In article ,
 Josh Hill  wrote:

> On Tue, 19 Feb 2008 07:49:50 -0800, Jon Schild 
> wrote:
> 
> >
> But I do blame Reagan. Not because he was responsible for the policy
> of deinstitutionalization, but because he failed to mandate and
> provide the care that was to have taken its place.
> 

   Of course the largest part of deinstutionalization had taken place 
long before he became president and the %age of beds in mental hospitals 
closed during his governorship in CA was roughly the same as the rest of 
the country. But hey, never let the facts get in the way of a good rant, 
old buddy. 

> By the way, while I believe that some deinstitutionalization is
> excessive, and join you in assigning a share of blame to overzealous
> civil liberties advocates, as I understand it, for the most part
> deinstitutionalization was justified and even mandated by the
> introduction of anti-psychotic medicines that meant that many mental
> patients who had formerly required hospitalization and even restraint
> could be released. You can't keep locked up someone who isn't
> hallucinating or dangerous to themselves or others, nor would most
> people want to.
    Yeah but... (g). Deinstutitionalization got going before many of the 
psych medications were available. IIRC, thorazine (the lead 
antipsychotic) wasn't approved for schizophrenia until the early 60s. 
The others came even later. I think it was more the medications catching 
up with the policy in the 70s and especially the 80s. 

> 
> The problem is that these improvements last only as long as the
> patient is monitored and continues taking his medication, that they
> aren't always consistent, and that the more fragile patients, while
> able to live in the outside world, still needed support and guidance.
> That's why the mental heath professionals who advocated the new
> policies assumed that the mental hospitals would be replaced by
> half-way houses and other forms of outpatient care.
      Which they were, successfully for many. But again, the homeless 
side is largely voluntary in the psych sector. 


> Bottom line: Before Reagan, I never saw homelessness. Beginning in the
> Reagan years, it was commonplace. One of the worst changes I've seen
> to America in my entire life. It may not have been entirely his fault,
> but this particular national shame happened on his watch, and it
> happened in large measure due to his policies and the callous
> philosophy he espoused.
    Well heck, if you never saw it it much be true....
--- SBBSecho 2.12-Win32