In California, for example, the number of patients in state mental hospitals reached a peak of 37,500 in 1959 when Edmund G. The records show that the politicians were dogged by the image and financial problems posed by the state hospitals and that the scientific and medical establishment sold Congress and the state legislatures a quick fix for a complicated problem that was bought sight unseen. Many of the psychiatrists involved as practitioners and policy makers in the 1950's and 1960's said in the interviews that heavy responsibility lay on a sometimes neglected aspect of the problem: the overreliance on drugs to do the work of society. The picture is one of cost-conscious policy makers, who were quick to buy optimistic projections that were, in some instances, buttressed by misinformation and by a willingness to suspend skepticism. Sweeping critiques of the policy, notably the recent report of the American Psychiatric Association, have spread the blame everywhere, faulting politicians, civil libertarian lawyers and psychiatrists.īut who, specifically, played some of the more important roles in the formation of this ill-fated policy? What motivated these influential people and what lessons are to be learned?Ī detailed picture has emerged from a series of interviews and a review of public records, research reports and institutional recommendations. THE policy that led to the release of most of the nation's mentally ill patients from the hospital to the community is now widely regarded as a major failure.
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