bunch of nutcases — the majority of whom, now “the homeless,” have no “disease” but the incontinence of character that manifests in substance abuse.
I don’t recall the Atheistic Criminal-Lovers Union being involved at that time, in the late sixties and early seventies, but I was young — although not so young as to think this anything but the most spectacular cretinism. I take scant comfort in being proven right.
The ACLU got involved, as far as I recall, once the now deinstitutionalized people began to exercise their 1st amendment rights to sleep and shoot up and puke and crap and croak in public parks and sidewalks, and private gardens.
The problem is, there is no constituency now strong enough to put the furies back in Pandora’s box — or more precisely, the nuts back in the nuthouse. Even though normal people everywhere, and even the not-so-normal people in San Francisco, for crying out loud, are sick of them, they’re here for the long count.
It’s been 40 years, but liberals still don’t want to harm them (and I don’t think conservatives want to harm them, although you could probably get Ann Coulter to suggest they ought to be parted out for transplants, if she had a book in release), and conservatives still don’t want to spend lavishly on them.
What’s the answer? Make as much money as the ACLU lawyers did, representing indigent clients for scale. Then you can move to the ‘burbs like the ACLU lawyers do: where any “bear scat” you find on your stoop comes from authentic bears.
Kevin R.C. 'Hognose' O'Brien (88bf29) — 10/11/2007 @ 5:49 pmThe ACLU was invlved from the beginning with lawsuits against involuntary committment. Here is an interesting bit on the subject on Volkh. I did not mention the influence of Scientology which grew after 1970. Hostility to psychiatry was stoked by them and by books like Michael Foucault’s Madness and Civilization which proposes that psychosis is normal. Another skeptic, supported by Scentology, is Thomas Szaz. Interestingly, my own book shows up on his page.
Mike K (86bddb) — 10/11/2007 @ 6:28 pmSo what are you saying? That mentally ill people would be better off in jail? I doubt that. What’s the solution then?
There are many factors that led to deinstitutionalization. Lack of money was one of them. Inhumane conditions in hospitals was another.
Psyberian (9a155b) — 10/11/2007 @ 6:49 pmChristoph – *bzzt*, wrong. The implication that those who oppose this decision are against the Constitution is an attack. Challenging someone to show basis for their statement isn’t even an attack, let alone a dishonest one.
Foxfier (f765f6) — 10/11/2007 @ 7:13 pmSo what are you saying? That mentally ill people would be better off in jail? I doubt that. What’s the solution then?
From the post:
“They need to be institutionalized and receive proper treatment for their mental diseases.”
There are many factors that led to deinstitutionalization. Lack of money was one of them. Inhumane conditions in hospitals was another.
From my comment 3 above:
If there’s anything else you’d like me to repeat, feel free to ask.
Patterico (bad89b) — 10/11/2007 @ 7:13 pmAJL – As always, some citations for your memories would be helpful:
“And getting left out of your version of the story is the joy conservatives felt when they could zero out an expensive line item like mental hospitals from state and local budgets, which could then be used for tax cuts, the highest purpose of government.”
Otherwise, it sounds like the pure projection of a one trick pony. Why don’t you look into some of the cost shifting gambits employed by both the states and the federal government that contributed significantly to the shut down of state mental hospitals and a focus on “what federal funds are available” rather than what the patients need at the state level. How about focusing on how much more difficult civil rights advocates have made it to obtain involuntary commitments over time, directly and indirectly through the inadmissability of certain testimony about prior conduct. Just a few suggestions so you don’t leave things out. Everyone wants a “balanced” presentation, doncha know.
daleyrocks (906622) — 10/11/2007 @ 7:52 pmAll so-called mental illnesses have a physical cause. Chemical imbalance, injury, developmental anomalies. Depressives and people with anxiety disorders often have small amygdalas. Pedophiles have lopsided ones. Brain injuries often result in changes to personality and behavior. Mental illness has never been a choice.
I take Effexor because I have to. If I don’t I get very depressed, confused, and anxious. This is not something that happens because I want it to, it happens in spite of my desires.
Some people want things like mental illness to be voluntary on the part of patients, because to insist otherwise means we are not in total control. There are constraints on what we can do that we can’t ignore. To accept that we are not totally free is to say we are not free in any way. Which is foolish.
