Saturday, April 4, 2009

California Mental Hospitals

Robin is picking on me again, and I just have to reply to her. My cousin "Oregon" tells me I should leave her alone, because she is a lot smarter than me, and she is one of those newspaper people that pays attention, and get all of the "5 Ws" Right.

But she taunted me with:
"You mean I'm not the only one who knows it's bullshistory that Reagan closed the mental hospitals in California? Glory be! This is such an oft-repeated tale that most people think it's true!"

No Robin, you are absolutely right. Reagan did NOT close the state mental hospitals. He just made them obsolete, and removed their funding. It was okay with him if they stayed open, but with no funding and no inmates they didn’t last long. Maybe you are not old enough to remember Reagan’s “Mental Illness is a neighborhood problem” speeches like I do.

Living under a bridge is not better than being institutionalized. Granted, there were serious problems with the “Cuckoo’s nest“, but none that could not be fixed better than lost and living on the street.

I’m not a socialist, but I have a problem with thinking someone is better off dieing of exposure, alcohol or drug addiction, than being in a hospital. I see people every day that need somebody to tell then that “No you can’t drink that drink“, or “no you can’t do that drug” Some might even have a chance to be happy.

From the San Francisco Chronicle:
“In 1967, Gov. Ronald Reagan signed the Lanterman-Petris-Short Act (LPS), which went into effect in 1969 and quickly became a national model. Among other things, it prohibited forced medication or extended hospital stays without a judicial hearing.

A mental patient could be held for 72 hours only if he or she engaged in an act of serious violence or demonstrated a likelihood of suicide or an inability to provide their own food, shelter or clothing due to mental illness. But 72 hours was rarely enough time to stabilize someone with medication. Only in extreme cases could someone be held another two weeks for evaluation and treatment.

As a practical matter, involuntary commitment was no longer a plausible option.

The LPS Act emptied out the state's mental hospitals but resulted in an explosion of homelessness. Legislators never provided enough money for community-based programs to provide treatment and shelter. Even the most modest programs encountered local resistance.

'No neighborhood wanted the mentally ill living among them,' recalled former state Sen. Tom Bates.

Lanterman later expressed regret at the way the law was carried out. 'I wanted the law to help the mentally ill,' he said. 'I never meant for it to prevent those who need care from receiving it.'

But that's exactly what happened for three decades."

If it looks like a duck, quacks like a duck, and walks like a duck, It's a duck. Reagan closed the mental hospitals.


Robin Shelley said...

Ouch, Ernie. I think I've been personally insulted. (And to think that damned Oregon wants to come over to my house today!)
You are all over the place in your post so I need to think about it awhile but I do have one question for you right off the bat: do you think alcohol & drug addiction are mental illnesses? I see you lumped those problems in with LPS.

spyrock said...

i had a friend back in the sixties going to cal who took his girlfriend to watch elvira madigan on mescaline. this was late 1968. his girlfriend's roommate called the cops on him because he was black irish afterall and she didn't like him anyway. they took him to the 6th floor at merrick hospital which was the pysch ward and looked just like that place in cookoos nest. steve spent the next 4 years in mental institutions that were like country clubs because his family had money. they kept him on thorozine for 4 years. that's what rich people used to do with kids that misbehaved. he finally ran away from home in marin county and on the way down to long beach to see his sister he stopped at one of those missions where you have to hear a sermon before you eat. he was up there confessing his sins and they called the cops on him. when they found out he had a mental history they sent him to the prison for the mentally insane at cammarillo. after some inmate tried to kick down the bathroom door to be bedbuddies, he called his dad and his rich dad got him out of there. he's been sane ever since. of course, that's where a lot of crazy people wound up that weren't rich.

Ernie Branscomb said...

Actually Robin, If I “personally insulted” you, I deeply apologize. That was not my intent. When you mentioned that I was wrong about Reagan (effectively) closing the mental hospitals. I perceived that you must have some knowledge on the subject. I’ve always been anxious to learn something new. I simply smelled the blood of new knowledge in the water. If I bit too fast, and deeply, again I’m sorry.

For those that are wondering LPS stand for. It’s the “Lanterman-Petris-Short Act”. It prohibited forced medication or extended hospital stays without a judicial hearing.

Now, on to the question that Robin asked: “do you think alcohol & drug addiction are mental illnesses?”

