Reagan’s Disdain for Mental Hospitals, With Us Still Decades Later

    

California’s Camarillo State Mental Hospital Became Cal State Channel Islands   

                                Homeless in LA

It’s not as if California had a magnificent set of governmental mental hospitals (under the “Department of Mental Hygiene”) when Ronald Reagan became governor in 1967. According to a KQED report, the number of patients had fallen to 22 thousand, so the austerity-driven Reagan administration promptly cut 2,600 jobs and 10 percent of the budget despite reports showing that hospitals were already below recommended staffing levels.

Shortly, thereafter, under the pretense of creating a mental patient’s bill of rights, Reagan signed the Lanterman-Petris-Short Act to end the practice of institutionalizing patients against their will for indefinite amounts of time, absent a trial with due process. The law also made it easier to shift care into private hospitals, which it turns out, were woefully unprepared to handle the change. State hospitals accordingly began a slow phasing out, as the above photos illustrate.

The new law did not work out as planned. According to KQED, for example, the year after the law went into effect, a study shows the number of mentally ill people entering San Mateo's criminal justice system doubled. Over time, the public care and “treatment” of the mentally ill, as they were removed from society for indigency or more serious criminal acts, shifted almost entirely to the California criminal justice system.

Prior to leaving the presidency, President Jimmy Carter signed the Mental Health Systems Act to support better care for the mentally ill in furtherance of John F. Kennedy’s dream for a kinder America. According to KQED, early in Reagan’s term as President (1981), his administration led the repeal of Carter’s legislation with the Omnibus Budget Reconciliation Act. This pushed the responsibility of mentally ill patients back to the states. The legislation created block grants for the states, but federal spending on mental illness declined.

As waves of austerity swept the states, cutting back infrastructure repair and educational support as well, public funding for specialized mental treatment facilities faded even more. This was also the beginning of the shift of post-secondary education costs from states to students and their families, the inflection point where tuition costs began to pass inflation by a rising multiple.

Up to the present day, not much has changed. Student loans are now staggering. And, for those not in jails or prisons, a whole lot of mentally insufficient or ill people find themselves among the hordes of the homeless, now a huge new political issue, particularly in sunny California. Meanwhile, those with serious mental illness often languish as inmates under horrific conditions with no meaningful treatment, even for those unconvicted but still jailed. “Liberal” California is a particularly egregious offender. Writing for the September 14th Los Angeles Times, Kevin Rector, explains that “Despite court orders, thousands found unfit to stand trial languish in state lockups…

“It was 2020, and he thought his downstairs neighbor was spying on him. They exchanged words, and she called the cops. He was arrested on suspicion of making a verbal threat and booked into a Kern County jail… Haasjes has a developmental delay and schizoaffective disorder. The 58-year-old Tehachapi man has been in and out of mental health facilities most of his life. But he had never been convicted of a crime, and he said he didn’t really understand the felony charge against him.

“Authorities soon acknowledged the same. In March 2021, Haasjes was declared ‘incompetent to stand trial.’… The legal designation meant Haasjes could not understand the court process for determining his guilt or innocence. It meant he was entitled to mental health treatment before he could stand trial. It also should have meant his prompt transfer to a state hospital or treatment program to receive care — but it did not.

“Like thousands of other mentally ill detainees incarcerated across California in recent years, Haasjes instead languished in jail, where he was denied trial or proper treatment from the Department of State Hospitals for more than a year. He was only transferred to a hospital in February, after his cousin, a retired social worker, testified about his lack of care before state lawmakers, and his case was suddenly fast-tracked.

“Others have fared much worse… According to a decade of legal filings reviewed by The Times and interviews with mental health advocates, public defenders, family members of the mentally ill and former detainees, Haasjes’ experience fits within a much larger pattern of neglect involving some of the most vulnerable people in state custody.

“At the heart of the problem is a persistent failure by state officials to sufficiently expand state hospitals or other community-based care options despite surging numbers of incompetent criminal detainees and a string of court orders mandating the state transfer such defendants out of jails faster.”

Simply put, there really are severely limited public treatment facilities to send these hapless individuals to. State ballot initiatives and competing agendas among and between political candidates seeking office, mostly focused on homelessness, have failed to produce solutions. It’s still easier to buy an AR-15 than to find viable treatment facilities for criminals or homeless individuals with severe mental illnesses or addiction issues. Does California Governor Gavin Newsom’s new “Care Court Bill” provide a possible alternative for some of the homeless and hapless?

“An estimated 7,000 to 12,000 of California’s most vulnerable residents are expected to qualify for CARE Court, the ones at greatest risk of death or deterioration due to their conditions… To initiate a CARE plan, family members, first responders, medical professionals and behavioral health providers, among others, can first petition a judge to order an evaluation of an adult with a diagnosed psychotic disorder who is in severe need of treatment and, often, housing.

“If the person meets the criteria, the judge would order a series of hearings and evaluations to begin drafting an individualized CARE plan, which could include medication, social services and treatment for stabilization, along with housing specific to their needs.” LA Times, September 15th. Is this the answer? There’s $1.5 billion in the offing. Let’s hope this at least makes a dent. But will the process reach those who need it most? Time will tell… but the problem is much bigger than this law.

I’m Peter Dekom, and it is amazing how expensive so many unthinking austerity programs turn out!