Thursday, January 27, 2005

The history of vanishing options

...for our homeless mentally ill. Liz Ditz, of I Speak Of Dreams, sends links and insights about de-institutionalization:
Jeff Jarvis is historically naive.

It is as likely to have originated with Geraldo Rivera's 1972 documentary on the deplorable conditions at an institution, Willowbrook.

I believe the movement had complex roots in the general movement challenging all authority that began swelling in the 1960s, the romantizing of mental illness that began not with Szasz but with British psychiatrists such as R. D. Laing, (who thought that schizophrenia was not a disease, but a response of a sane person to an insane set of social controls, administered by the patient's parents.)

There were other forces at work: a brief canter

In California, the findings of SPRA and others led to the passage of the Lanterman-Petris-Short Act of 1968. The act, thought to be a major victory for the deinstitutionalization movement, provided a legal basis for treatment, strengthened patient's rights protections, regulated involuntary commitment criteria, and set the stage for community-based mental health services. But the victory was narrowed when then Governor Ronald Reagan saw the act as justification for social service spending cuts. By releasing patients and dismantling state facilities, Reagan shifted the burden for mental health services to county and local governments who lacked the resources to provide the "world-building" support systems recommended by researchers.

Ms. Ditz reminds us that de-institutionalization was devastating for many developmentally disabled patients, and that we're still struggling for solutions:
Current issues:

The Strauss report was published in July 1996. Dr. David Strauss, a statistician for the University of California, Riverside, found that people with developmental disabilities had a 72 percent higher chance of dying in the community than in an institution. The report was funded primarily by the federal government; some money came from what Strauss calls "allied groups" -- the California Association of Psychiatric Technicians is named as the primary union underwriter.

Fear of people with mental retardation living on the streets, coupled with the Strauss report, has stirred up worries of a repeat botched deinstitutionalization process like the one California experienced under Gov. Ronald Reagan when thousands of psychiatric survivors were freed from institutions without adequate funding or community supports and many became homeless.

Repercussions from what's currently happening in California have been felt across the nation from Tennessee to Pennsylvania. The Strauss report is being touted by such pro-institution groups as Voice of the Retarded (VOR), a parent organization, as definitive proof that people with mental retardation are much better locked up than loose in the community.

Other blogs you should read about people working with very damaged kids:
Introduction to This is a weblog written by a real life special education teacher. The original writer, Riti Sped, has retired from teaching and is now pursuing other interests. She may return to teaching at some point, and if so, she is always welcome to come back and write again.


If we must have "institutionalization," let's hope that the staff are like Ms. Jaye: Introduction to Slow Children At Play

My name is Stokie Jaye, and I work in a group home for emotionally disturbed boys.

As I drive into work every day, I pass a battered old road sign that was probably erected when the place was built. To me, the sign means absolutely nothing about traffic; it encapsulates what I experience and what I have come to know as the god-awful truth about these kids. It says simply, "SLOW: Children at Play."

The organization I work for is a religious-affiliated non-profit which means its run by very well meaning people who have strong ideals and no idea about how to run a business. Consistency is a problem. Balls are dropped. There are communication breakdowns, grudges kept, infighting, secret liaisons, heavy drinking and AWOLS. And this is just the adults I'm talking about.

For the most part, the average group home counselor is a college student or freshly out of college and applied for the job because they have no idea what a group home is and someone told them that it's like summer camp. For those unlucky applicants, war is not hell--their job is.

I have been a counselor in this home for more than a decade and yes, I do wonder if something is wrong with me to have stayed so long and put up with the shit I've been through time and again. But I love my job and love helping my kids. At least to the extent that they can be helped...

Ms. Ditz also sends us this:

"Success: fall down seven times, stand up eight."
How can we stand up again, for our most vulnerable and challenging patients?
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