I have some advantage in knowledge of this issue over most folks. I’m a Medical First Responder with the fire department. When a call goes out, you may hear over your scanner: “35 year old male having seizures, In front of the Laundromat”. What you don’t hear is how many of these “Seizure” calls are actually over-doses of any of a great number of substances, including alcohol. It’s wonderful that Marijuana over-doses don’t usually involve emergency medical care. A marijuana overdose simply leaves you suspended in stupidity until it wears off. I’ve been on many calls wear the person involved needed to smoke a joint before they could calm down enough to even talk to us. Is that addiction? I don’t know.

Back to the question:
The standard for whether you are “insane” is those who are "gravely disabled" defined as unable to obtain food, clothing, or housing. That definition is beginning to include many more people each day, so I think that definition is somewhat archaic.

Back to the question:
If I’m on a medical call to a person with two broken legs, under a bridge, with no blankets or food, with no one to care for him, or no way of getting food. He is, by all outward signs, sane. Say, he knows who the president is, what day it is, the last time he ate, he can count to ten backwards, and understands the instructions to do so, he refuses to go to the hospital voluntarily. We have no right to make him do so. A sheriffs deputy has to declare him mentally incompetent before we can get him to a hospital to be cared for. One of the standards of mental incapacity is being unable to care for oneself.

Back to the question:
Yes. But I wouldn’t call them “Mental Illnesses” specifically. Any incapacity to care for oneself is an illness, whether it be broken bones, a broken mind, or a broken heart.

I knew many people that stayed away from alcohol because they didn’t want to be locked up in “The Loony Bin”. So it was a deterrent. The same as jail stops people from committing crime.

spyrock said...

the insanity of the war on drugs espoused by the bush administration and other extreme fundamentalists means that we can just sweep people under the rugs or lock them up in prison rather than deal with the dysfuction or health issue that made them that way in the first place. so nothing changes. alcoholism is a disease. it is passed down from generation to generation through families as is addictive personality. most of these problems are dealt with very cheaply by self help groups like 12 step programs. the trick is to get the person to keep going.
a couple of hours a week does wonders with people who would otherwise cost society millions of dollars in incarceration or medical care.
also, there is a whole prison system built on having a larger population than public education these days. laws on victimless
crimes such as pot keep these prison populations growing. as a result of these policies, the rest of us live in neighborhoods with crank monsters and gang bangers who exist by simply selling these drugs and now the cartels from mexico are moving up here to grow weed because they are shutting the supply off better at the border. this is a no brainer people. the war on drugs is a bust. and the real insanity is to continue it.

Ernie Branscomb said...

Just say no.

Ben said...

Ernie... What a great post!.. Lanterman came from a district next to mine in Southern California. I remember sitting in a San Francisco deli, about 1982, and being astonished at the derelicts passing by. Hundreds of mental patients had been turned out and left to their own devices. I wonder if anyone ever did a mortality rate study during that time. It surely resulted in many deaths. The kind of result politicians try to ignore when they are only trying to save money. I do remember a time when there were public institutions available to alcoholics and addicts. These days we see so much mental illness on the streets which is a result of alcohol and drug toxicity. The cost of caring for these people has shifted from institutions to local emergency and police services. I wonder what that cost is compared to the old one of institutions. In this computer age, it seems like a study could be done. I believe that many alcoholics who are near death, consciously or unconsciously get themselves to jail or prison simply to save themselves. I'm sure 12 step programs have saved the taxpayers billions but they only work for a percentage of addicts. If we can see addiction as a part of our huge health care problem then we may begin to find solutions which include institutions for those at the end of the road as well as the mentally ill who cannot care for themselves. Let me ask everyone a question. What would you do if you found yourself suicidally depressed to the point where daily life had become unbearable? What would happen if your doctor recommended a hospital? Would it bankrupt you? Very possibly. Yet even the most severe depression is an illness that can be survived. How strange that we now live in a society that discards the mentally ill rather than finding systems to make them well and productive.

Bunny said...

"I’ve been on many calls wear the person involved needed to smoke a joint before they could calm down enough to even talk to us. Is that addiction? I don’t know."

No more addition than having a valium or xanax or whatever they are these days. Sometimes pot is a stimulant but also it can be a sedative type drug. That's why it's a good medicine as well as a good way to get high.

I'm with spyrock and I say legalize them all, pull the rug out from under all the bad guys, help the users medically and I'm sure there will be less users without pushers. That's simple logic.

America has to stop living the drug war, it's a big lie.

Bunny said...

addiction, not addition.

Ernie Branscomb said...

That's okay Bunny, I made a few Typos myself.

I've been on the Bell Springs Trek with my wife. What a beautiful day!

