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***As a preface to my response, I would like you to know I spent several hours searching for
documents in the Apollo Library (and found nothing locally, and very little from even within the
United States about this subject with any detail attached). I finally ended up looking for local
information in The San Francisco Chronicle and Sacramento Bee. There, I found nothing more
than editorials (one backed with fairly decent reference material, the rest strictly opinion) to base
my "local" perspective from for this checkpoint.)***
California mandated as a whole the deinstitutionalization of the mentally ill in 1967 when
Gov. Ronald Reagan signed the Lanterman-Petris-Short Act (LPS). Under this act, "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."(San Francisco Chronicle, 1999, http://users.cwnet.com/phelps/neglect.html )
In the City of San Francisco, patients of the Atascadero and Napa State Hospital System
flooded into the streets to begin their steady decline into homelessness and addiction cycles.
Halfway houses were soon filled to capacity by re-entry clients from our State Prison System.
Where were the mentally ill to go since they could no longer be kept in private or public mental
institutions? The impact of this "dumping" of people in need of mental health care is and was the
increase in indigent populations within the city. Private non-profit, church and community groups
continue to try to seek help through advocacy and basic human need fulfillment (shelters, food
kitchens, healthcare), but money is a finite resource. With the continuing cuts in state funded
services (medicaid and other programs), the dollar to help these people stretches even thinner.
By releasing people in need of mental health care back out into the streets, as opposed to
halfway house and assisted living situations, the problems of homelessness, poverty, crime and
spread of communicable disease has intensified. The concept was to give people a "second
chance" away from institutions and save the government money at the same time. However, the
effects showed that the whole plan pretty much backfired. When people become desperate,
they turn to crime to find food or a night off the street in the city jails or commit crimes which
place them in prison populations where they are further abused. The public does not share the
empathy that some past people have....no one wants a halfway house or food kitchen in their
neighborhood. No one feels good about seeing the wandering homeless digging through
garbage cans for food, but neither do they wish to pay for their dinner. Clinics and other free
medical care facilities are questioned constantly about their issuance of drugs, condoms and
other means to control infectious disease. Lawsuits and the continued weakening of the state
economy are forcing many to close doors and remove their needed health services.
Henry A. Nasrallah, Bring back the asylums? The tragic consequences of
deinstitutionalization.(From
the Editor) Current Psychiatry. March 2008 v7 i3 p19(2). Retrieved from Ebscohost Database,
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July 11, 2009.
Ronald W. Manderscheid, Stepping back from deinstitutionalization? The jury is still out, but
new data show some disturbing trends.(THE MANDERSCHEID REPORT)
Behavioral Healthcare. April 2009 v29 i4 p34(2). Retried from Ebscohost Database, July 08,
2009