The pleasant little theory about deinstitutionalization was that the severely mentally ill would end up back in their communities....

I don't necessary disagree with Cramer's conclusion, at least superficially. However, I doubt that the "pleasant little theory" actually included the deinstitutionalization of the severely mentally ill. As I recall, back in the late sixties and early seventies, there were a good number of patients who were suffering from cerebral palsy, Down syndrome, early-stage ALS, and other such conditions who were just "dumped" into these places. Of course, such patients do much better -- physically, emotionally, and mentally -- when placed in assisted-living arrangements.

I honestly don't know how, when, or why the deinstitutionalization of the moderately disabled to smaller assisted-care places -- especially as better physical and pharmacological treatments became available -- abruptly expanded into the wholesale discharge of the severely mentally ill, but I'm willing to bet that someone, somewhere, someway is making money on it.

Here's an idea, just put homeless people in jail!

"I'm pro human rights, but I'm also pro human responsibilities too!"

The real problem is the people in the middle. Those who are in reasonable shape one week and terrible the next.

A lot of them won't take the drugs. Why? Because if you look at the contraindications on many of those drugs they are flat out poisons. Some cause uncontrollable muscle tics that don't go away when the drugs are stopped. They cause permanent liver damage. And to top it all off they have warnings that long term use is not advised.

Andrew Dawson - please explain how some one semi-permanently not in their right mind can be held responsible. It is folks like you who give libertarianism a bad name.

Sociologist Erving Goffman wrote _Asylums_ in 1961, using mental institutions as an example of how any institution works, as to motivations of various participants and their views of what they were doing.

It was taken as proving that mental institutions were frauds, rather than his actual discovery, that any institution's accounts of itself are far from accounts of what is happening ; mental institions might or might not still be valuable and desireable.

It is such a great and readable book that it got wide circulation, and so had this unintended effect in the end, of eliminating mental institutions.

A snippet of Asylums I happen to have up.

"However, I doubt that the "pleasant little theory" actually included the deinstitutionalization of the severely mentally ill."

Actually, it did. Several movements collided in the 1950s and 1960s. The most foolish was the conclusion that because World War II soldiers suffering from combat fatigue (men who had been healthy entering the service) responded so well to psychiatric first aid stations, that the same approach--community-based mental health care--would work for psychotics in civilian life.

The antipsychiatric movement of the 1960s built on Goffman's book _Asylums_, but also on the emerging delusions of Thomas Szasz, R.D. Laing, and Michael Foucault, that psychosis did not exist; it was just a mechanism for social control. While Szasz was pro-capitalism, Foucault claimed that capitalism invented the concept of mental illness as an instrument of economic control (ignoring that non-capitalist systems have always recognized mental illness).

Ken Kesey's _One Flew Over the Cuckoo's Nest_--written after Kesey dropped LSD before going to work in a mental hospital--profoundly influenced a generation of thinkers. And it was as accurate and meaningful as something written while taking LSD.

Visit http://www.claytoncramer.com/weblog/labels/deinstitutionalization.html for all the postings about this over the last several years. I think you will find it enlightening.

By the way, my wife has often made the same comparison--that we would not allow dogs to be treated as badly as the homeless mentally ill.