Ben has stolen most of my thunder, I was going to go on to say that there is a segment of our society that soaks up more than their share of public resources. Cops are called to break up disturbances of the peace, fire departments are called endlessly to “smoke check” their campfires. Warming fires are legal but when the smoke and flames are coming from a wooded area, most good citizens will become concerned and report it. When they become ill they are taken to the hospital by ambulance. Their medical care is taken care of by hospitals. A good percentage of them end up in jail. When they camp in store fronts they always leave a mess that needs to be cleaned up. They cause people to avoid areas that they hang out in, so effectively parks become useless for people that don’t like to be around “those kind of people”. They harm business by hanging-out and panhandling business patrons. They cover the cost of none of that. So what would be cheaper? A mental institution? Or living on the street?

We are talking about people that are unable to care for themselves. Again, the standard is: those who are "gravely disabled" defined as unable to obtain food, clothing, or housing We are not judging their addiction, or physical illness, only that they are unable to care for themselves. I don’t want to see this discussion slide into economics, or what kind of addiction is okay. Only that people need help taking care of themselves, and what is the best way to accomplish that. Would people be better off caged up and given the proper medication for what ails them? Could their life improve? Or should they be allowed to roam the streets with all of the obvious hazards?

I realize that the type of disability has to be analyzed before any kind of treatment can be started. But I really think that some people that are now living on the street could live longer happier lives in an institution. An example could be the elderly, some live in care homes because of disability or dementia, and most of them suffer some misery because the feel confined and disabled, but some would surely die without care.

spyrock said...

california is a mental hospital. whats that song by the eagles?
hotel california. you can check out but you can never leave. can someone explain to me what is victimless crime? is it crime that doesn't exist? is it mind control. that's another song.
don't tell us that we aren't free.
easy rider. what are we fighting for? country joe. economically can we put everyone who doesn't agree with us in jail. economically can we convert by force everyone in the world who believes in another religion to our religion.
how long can we afford to be this crazy?

Robin Shelley said...

The 1960s were an interesting & violent time in the history of America what with war protestors & civil rights activists taking to the streets & a young Catholic president shot down before his time. That president, John F. Kennedy, had a younger sister, Rosemary, who was born "mildly retarded" but who, at age 23, became a victim of the very latest, cutting-edge technology at the time - a frontal lobotomy - & was left almost completely incapacitated for the rest of her life. The care & treatment of the mentally retarded & mentally ill, as well as the education of those who give the care & treatment & research into the ,were matters of great personal interest to JFK.

On Feb. 3, 1963, at a news conference in the Fish Room at the White House, President Kennedy told reporters, in part:
"I have sent to the Congress today a series of proposals to help fight mental illness and mental retardation. These two afflictions have been long neglected. They occur more frequently, affect more people, require more prolonged treatment, cause more individual and family suffering than any other condition in American life. ... With respect to mental illness, our chief aim is to get people out of State custodial institutions and back into their communities and homes, without hardship or danger. Today nearly one-fifth of the 279 State mental institutions are fire and health hazards.

"Three-fourths of them were opened before World War II. Nearly half of the 530,000 persons in our State mental hospitals are in institutions with over 3,000 patients getting little or no individual treatment. Many of these institutions have less than half of the professional staff required.

"Forty-five percent of them have been hospitalized for 10 years or more. If we launch a broad, new mental health program now, it will be possible within a decade or two to reduce the number of patients now under custodial care by 50 percent or more.

"We, as a nation, have neglected too long the mentally ill and the mentally retarded. It affects all of us and it affects us as a country. I am hopeful that beginning today this country will move with a great national effort in this field so vital to the welfare of our citizens."

On Oct. 31, 1963, Kennedy signed Public Law 88164 which provided millions of dollars for mental health program grants to states as well as to private & public institutions for construction of research facilities & hospitals for care & treatment of the mentally retarded, mentally ill & handicapped children & for education of providers. It also "authorizes $150 million during the 3 year period beginning July 1, 1964, for formula grants to be allocated among the States to pay 33 1/3 to 66 2/3 percent of the costs of constructing public and other nonprofit community mental health centers."

On signing the bill into law, President Kennedy said, in part:

"I am delighted to approve this bill. It will make possible the major attack on the problems of mental retardation and mental health." He talks a lot about mental retardation & birth defects here, then says: "Other parts of the bill are equally significant. Under this legislation, custodial mental institutions will be replaced by therapeutic centers. It should be possible, within a decade or two, to reduce the number of patients in mental institutions by 50 percent or more. The new law provides the tools with which we can accomplish this. ... today, under present conditions of scientific achievement, it will be possible for a nation as rich in human and material resources as ours to make the remote reaches of the mind accessible. The mentally ill and the mentally retarded need no longer be alien to our affections or beyond the help of our communities."

