Why Are The Three Largest Mental Health Care Providers Jails?

The three largest mental health providers in the nation are the following jails: Cook County in Illinois, Los Angeles County and Rikers Island in New York.

It didn’t have to be this way and it’s not as if past political leaders haven’t tried. This week, USA Today took a look at the Community Mental Health Act,  the last piece of legislation signed by President John F. Kennedy. The act, which turns 50 on Oct. 31, “aimed to build mental health centers accessible to all Americans so that those with mental illnesses could be treated while working and living at home, rather than being kept in neglectful and often abusive state institutions, sometimes for years on end.”

The goal was to build 1,500 centers and cut the size of those living in state mental hospitals–at the time more than half a million– by half. Addressing Congress about the legislation, Kennedy called it a “bold new approach” and stressed the importance of local communities taking care of its own and help them discover “a useful place in society.”

But, as the report highlights, Kennedy’s goal was never realized as only half the centers were built and none were fully funded.

Another Democratic president, Jimmy Carter, tried to do his part to aid those mentally ill, signing theMental Health Systems Act, which sought to continue the federal community mental health centers program. The provision reportedly included a provision for federal grants “for projects for the prevention of mental illness and the promotion of positive mental health.”

Then came President Ronald Reagan, who deserves most of the blame for the piss poor state of mental health care in the U.S. Writing for Salon, Dr. E. Fuller Torrey, a research psychiatrist specializing in schizophrenia and bipolar disorder, explains that, “President Reagan never understood mental illness. LikeRichard Nixon, he was a product of the Southern California culture that associated psychiatry with Communism. “

In other words, they suffered from a severe case of ignorance and yokel syndrome. During his time as governor of California, Reagan pushed deinstitutionalization in the state, leaving those suffering to lives of homelessness and subjecting California residents to violence. Once he became president, he took this ill-advised strategy nationwide, creating a culture that doesn’t value mental health care to damaging results.

Speaking with USA Today, JFK’s nephew, former U.S. Rep. Patrick Kennedy notes, ”The goals of deinstitutionalization were perverted. People who did need institutional care got thrown out, and there weren’t the programs in place to keep them supported. We don’t have an alternate policy to address the needs of the severely mentally ill.”

Kennedy will mark the 50th anniversary of Community Mental Health Act by gathering mental health advocates in Boston to come up with new ways to improve mental health care. It couldn’t come at a better time. While it should be noted that most people suffering from mental illness are not prone to committing violent acts, the few who have had in recent years should have emboldened our political leaders to do something.

As much as many of us advocate for members of our own community to take better care of their mental health, the sad reality is even if they do recognize they or someone they know is in need, they’d likely have to commit a crime before getting reasonable treatment. That is, if they don’t die first. A study conducted by the Portland Press Herald and the Maine Sunday Telegram estimated that half the estimated 375 to 500 people shot and killed by the police nationwide each year suffer from mentally illness.

On his own legislation to improve mental health care in America, President Carter said that the mentally ill were the “most underserved group in this nation” and that they have not “been served well even by those who’ve dedicated their lives, as you have, to their care. “

It’s a shame how little has changed.

Michael Arceneaux is a Houston-bred, Howard-educated writer. You can read more of his work on his site, The Cynical Ones. Follow him on Twitter: @youngsinick