A Very Capitalist Condition by Roddy Slorach

Author:Roddy Slorach
Language: eng
Format: epub
ISBN: 9781910885031
Publisher: Bookmarks

From asylums to community care

The closure of psychiatric institutions was not the breakthrough previously hoped for. As one mental health advocate noted in 1980:

Tens of thousands of mental patients have been released in the United States through court suits in the last ten years… It has been a disaster. Institutions have been shut but there has been nowhere for the patients to go. They have ended up in prison, or exploited by private landlords, readmitted to other mental hospitals or just dying… Courts are unable to plan, budget or build alternative facilities.599

For anti-psychiatry campaigners and others, it only later became clear that the closure of mental institutions had little to do with their arguments. In California, conservative Governor Ronald Reagan was enthusiastic about closing down “superfluous” institutions. In 1961, Minister for Health Enoch Powell became the first major UK politician to champion closures. Powell had resigned from the previous Conservative administration only three years earlier due to its refusal to make huge public spending cuts.600 Despite evidence of significant financial savings for the state, it was a full decade before another UK Conservative government announced its intention to close all mental institutions within 15 years. A final indictment of the asylums came in 1975, when research showed that 40 percent of asylum inmates had been incarcerated for over 20 years.601

Political support for the philosophy of community care quickly became the new political consensus, but adequate and appropriate funding has been another matter entirely. In practice, newly liberated patients have often been simply handed back to their families. With support from health and social services inadequate or non-existent, this has placed an often intolerable burden on unpaid (usually female) carers. Community care is, as one official survey of British practice put it, “a poor relation: everybody’s distant relative, but nobody’s baby”.602

For thousands of the old, already suffering in varying degrees from mental confusion and deterioration, deinstitutionalization has meant premature death. For others, it has meant that they have been left to rot and decay, physically and otherwise, in broken-down welfare hotels or in what are termed, with Orwellian euphemism, “personal care” nursing homes. For thousands of younger psychotics discharged into the streets, it has meant a nightmare existence…603

Boarding houses and prisons are often now the biggest local providers of mental health “care”, a situation not unlike that 200 years ago before the large-scale building of asylums. The substance of health or social insurance schemes developed since then—ensuring welfare support to individuals—has in recent years been greatly diminished.604 As one UK service user explained: “general hospitals have emergency psychiatric wards, with a limited number of beds and as fast a turnover of patients as anti-psychotic drugs can sustain. Then, you’re on your own with the pills, and the underfunded, understaffed, sometimes mythical care in the community”.605

The growing trend towards the closure of institutions did, however, provide more space and opportunity for mentally distressed people to begin to find collective voices of their own. Service users are often highly critical of community care.

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