By 1965, Congress was granting federal funds for construction of new mental health facilities in communities across the country & there was, of course, an indignant public outcry of "not in my backyard!"

Ernie Branscomb said...

Yeah, I remember that. Because of John Kennedy’s attempt to take care of people closer to home, it all fell apart. Sadly, he was shot by a mentally unstable person, and that person was shot by another mentally unstable person. I believe if John Kennedy had lived, he would have found a workable solution to the problem of care for the mentally unstable and deficient. Just like any great cause it takes a great leader to fulfill it’s destiny. Just like a ship with no one at the helm, it soon hit’s the rocks.

I found the irony of Reagan being shot by one of the people that was having his mental problems cared for on the streets. I remember thinking at the time that maybe he would notice that we are trying to run a society at it’s lowest common denominator, and do something to get dangerously insane people off of the streets.

Just like any project funded by the government, it doesn’t take much of a protest to stop it. The politicians all have something in mind that they would rather spend the money on, and it disappears into the government structure.

The problem with “local” care facilities, is everyone wants to get their friends and relatives into the best ones. California was well known as having some of the best mental care facilities, so we got people from all over the nation into our care facilities. They became over loaded. They became the nations warehouse for the mentally altered. I believe that the answer is a national mental health care policy where care is uniform, and consistent.

I agree with Ben about suddenly seeing all of these people on the street trying to find their way. For years the town of Napa seemed like walking through an asylum. People arguing with themselves and yelling at their devils, it would have been scary if it hadn’t been so sad.

Leave it to Robin to start at the beginning with Kennedy. Thanks for the insight Robin. (And the incite)

Robin Shelley said...

On a lighter note, Ernie, & going back to your astrological post (but still on the subject of health - ha!), an article came up on my computer news today pointing out specific areas of the body where astrological signs suffer the most ailments. In short:

Aries - headache
Taurus - sore throat
Gemini - general tension & stress
Cancer - stomach & esophogus
Leo - cardiovascular system
Virgo - digestive tract
Libra - backache
Scorpio - irregularity & bowel
Sagitarrius - weak muscles
Capricorn - knee
Aquarius - lower legs
Pisces - feet

Wonder if your readers care to validate this? If it is true, then I must be a bunch of signs rolled into one... or possibly ready for admission to one of those community-based care facilities!

You're a good guy & a good sport, Ernie. I understand I missed a chance to meet you last week... sorry about that. Had I known what "Oregon" had in mind, I would have been there. Next time! By the way, had a lovely afternoon with "Oregon" & his beautiful daughter yesterday. You should come up this way sometime when you feel the need for sea air.

Ernie Branscomb said...

"Aries - headache"

Sorry, I don't get headaches. No brains no headaches!

The Great Pontificus said...

We do not read the whole personality from only the sun sign, nor we do read the health only from the sunsign. Planets that are afflicted in a sign may manifest health issues in that sign.
But not always. I, The Great Pontificus, have both proof and not proof of the above in my chart.
And so, to summarize, astrology is a very precisely vague science that is so right on, except when it isn't.

Ernie Branscomb said...

Thanks for the pontificusation Pontificus.
Do they know that you've escaped?

The Slightly Less Great Pontificus said...

My home planet knows exactly where I am in order to protect me from the humans, lest they find out. No one from our planet escapes here, it is strictly on a volunteer basis that we are placed and protected here. A good analogy would be your volunteers in a city slum, only instead of material poverty...we walk amongst the spiritually blind, greedily depraved, neurotically conflicted, emotionally torn and dramatically expressive, and oft violent proto-humans still evolving into a species that might be trusted to get out of its own solar system. Might, someday.
Now if astrology seems, what is your local word, "doobius"? you, may I suggest that someone come to your house and read your palms? Presuming that you have planted such. The Chinese have a coin or yarrow stalk system of divination called the I Ching, but using it has caused so many westerners to scratch their heads that... they have to use I-Ching powder. There are alternatives to astrology is my point.
I think I hear the footsteps in the corridor getting closer and louder. I must hide now and make myself look like a mop so they will not notice me.
O crap they have a bucket with soapy water!

Anonymous said...

If you're out there. Call Bud Bowman at 707-984-6922. I spoke with him today and he's waiting for someone to call him back. Said he got a call about 6 months ago but the person didn't call back. He's eager to speak with you regarding family.
Good luck, Penny

Anonymous said...

My Aries friends have had a tendency to bump their heads a lot.

Anonymous said...

Since no one else has mentioned it, I will.

One of the disturbing features of spending time in a mental facility, even for a short stay, is that they won't let you out unless you sign away your right to keep and bear arms for five full years.

