Quote:
Originally Posted by Tom In Chicago
Isn't the homeless problem in San Francisco, California - and across the country for that matter - something that /started/ with the shuttering of mental health care facilities in the first place?
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Not really. IMHO that is an urban myth and I was around to see what was happening in those years.
Most locked state mental facilities were closed in the 1970s. I (a) worked briefly in a state mental hospital in North Carolina in 1971 when they were still operating just about everywhere, and (b) moved to San Francisco in 1982 when no one really felt "homelessness" (or mentally ill/addicted people taking over the streets) was an issue in any way comparable to today.
In CA many people blame Ronald Reagan, who was Governor from 1967 to 1975 with the closing of the mental hospitals in that state and say it was to save money. But really, the action was supported by a wide range of political groups from liberals concerned about "human rights" to libertarians with similar concerns to conservatives who, yes, were happy to save some money.
What also was happening in those years that made the closure seem justifiable was the proliferation and wide use of anti-psychotic drugs.
Here is an interesting article on the invention and beginning use of chlorpromazine (Thorazine), the first such drug. To quote
Wikipedia, "In 1955 it was approved in the United States for the treatment of emesis (vomiting) (and later for treatment of psychosis).
The effect of this drug in emptying psychiatric hospitals has been compared to that of penicillin and infectious diseases".
But by the time I was on the scene to observe, in the late 1960s and early 1970s, there was beginning to be a proliferation of these drugs. Notable in 1971, besides Thorazine, there were in common use Mellaril, Stelazine and Haldol. A real breakthrough was a form of these drugs, fluphenazine decanoate (Prolixin) that could be given by injection once every 2 weeks so there was no need to depend on mentally ill people to take a pill every few hours--they could be seen every 2 weeks and given a shot. That, as much as anything, made it seem as if forced confinement of schizophrenics was unnecessary and even barbarous.
Of course as we all know, once the mental wards were closed, the clinics to give those Prolixin shots or any other form of treatment were, for the most part, never funded or opened, although that's not entirely true in San Francisco. Here the Dept. of Public Health has always run facilities capable and wiling to provide treatment. The problem is getting those needing it to present themselves. The typical raving lunatic on the streets is taken to the psychiatric emergency ward at SF General Hospital, given acute treatment that may well incldue anti-psychotic medication, perhaps even kept for up to 3 days observation, and then released, with followup in the DPH's clinics up to them.