I was in New York as an intern during the times when crazies were allowed to roam, the early 70s. I lived in the part of Manhattan where the rag men would accost you to clean your windows. I was on Central Park West one day when a crazy man, maybe the Larry Hogue mentioned in this essay, was creating a scene in the street. He had actually stopped traffic and no one took him in and put him in a cell until something could be done to tone down his behavior. Big deal at that time–do your own thing, anything goes–who knows who’s crazy after all, said some.
After I went into practice in the 70s, I ran into the deinstitutionalization crusade of the 70s, Nebraska was one place where it was hot, they closed down the home at Beatrice for the retarded. I dealt with the anguish of parents of the retarded and severely mentally ill who were getting old and worried about their adult retarded and disabled children. They didn’t trust the new “community care plans” populated and run by political hacks and crusaders, not people care givers.
Most of the deinstitutionalization crusade was fueled by the antagonism to the “medical model” the left hated so much.
Got started because writers made the institutions sound so cruel. Problem is aesthetics–if you go to a nursing home you see people who are disabled–if you are unfamiliar with that you think–must be because they aren’t treated right and you write a book–they need to live normal lives and live in the community.
As a “medical model” provider I always thought the problem was they were antagonistic to professionals. DIY was their schtick. I knew some people who couldn’t get their lives straight who worked as community mental health, mental retardation workers and it was uneven at best how they handled their work. My experience with institutional workers was they seemed to comfortable and committed in most cases, certainly not monsters.
Here’s the latest from New York–they want to make the community the mental hospital. Ambitious plans and no more “punishing” the crazies or the severely disabled or keeping them from their freedom.
Would they suggest the community for people who are old, demented and disabled? No, but they would let loose in the community people who are young psychotic, disruptive, sometimes dangerous to others and definitely dangerous to themselves.
Judges can adjudicate people to force them to take medications required to keep them straight–if they will.
Community programs are often just baby sitting to assuage the people who hate the medical model and institutions, but that’s a matter of taste isn’t it?
The Activists always complain that institutions are bad, but my experience is that institutions can be the ideal place for the severely mentally disabled, just like residential and then nursing homes are the best answer for people declining from age and dementia.
At one time in my career I was Medical Director of a number of nursing homes. My mother had a great residential nursing home in her last years–wonderful dedicated people.
Commies always think they have a better idea and the Mayor of NY is a commie. Let’s put em in the community with relatively untrained baby sitters. It will make us feel better–Did you ever see One Flew Over. . . that is what we don’t want–crazy is just a point of view, isn’t it? RD Laing and Thomas Szasz taught us crazy doesn’t exist.
Except, I assure you, if you have a schizophrenic or real manic-depressive in the family–you will be a believer in psychiatry. Spend a couple of hours with a psychotic and Laing and Szasz will sound pretty hollow.
These programs better have something more than a kiss and a promise or NYC will be a kind of stinky nasty place for the street people .
Now that DeBlasio has given the criminals a release from broken windows, how far down do you think NY will go?
I visited NY when Dinkins was mayor and I remember the stickers on car windows–no radio. I had been away and didn’t realize that petty crime was that bad. Murder and violent crime went up with the petty.