The paper by Paul S. Appel baum, 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 19 th 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 gros 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.