Why I Go Back and Forth On Issues of Forced Psychiatric Institutionalization
I was among those who has opposed forced institutionalization. The practice used to be rife with abuse, and when it was really being challenged in the 1970's it was with recent knowledge of how institutionalization for supposed mental health issues had been used in the Soviet Union as a tool against dissent. And in a world where political partisans still routinely assign negative mental health diagnoses to their political enemies and have even suggested using mental health diagnosis-from-a-distance to unseat the current President, there is still a lot of possibility for abuse. But seeing that most of those who would have been in state mental hospitals are now in prison or living (and dying) on the streets, I am open to having made a mistake. I am still not sure, though, who advocates for such people who are without friends and family and would help guard against their abuse.
I understand that the general media explanation of homelessness is to blame it on the cold heart of whoever was the last Republican President in office, but it is hard for me to correlate national policy with trends in homelessness. I am maybe 70% convinced that the closing of mental health facilities in the 70's and 80's across most cities and states was the main cause, a hypothesis born out by the high rates of mental illness recorded in most homeless populations. This is why I think so much government spending for the homeless is wasted -- it all focuses on creating homes, I guess just because of our word choice of "homeless". If we called them the mentally ill, or perhaps "helpless" rather than "homeless" we might investigate other approaches.
I see a number of sources nowadays trying to pin these closures entirely on tight-fisted Republican governors, and I am sure this is partly true. But this misses an important element -- that civil libertarians had real issues with both the conduct of these institutions (e.g. One Flew Over The Cuckoo's Nest) and the fairness of the forced-institutionalization process. Also tied up in all this were Cold War stories of Soviet Russia using institutionalization in mental hospitals as a way to dispose of dissidents. After all, it is a short step from the totalitarian view of ideology (ie that everyone must believe, not just comply) to declaring that any deviation from the official orthodoxy constitutes mental illness.
Which leads me to this story, which got me started thinking about this again: