Mary Pfeiffer through her journalistic anecdotal advocacy: Crazy in America: The hidden tragedy of our criminalized mentally ill (2007), have opened the proverbial Pandora’s box, depending on what sector of the society moral judgment is aligned with. The tragedy is no longer hidden but confronts us demanding an intervention that will disrupt its history. Critical analysis places us all in the glaring light that pans negligence, but it is the policymakers that stand in the focus of this beam while the rest of us are in its important penumbra. Policymakers are challenged to 1) restore and increase proper community mental health structures, 2) deinstitutionalize mental ill-health patients, 3) train police officers, and also personnel serving as wardens where mental health victims are likely to have a presence, to recognize and intervene appropriately is the situation morally requires, 4) provide pre-natal care for mental health patients, 5) and increase government funding for the sustainable care of mental health patients, while 6) providing more public education regarding mental health victims and treatment, and 7) finally to decriminalize drug abuse so that they may the necessary help and attention from the health system that their condition demands.
The urgency of these demands is seen in the six cases Ms. Pfeiffer presented. There is only one mutilated survivor of the six, and all of the five deceased have left behind harrowing tales of wretchedness leading up to their deaths. These tales are located in public institutions, facilitated by public policies, to the full knowledge of public officials serving to carry out modern public policy. There is no throwback period of
history when the present condition was tolerable, since the 1827 Act forbade the incarceration of insane persons in prisons or houses of correction. This Act provided that mental illness was i) a curable disease of the brain, ii) that patients must totally isolated from family and the stresses of society, iii) that an orderly regime of light work, exercise and rest will induce self-discipline in patients, and iv) that the causes and solution of insanity rest with the society and not with laboratory. There is a certain amount of compassion and humanity that was carried by this Act that none of Ms. Pfeiffer’s six mental health victims seemed to have experienced. The resulting death of five is an urgency pressed upon a ballooning emergency.
This emergency follows a downward spiraling trend despite numerous policy reforms between the 1940s and 1959. Fountain House, a Manhattan base support group, constituted from former patients, were the main activists, advocating reform in the 1940s. This led to the Hill-Burton Act of 1946. From that time there exist a prevailing historical trend since the National Mental Health Act of 1946 was passed by President Harry Truman. More accurately the trend started after 1949 when the National Institute of Mental Health (NIMH) was founded, the New York State Mental Health commission was formed, and that state had 27 inpatient facilities that was of the largest population in the nation. At this time surgery was still the primary option for treating the mentally ill. The surgeries went out of vogue in the 1950s, but so all did New York’s building program due to the war. The “Social Milieu Therapy” offered a change in the method of treatment,
due to a fresh reliance on psychiatric pharmaceuticals like Thorazine. In 1960-1970 the Federal Court ruled that mental health patients could not be forced to take these drugs, and many filled the streets. New York mental health population peaked to 93,600 since 1955 and there was a deterioration with a resulting explosion of needs.
Pfieffer’s stories could not even belong to the 1840s -1890s era of the asylum, so how much more frightening in the present. Yet the present can be seen to the outcome of professional take charge that excludes community and their...
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