Mental Illness: Erving's Theory Of Social Stigma

In the video, “The New Asylums”, it demonstrated how deinstitutionalization has left thousands of mentally ill patients in the hands of the prison system. As the mental health hospitals closed down, the police department and prison system has become responsible for the mentally ill people that are on the streets. There was a firm point made about the release of mentally ill patients- “When hundreds of thousands of mentally ill are released, they do not magically become healthy. They went to the streets, became homeless, and turned to a system that cannot say no.” The video also stated that today, there are nearly 500,000 mentally ill people being held in jails and prisons throughout the country. Furthermore, there was no safety net for those

Before 1955, the mentally ill took shelter in mental facility institutions. After 1955, the United States’ deinstitutionalized these facilities and made policy changes to the mental illness treatment system. However, those policy changes are flawed. Some say rather than abandoning mentally ill patients and depriving them of shelter, the United States government should change the way the mentally ill are treated in their current living situations. Instead of changing the attitudes of those who provide services to the mentally ill, it would be more beneficial to change the services themselves.

Deinstitutionalization is defined as the movement of severely mentally ill people out of large state institutions. In the 1950s, public hospitals housed well over 500,000 people. The reduction in the number of institutionalized people began in 1956. By 1980, the residential population in mental hospitals dropped by nearly three-quarters, an average of 154,000 individuals. This decrease is due to the process of closing public hospitals and transferring patients to community-based mental health services. Consequently, community services were implemented (Talbott 2004).

With states closing many of its mental facilities in the communities, there were a lot of people in need of outpatient care who fell through the cracks of the system and ended up in prison. Prison is where many of them died from inadequate treatment. Prisons were suddenly receiving inmates with the following types of mental illnesses: Schizophrenia, bipolar, and deep depressions. These prisons just did not provide these inmates with any medication during their incarceration. Because the community based health services is lacking, and patients aren’t receiving sufficient outpatient care, it makes the effectiveness of deinstitutionalization a serious problem. Without the availability of 24/7 psychiatric services that are well structured, I believe that deinstitutionalization is what is accounting for the increase of the mentally ill inmates in the correctional facility.

The basis of such a policy was ill founded, and clearly, the results are not as were intended. However, despite vast improvements and numerous breakthroughs in the fields of psychological and psychiatric treatments, as well as medications for a myriad of mental illnesses, our nation continues to ignore this epidemic. Without question, it is essential that we, as a nation, begin to develop and implement some sort of re-institutionalization and treatment programs.

Mental illnesses have always been treated differently than physical illnesses. Physical illnesses are given more importance than mental illnesses such as depression and anxiety. While those with physical injuries are told to seek help immediately, so often the only advice those who suffer from mental illnesses receive are to “get over it”. The mentally ill deserve just as much help and attention as those physically ill. Furthermore, it is wrong to incarcerate the mentally ill in prisons because they do not receive the sufficient amount of help that they need there.

Due in part to the community's lack of preparedness and resources, the needs of many of the deinstitutionalized has not been meet. Therefore many of the mentally ill have ended up exchanging hospitalization for institutionalization in prison or jail." This situation left many mentally ill on the streets with no one to look after them except the nation's police. Another reason for the increasing number of mentally ill individuals in the community is the expense of mental health services. Many individuals are unemployed and therefore without income. Many are not covered by health insurance and the individuals who do have insurance are often smothered under restrictions on coverage for mental illness. Others face time limits on in-patient treatment that will have rewarding effects. Others have difficulty accessing government-funded health coverage. Others depending upon their condition are not even aware that this program exits. Regardless of the reasoning police, as well as judge's and probation officers are on a daily basis faced with the increasing number of mentally ill individuals that are rotated amongst the system.

According to Yohanna (2013), there were three forces that led to deinstitutionalization as individuals with severe mental disorders were moved from hospitals into community. One of these forces was the hope that new antipsychotic medications offered a cure, secondly that community care was considered more affordable less than institutionalisation and lastly mental hospitals were considered inhumane and cruel. Although these implementations were not considered effective because researchers have claimed that deinstitutionalization led to the increase in offending and imprisonment among individuals with serious mental disorders (Wallace et al., 2000).

