To give you an idea of just how acute the need for mental care is, we need to go back in time. In the'30s, '40s, '50s & '60s there were state run mental health hospitals. To give you an example of what kind of numbers we are talking about, think back to Jack Nicholson, and Nurse Ratchett in the movie, "One Flew Over The Cuckoo's Nest". That was filmed at Pilgrim State Hospital on Long Island NY. The patient population was right around 6,000 patients who had bed space in that hospital, and just a part of the New York State Department of Mental Health. My home town had a similar NYSDMH with an average bed count of 2,500. There were several other DMH facilities throughout NY State. Most states had similar facilities, it was the state of the art at the time.
These facilities were all self sustaining, and required nothing from the cities they were near. They had their own farms, my dad ran a 3,000 plus acre farm that fed the patients, and staff. They had their own cows, pigs, beef cattle, laundries, carpenters, mattress shop, bakeries, orchards, quarters for MD's, Nurses, Attendants, power plants, police/fire Dept, Nursing Schools, Recreation Dept, Bowling alleys, indoor , swimming pools, auditoriums...and so on. Some patients were locked inside the hospital 24/7 because they were too unstable to let outside; they were seen an threats to themselves and others. Many patients were allowed to be out on the hospital grounds, and they were inside at night. The hospital grounds covered thousands of acres of land, and hundreds of buildings.
In the late 50's and early 60's health care was changed with the advent of tranquilizer meds like Thorazine, Mellaril, Stelazine, and a few others. These meds allowed for patients who were stable enough to actually work on the farm, bakery, and other facility shops. There were patients who needed 24/7 attention and could not care for themselves, and they were pretty much warehoused at the hospitals. Still others were simply too violent to be allowed outside of locked doors. The trend, however was to get as many patients out of locked wards, and cost less to care for. Politicians, and "citizens groups" were appalled that patients were learning to farm, work in a laundry, or bakery, etc.,etc. One of the early problems was, that if the patients left to manage for themselves, most were noncompliant with their meds, and would backslide to needing inside care for a few weeks. That still happens today, everyday. The bottom line here is that these were patients of the DMH, and did not interface the locals, or the police. The cities near these hospitals were largely unaware of the number of patients that were being treated.
Jump ahead to today. The percentage of patients requiring mental health care, or have significant mental health issues, are pretty much the same. With the advent of more, and newer psychotropic drugs, fewer beds are thought to be needed than 40-50 years ago. Today the percentage of beds available for inpatient mental health care needs, do not match the number of patients needing them. The bulk of the mental health care is outpatient, on what is really a skeleton crew of mental health workers. The states are not spending the money needed to house the patients needing inpatient hospital beds; they just are not there. The last time I was home that 2,500 bed facility was down to one building to provide bed space for 50 mentally ill patients. That is down from around 12 buildings.
Today, when a patient stops taking his meds for too long, he winds up in jail because of his behavior. That means LOEs to arrest, incarcerate and "care" for the mentally ill. To place someone in a locked mental health facility requires a court order, and it expires at the 72 hour mark. Many of the psychoactive meds we have today, can take up to a week to see the full clinical effects. Judges are reluctant to keep people behind locked doors because of the loss of liberties to the mentally ill. That said, three days after arrest, the person is back on the streets, with a pocket full of meds. They trade the meds for alcohol, and the cycle begins all over again. If you want to reduce the LOE's workload, start paying for treatment of the communities mentally ill. It will create jobs, and get people the care they need. Some how all of the great political health care program have ignored the mental health issue. It requires money, attention to detail, and people to care for people; not bitch about them. For me this is :wall::wall::wall:.
