The paper by Paul S. Appelbaum ,Crazy in the street is reflected on the
implications of societies treatment to the mentally ill. He begins with in the past and
present about the maltreatment of people suffering from psychotic illnesses. Where in
New York City, these people find refuge in subway tunnels, and depend on cardboard
fragments for comfort. These conditions are considered to be sprayed out through urban
America.
Paul mentions that our nation has turned it s back and abandoned the mentally ill.
In the period of colonial and federalist period this nation depended on Almshouses and
jails to house the mentally ill. The mentally ill were accompanied with killers and thieves
where they were often treated with cruelty similar to criminals.
The change happened in mid 19th century, a small number of physicians begun a
system called moral care. This physicians were devoted to a therapeutic system. Where
rational ideas gave ways to a different kind of treatment that kindness and, encouragement
were established to treat and cure the mentally ill. Another founder of this method was
Dorothy Dix, a Sunday school teacher from Massachusetts. Who studied the barbarities
inflicted on a mentally ill and also petitioned to establish facilities to practice the so called
moral care system.
During World War II, the government established these facilities within the
hospitals throughout the country. Predicaments came soon after these hospitals were
swelled to one million patients to occupy state hospitals. For instance pilgrim state
hospitals in Long Island the largest hospital in New York State held 20 thousand patients.
Also, St.Elizabeth hospital in Washington D.C. which cared for the mentally ill had it s
own railroad and post office. And used patients to produce economic gross to run the
institution.
Then after psychiatrist dramatically emphasize the desire for the return of mentally
ill patients to the community. Where program of new ideas where male and female
patients were able to interact with each other. Soon after in 1955, the number of residents
began to decrease that was a phase of deinstitutionalization begun.
In 1952 A French scientist discovered chlorpromazine, a antihistamine which
suppressed and reversed symptoms of psychosis. In 1954 this drug was introduced in
America named Thorazine. This drug discontinued severe treatment of bleeding and
purging, cold baths, and whirling chairs. Also this drug lessen the mental burdens for
those who suffer from schizophrenia. The stage deinstitutionization increased and
gradually decrease the number of patients.
In mid 1960 s some patients were treated and maintained in community. Where
patients were released to professionals of mental health. And in time psychiatrist sought
to release all mentally ill patients to the community. This movement was realized by
socialist named Urban Golfman, the author of Asylums. The book was about patients and
staff interactions. Golfman states the institution forces their patients to act in a way for
the convenience of the hospital staff. This was so called institutionalism; the progressive
loss of functional abilities caused by the denial of opportunities to choose for oneself. This
led patients to be dependent like an infant.
In 1963, the government gave fund to build out patient clinics in every area of the
country for the mentally ill. These community based clinics led a path to closing state
hospitals. Another movement came to play a free will where involuntary
institutionalization was illegal unless apparent threat to others might occur.
Between 1960 through 1980, state hospitals decreased the populations by
transporting the patients to nursing homes. A large part of reason why this method of
treatment failed was because of institutionalism. Where staff were not able to take care as
much as state hospitals. Many other mentally ill were entirely misplaced and drafted from
any form of care. This accounts for the many homeless people present today.
Psychiatrist hoped for liberating patients from state hospitals to demolish the
chronic dependency that strained from state hospitals. This studies show that patients
discharged to the community were discriminated for their illness.
Deinstitutionalization was practiced in this country to move against poverty and
injustice but it failed. The government officials actually created more poverty and more
injustice by pursuing these goals.
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