I recently read a letter to the editor on these pages in which the writer stated she opposed the criminalization of mental health. The writer states she is a graduate social work student and states there has been “a growing number of people with mental illness in our jails and prisons since deinstitutionalization took place from 1955 to 1980.” As someone who worked for the state Department of Mental Health in both direct care and support services for almost 41 years before retiring in April 2013, I do agree that many of our jails and prisons are full of inmates with some kind of mental illness.
The writer also speaks of drug courts and mental health courts for this population. To me, these reforms while helpful often come as a reaction to some crime having been committed. We need to get the untreated mentally ill before they end up in the courts and behind bars. Sixty years ago, Massachusetts Mental Health Center still located in the Longwood Medical Area became the first community mental health clinic in the country. Under President Kennedy, more monies had been allocated to funding community clinics across the country.The dream was to treat folks in outpatient clinics in the community rather than locking folks up in those large state hospitals. Funding was always a problem since the mentally ill and their families had little political clout and as a result our political leaders under little pressure if any pretended there wasn’t a crisis anywhere. In 1975, under the Dukakis administration, this state started deinstitutionalizing the mentally ill from in-patient facilities, but too often with nothing waiting for them on the outside. Later in the early 1980s, the wording changed to “community-based settings,” but changing the word didn’t create properly funded community-based programs.
I spent the last 27.5 years of my DMH career as a Department of Mental Health Police in various Metro Boston sites. I saw first hand the inevitable happen. Too many folks were released to the streets—and I mean the street—too often on their own where they could swim or sink. For too many it was sink into oblivion until, of course, when they ended up in trouble with the law.
If it were that easy to plug them into appropriate community programs, it would have happened long ago. We have all seen our homeless shelters turned into de facto mental health centers and the same thing has happened with those in custody. Sadly, we have seen the same mentality that locked up folks in backwards now accepting there is very little we can do to keep those we set free from ending up in our back alleys. We need the political will to treat mental illness as the disease that it is. We need to demand action from our elected leaders because this issue will not disappear on its on. And we can’t pretend it isn’t there.