No, this isn’t about you and your mental health–not about the battleground in your noggin’. It’s about the sad state of our country, and it’s almost totally broken system of care for the mentally ill and addicted. Mental health was much in the news a few weeks ago after a lunatic shot up a school in Connecticut and slaughtered over 20 kids–the Sandy Hook Massacre, as it will forever be known. That perpetrator, as well as the shooters at the Aurora, Colorado, theater and the Tucson, Gabby Giffords shooting all appear to be quite deranged. This has again led to a national debate over increasing mental health funding vs. gun control. I recall seeing a morbid cartoon that showed a person standing outside the locked door of a mental health clinic, and next door there was a gun shop open for business. But the Newtown shooting is starting to fade, pushed off the front page by (a) the Oscars or (b) the Pope’s resignation–take your pick.
I’ve worked as a psychologist and licensed counselor in one capacity or another for over 40 years. I started my career in the late-1960s at a state facility in Illinois. I worked for the Illinois Dept of Mental Health for five years in a program that was both comprehensive and well-funded. Singer Zone Center was considered one of this country’s premier community mental health programs in the late-60s and 70s, and I was fortunate to have worked there when I did. After that, I spent 13 years at Seminole Community Mental Health Center, a public, tax-funded, entity that serves a county just north of Orlando. In 1973, SCMHC had about 10 employees. Five years later we received a federal staffing grant and grew to a staff of over 100. When I left there in 1987, the center was in decline and the hand writing was on the wall. Sadly, if there ever was a golden age of care for the mentally ill and addicted, it ended over three decades ago.
The very first piece I ever published was a “My Word” column that was on the op-ed page of the Orlando Sentinel in May, 1985. My topic was the de-institutionalization of the mentally ill, and the concomitant lack of public funding for outpatient services. It was a lethal mix–closing state hospitals and not providing enough funds to maintain the chronically mentally ill in community settings. I worked in one of the country’s first de-institutionalization programs in Illinois, and I know that its initial impetus was humanitarian–to get the forgotten chronics out of the backwards and into society again. And community maintainance works when there is enough funding for nurses and case-managers to keep track of the clients. However, legislators quickly picked up on the fact that it was cheaper to maintain someone in the community than in a state facility–and really, really cheap if you did it half-assed. They didn’t care because the chronically mentally ill rarely vote.
In the 1970s Florida had four state hospitals. The one that served our area was NEFSH at Macclenny, near Jacksonville. In the 70s it had an inpatient census of about 3,000. Today it has 600 beds and I do not know how many of those are occupied. Two of Florida’s four state hospitals have been closed. The other state hospital is at Chattahoochee and its 1000 beds are reserved for the criminally insane–you know, the Hannibal Lecters, who given a chance will chew your face off.
The Zone Center where I worked in Rockford, Illinois, opened in 1966, and last year it closed forever, its 400 beds now sitting vacant. It’s the same story all over the country. While our country’s population has grown over the past four decades the numbers in state hospitals has declined drastically. So, you might ask, where did all the seriously chronically mentally ill and addicted go? You will find them where the homeless congregate–in public parks, under the viaducts and camped in urban wooded areas. Also, it is no coincidence that the prison population has boomed while state hospitals have declined. Some are in group homes, but most just live on the fringes of society, or are incarcerated in state prisons and county jails.
Florida ranks 48th in funding for mental health services. The national average in per person funding is $120., but in Florida it’s just $39. Our legislators undoubtedly feel that just living in Florida is such a privilege that it sort of precludes the need for mental health services. Heck, Disney World is officially “the happiest place on earth.” We’ve got sunshine almost every day, and no state income tax. What more could a person ask?
Sadly, it usually takes a tragedy to get debate going about the need for better services for the mentally ill. Back in 1983, a chronic paranoid schizophrenic named Billy Ferry fire-bombed a Winn-Dixie Supermarket in Tampa because the “voices” told him to do it. Five people died and another 13 were seriously burned. There were plenty of warning signs. He was off his medication and out of the mental health system. His family had pleaded for help for him for years, but to no avail. Ferry was guilty but spared death because he was so obviously crazy. He’s currently serving five life-sentences. I worked in the public mental health system at the time, and as I recall that tragedy resulted in a slight uptick in funding.
Statistically, the chronically mentally ill are no more prone to violence than the average person. But there are some individuals, paranoid and violence prone, who need to be very closely monitored, and there needs to be beds available for them in long-term facilities that are not prisons or jails. However, for most mentally ill, incarceration in the criminal justice system is a very costly alternative–but many end up there due to relatively minor offenses like vagrancy, trespassing, shop-lifting, public intoxication, etc. Also, incarceration for most drug offenses has been shown to be far more costly than rehabilitation. However, most legislators do not understand mental illness or addictions. What they do know is getting reelected by give their constituents what they think they want, and that is–keep the crazies and the addicts off the streets and locked up in jails. But in the long run it’s more costly and it’s not a bit humane. Jesus says we will be judged by how we treat the least among us (Mt. 25:40), and I would say that the chronically mentally ill qualify as that.