Even if you entered the facility voluntarily, and not for being a danger to yourself or others.

They don't tell you that when you sign yourself in.

It's hard to refuse to sign away your rights when you are being housed in a locked mental facility. The tendency is to want to be released, obviously.

Other than that, though, they were very helpful and polite.

My knowledge of this subject is based on an episode involving Sempervirens in Eureka.

Anonymous said...

Over the years, I have been in the position to try and help friends stay out of such institutions during times of breakdown, dark depression, psychotic episodes, etc. by providing supportive environments, good food, massage, and a host of healing modalities. When it just doesn't work and your friends are posing a threat to themselves and/or others, it is the worst feeling to offer someone up to the system by asking for intervention. Even when they thank you later.
I used to volunteer in a state mental hospital decades ago and had to quit because it hurt too much to watch the people caught up in the system being sedated heavily rather than helped. I am not going to sensationalize about all that I witnessed but my encounter with one patient was noteworthy. One week there was an young woman on the ward for depression. She would talk to no one. After a few weeks I coaxed her out of herself playing cards and even getting a few smiles and laughs. The daynurses were delighted to watch her get lighter.
One week I returned to find that she didn't recognize me, and had to start from scratch to get her to open up again, with limited success. The following weeks were the same, by the end of my shift she was starting to respond to things said to her. Then back to blank the next week. Naieve as I was/am, I did not know that she was getting electro shock for her depression. Successful human rehab wasn't enough to ward off the practice of the time. I always wondered happened to her...Cat Stevens had a song "Sad Lisa" that seemed to fit.
No easy answers on these issues, pardon my previous non serious posts.

Ernie Branscomb said...

"I have been in the position to try and help friends stay out of such institutions during times of breakdown, dark depression, psychotic episodes, etc."

The operative word being "Friends". Many street people have no friends. There are few people that want to intervene in a mentally unbalanced persons life. Even when the cops know that someone needs help, there is no funding for mental care, other than for the seriously deranged, or predictably dangerous person, and that type usually ends up in jail.

same anon said...

So true Ernie.

spyrock said...

i'm watching forest gump reading this stuff and i've never really seen this movie all the way through. but this time i saw the end where he marrys jenny after finding out that he has a son named forest who is smart and then she dies leaving him in charge of raising the boy.
there were two retarded girls living accross the street from me when i was very young. they lived with their grandparents and they had a tv. i used to see saturday night fights with rocky marciano and carmen basillio in black and white. brutal fights. the old man raised pigeons in the attic of his garage. they flew all over town and their decendants are still here. they live where i work. in between two warehouses. they've tried all kinds of things to get rid of them. the grandparents died years ago but the younger girl got married and lived in town for a long time. they were always happy.
one of the stories my british ex told me was that her previous husband was a good friend of cat stevens and that she had an affair with cat and became pregnant but she married jimmie and took the baby to america illegally when her step father, a chief master seargent in the air force, was transfered back to the states. the babys name was lisa. i spent the evening with lisa watching her daughters play high school soccer.
of course this could all be bullshistory. wouldn't be the first lie out of her lips. but i'm going to check out that song all the same. thanks.

eric said...

And if you live and work in Ukiah for any length of time, you can come to appreciate the daily sightings of the mentally ill, some longstanding homeless citizens booted out after the Ukiah Valley mental institution closed and later became the City of 10,000 Buddhas.

Yeah, thanks Reagan. Oh well, that just meant one more missile to win the Cold War with, eh?

Robin Shelley said...

Gawd, Eric! You make it sound like bird-watching.

eric said...

Robin, sadly in a way, it is.

Anonymous said...

SPY, you bring back some memories. When I was an older child in the early sixties we had the Gillett Friday Fights that my uncle and his friends watched. They made wagers with each other on their boxer. Well, believe it or not, I just happen to look through the Humboldt Times one day and discovered those fights were taking place on Thursday. Too good to be true I thought. I became an instant fan of the Friday night fights with my uncle and his friends. I made a few dollars but that was short lived before I was treatened with my life only after three Fridays.


Sophie Annan Jensen said...

very interesting blog! Found it in search for information about closing of the mental hospitals. That was inspired by news items like this latest from the AP:
"Most wildfires are caused by human activity, and government statistics show that people were faulted for 5,208 wildfires in Southern California in 2008 . . . Still, very few of the forest fires lead to criminal or civil cases. The U.S. Forest Service recorded nearly 400 arson wildfires since 2005, records show."
I wonder how much the fires cost us compared with more and better mental health facilities?