We are limited creatures with limited capabilities. Our knowledge is limited, our senses our limited, our intelligence, though prodigious, is ultimately limited. There are things we cannot perceive, thoughts we cannot think, paths we cannot walk because of our limitations. Our free will cannot be absolute because of our limitations.
Ultimately it comes down to this, some people insist we must always be responsible for what we do as adults. And that is the problem. There are people who cannot be held responsible for their actions, because they are incapable of behaving in a responsible manner. Whether it be due to a restricted intellect, or because they are prone to delusions and debilitating hallucinations. Not everyone who appears to be a responsible adult is.
Just recently there was a shooting in Cleveland. It resulted in one death (a suicide) and four injuries (all expected to survive). All the signs were there, but people auto-assumed the perp was rational. They were wrong.
My point is, the mentally ill are not rational. When I was not taking anti-depressants I was not rational. In some ways I’m still not. Certain parties insist that everyone has to be rational, and so their irrational beliefs make life a lot harder for everyone.
There will be a backlash against our current policies regarding the mentally ill. It may go as far as killing the homeless just to get them off the street. I hope not, but there will be a reaction. Let’s hope it leads to solutions that reflect well upon us.
Alan Kellogg (40d563) — 10/12/2007 @ 12:14 amI can’t read the article since the page is not up right now, but my guess is that the ACLU is keeping the homeless out of jail (or prison), not out of mental health institutions. If so, good for the ACLU. Incarceration is not going to help them.
…thanks in large part to the ACLU and related groups,…
Your post is one-sided. Rather than merely commenting in #4 (not #3), why not update it with more accurate information instead of blaming liberals? It’s a cheap shot.
Most liberals these days would rather not see the mentally ill in the street or in prison. “One Flew over the Cookoo’s Nest“ was an influential movie, but most have come to realize that jail is worse and living in the streets is not much better.
Psyberian (9a155b) — 10/12/2007 @ 4:32 amI can see the point of this, but… I see it going in the direction of some religious groups doing nothing by ear-banging the mentally ill, or worse yet, doing exorcisms to get the devil out of them or other such hokus pokus.
the friendly grizzly (82ada0) — 10/12/2007 @ 5:49 amthe friendly grizzly — that perception is exactly why they wouldn’t. Never mind that actual exorcists have to check for mental illness first (it is a lot more common, after all) or that “ear banging” might have a place (being mentally ill in one way doesn’t mean everything you do is because of your disorder). Never mind that having a roof over your head, food to eat and some kind of treatment is better than freezing to death in the street. Folks will go for the feel-good.
Foxfier (f765f6) — 10/12/2007 @ 6:04 amMore from the infamous ATHEISTS.COMMUNIST and LAWYERS.UNDERGROUND the most evil and militant bunch of subversives around its way past time that the ACLU had its tax exempt staues revoked. then we gott he COMMUNIST PARTY USA and THE SOUTHERN POVERTY LAW CENTER as well and sinster men like MORRIS DEES
krazy kagu (484aa9) — 10/12/2007 @ 7:28 am” “One Flew over the Cookoo’s Nest“ was an influential movie, but most have come to realize that jail is worse and living in the streets is not much better.”
The role of prison in the care of mental illness has grown since the ACLU suit that basically ended involuntary committmnt. Maybe your experience with 1960s-era mental hosptals is greater than mine. I do know that in 1962 those people had a clean bed and three hot meals a day. They were much better off than the 1930s era mental patients who had very few medications that had any effect. Most of the horrors of the early institutions were due to uncontrolled psychosis among the patients, not the institution, itself. Also, remember that prior to penicillin, mental hospitals contained a huge number of tertiary syphilis patients. Prior to chlorpromazine, shock therapy was the only way of calming many psychotics. Medications were limited to bromides and chloral hydrate. The chlorpromazines revolutionized care but the deinstitutionalization came along so quickly that we’ll never know what might have been.
On the subject of the cause of psychosis, most of which is schizophrenia, there are some very interesting papers suggesting that brain localization for speech may be related. Only humans have brain localization. There are no right or left handed chimps. That process may go wrong and the result is schizophrenia. The science is moving pretty rapidly now.
Mike K (86bddb) — 10/12/2007 @ 7:55 am