Businessman Thinking on StepsThe mothers of their mentally ill sons who created the recent horrific multiple murders evidently knew their sons were dangerous. Was there any place they could put them to receive help and protect the public from a killing spree?
As a journalist for many years I remember the 1960s when good intentioned or miserly psychiatrists and politicians started closing down the large mental hospitals. These large institutions were costly and many of the staff members were inadequately trained and some even stole from the patients.

Psychoactive drugs came on the market and many thought they were they were the means to let the mentally ill live a more sane life in the outside world. The idea was to close large institutions down and establish community mental health centers. A number of discharged patients without families were driven to parks or the center of towns and told they were on their own. What was not taken into consideration that too few centers would be established and patients often did not take their medicines.
Most mentally ill are not dangerous .The streets and prisons, however, are now populated with usually harmless but uncared for mentally ill individuals who really needed a safe mental institution with a good staff and nice surroundings. Twenty-four percent of state prisoners and 21 percent of local jail prisoners have a recent history of a mental health disorder. Seventy percent of youth in juvenile justice systems have at least one mental disorder with a t least 20 percent experiencing significant functional impairment from a serious mental illness

There are also those who are dangerous as the recent killings in Newtown and Aurora illustrate. We need a rebuilding of good institutions that will care for all the mentally ill who cannot live well in by themselves in the outside world.

When they first began to close the big institutions, I was told the cost per week was about $182 and psychiatrists charged about $20 per hour. The state hospitals spent approximately $2 to $6 a day per patient while general hospitals at the time charged $30 a day. Today, there are 48, 000 psychiatrists most of whom spend about 15 minutes with a patient and give them a prescription of psychoactive drugs. Insurance company reimbursement rates and policies discourage talk therapy, according to a New York Times article on the subject in 2011… A psychiatrist can earn $150 for three 15-minute medication visits compared with $90 for a 45-minute talk therapy session.
In the 1960s there were reported 35 million mentally ill. Today, according to the National Institute of mental Health ( http://www.NIMH.gov) there are one in four adults—approximately 57.7 million Americans— experience a mental health disorder in a given year. One in 17 lives with a serious mental illness such as schizophrenia, major depression or bipolar disorder and about one in 10 children live with a serious mental or emotional disorder. Suicide is the third most common cause of death.
The National Alliance On Mental illness (http://www.nami.org) reports less than one-third of adults and one-half of children with a diagnosable mental disorder receive mental health service. In the United States, the annual economic, indirect cost of mental illness is estimated to be $79 billion. Most of that amount—approximately $63 billion—reflects the loss of productivity as a result of illnesses.
Can we get the homeless living on the streets, the mentally ill wrongly imprisoned and the potentially dangerous help? Maybe large, well run institutions with qualified psychiatrists, psychologists, and social workers as well as a caring support staff is the answer.

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