A quick look into this country’s prison system and you will find that 16% of the prison inmates are mentally ill and about 40% of the mentally ill have been detained. In the late 1800’s, the mentally ill were located in prisons and local jails. Dorothy Dix began a reform movement to care for the mentally ill in mental hospitals to receive treatment and medication. This continued on until the 1950’s, when deinstitutionalization began. Deinstitutionalization is the process in which a mentally ill individual is released from a hospital or asylum to be cared for and treated in their community. Sates closed mental hospitals because they began to acknowledge that they could save more money if they shut down these institutes to treat the mentally

Due to understaffed and underfunded in the psychiatric hospitals, harsh criticism toward the institutionalized care increased. It was also because of changes in the attitudes of staff and abusive practices in the hospital (Leff, 2001, p. 25). The movement of deinstitutionalization reforms from the asylum-based to community-oriented care. Mentally ill people moved from psychiatric institutions to community mental health centers. Even though there were positive reports about the outcome of community-based mental health programs, other reports found opposite. “Many experts hope that by improving community-based programs and expanding inpatient care to fulfill the needs of severely mentally ill patients, the United States will achieve improved treatment outcomes, increased access to mental health care, and better quality of life for the mentally ill” ("Early History," 2000-2013, p. 2).

The study of mental illness has a long and rich history within medical sociology and health studies, dating back to at least the 1930s (Cook, et. al, 1995, p. 95). Many of the theoretical and methodological contributions of early medical studies were developed in research that was focused on the personal experiences of individuals with psychiatric disorders, along with the social conditions to which they were subject to (Cook, et. al, 1995, p. 95). For most of this century, the treatment of those suffering with mental illness has been centred around the institutionalization of the mentally ill within asylums, and hospitals (Cook, et. al, 1995, p. 95). In saying that however, over the last few decades, the mental care services have experienced a momentous shift, that has dramatically altered the lives of those with serious mental illnesses (Cook, et. al, 1995, p. 95). By the mid 1970s, state and federal efforts regarding the deinstitutionalization of inpatients was well underway, having begun in the 1950s and peaking in the 1980s (Mowbray, &Holter, 2002, p. 136).

Jails have been described as “de facto mental hospitals” because they have filled the void created when state psychiatric hospitals began closing in the early 1960s through a process known as deinstitutionalization. Supporters of deinstitutionalization thought the process would help individuals suffering from a mental illness live more self-reliantly while being treated by community mental health programs. However, the federal government did not provide the necessary funding to meet the mounting demand for these programs, leaving numerous untreated. Individuals with serious mental illnesses are often poor or homeless and are likely to have substance abuse problems. Therefore, when they are left untreated, they are more likely to commit minor crimes that have been the focus of law enforcement in recent years (H. Richard Lamb and Linda Weinberger).

Misinformation, low investments, difficulty in gaining access to the available programs and “… overreliance on drugs to do the work of society” (Lyons, 1984) are some reasons why many psychiatrists and policy makers consider the 1960s’ release of the mentally ill from the hospitals to the community a failure. Deinstitutionalization, they say, was used as a “quick fix” for complicated problems in the mental health care structure. The initiative could have been game-changing and fruitful, but did not have all the funds, programming and attention it

As the laws in the United States began to reflect that people with mental illness should receive treatment rather than punishment, alternative approaches have arisen to address the need for individual with mental illness. The earliest change made was in the mid-19th century as numerous states passed laws mandating that persons acquitted by reason of insanity should be committed to mental hospitals and not be held in prisons (Bayens, pg. 310). Furthermore, Dorothae Dix crusade led to the establishment of over 30 states psychiatric hospitals to address the need of insane inmates (Bayens, pg. 311). In 1960, the deinstitutionalization movement extend even less restrictive setting for people in with mental disorder to be treated in

Mental health and its stigma are an important issue plaguing today’s society. Many do not understand or acknowledge the severity of mental illness. The stigma against mental