Moving the care of thousands of mentally ill people from psychiatric hospitals — some straight out of “One Flew Over the Cuckoo’s Nest” — to the community was the right idea. Community mental health programs are usually more humane and effective — and always less expensive.
But even good ideas can turn out bad.
The state, mostly under former Gov. John Engler, closed three-quarters of Michigan’s 16 state psychiatric hospitals between 1987 and 2003; the shuttering of one, Detroit’s Lafayette Clinic, sparked a street brawl.
The closings were rushed and largely unplanned, and they caught Michigan’s already burdened local mental health agencies unprepared and ill-equipped. Despite promises to the contrary, state funding did not follow the patients from hospitals into the community.
And thousands of mentally ill people weren’t “deinstitutionalized” at all. Many were bounced from one kind of institution — psychiatric hospitals — to another: county jails and state prisons, where at least 20% of the inmates are now severely mentally ill.
The results are tragic: Tens of thousands of mentally ill people have ended up not only in county jails and state prisons but also in homeless shelters and hospital emergency rooms. I’ve reported on many of them, including the horrific death of Timothy Joe Souders in 2006 at a state prison in Jackson.
The answer is not a return to past policies. Local community mental health agencies no doubt will continue to provide the best answer for people like Christine Yates, 54, a Detroiter you’ll meet today whose schizophrenia and bi-polar disorder were not diagnosed until she was 34.
But Michigan needs a better funded and more efficient community mental health system, along with a real debate on whether it has enough psychiatric hospital beds to serve severely mentally ill people.
Read the editorial series: Criminal Negligence — Injustice in Michigan’s mental health care system