Mental health care, a disaster of Titanic proportions

Thank you, Tony Foster for writing this letter. The more that people speak out and write letters as you did, the greater the chances of change through awareness and education.

The historical account of Dorothea Dix’s work to deinstitutionalize mental health patients continues to need work. She started to help psychiatric patients in the 1800s. I wonder what she would think about the strides we’ve made? Think she’d flip her wig and ask lawmakers: “Why so little progress in 200+ years? ” I think she would.

Ninth plate daguerreotype of Dorothea Lynde Dix.

Ninth plate daguerreotype of Dorothea Lynde Dix. (Photo credit: Wikipedia)


Amarillo, Texas, USA

Amarillo Globe News

January 8, 2013

In the 21st century, prisons and jails have become makeshift hospitals for those who have mental illness, but it wasn’t always this way.

Philanthropists such as Dorothea Dix led crusades in the 19th century to decriminalize the mentally ill. Her prison ministry led to the discovery of inmates with obvious psychosis chained to walls, with no heat during winter, often naked and surrounded in feces. Poetic in her pleas to Congress, Dix challenged the sanity of salad-mixing the mentally ill with hardened criminals. With razor-sharp wit and a talent for diplomacy, she voiced the morbid conditions to legislators and garnered support….

Deinstitutionalization began in 1955 with the advent of a successful anti-psychotic medication (Thorazine), and was given a boost through federal programs such as Medicaid and Medicare.

The “grand experiment” ushered in a new era — the closing of mental health hospitals, reduced availability of beds and a mass exodus of patients released from hospitals. …

In the least restrictive environment, patients could anchor themselves to a robust outpatient system padded with supports. In theory, this would allay the uncertainty of institutionalized patients and assist healthy integration….

Weak investment in mental health care has created a human rights Titanic, capsizing in a sea of piecemeal provision and scant accessibility. The ship is sinking to the extent the contemporary face of mental health treatment is behind bars. …


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