California Was Doomed in the 1960s. Gavin Newsom Just Finished the Job.
Hey there friends! Below are some resources I referenced in preparation for this week’s video commentary. Enjoy!
Use of State Psychiatric Hospitals, 2025 - NASMHPD Research Institute
Community Assistance, Recovery and Empowerment (CARE) Act - CalHHS
Psychiatrists Under Attack: The Rebellious Dr. Szasz - The Atlantic
The complicated birth of the Lanterman-Petris-Short Act - Capitol Weekly
Hard truths about deinstitutionalization, then and now - Cal Matters
I worked for 29 years as an RN working with a mostly forensic population of mentally ill people. Forensic means they were "not guilty by reason of insanity" (NGRI) or they were "incompetent to stand trial" (ISTU) restorable and non-restorable. In Ohio and most other states there is an expensive network in place to deal with these individuals who are some of the most profoundly mentally people to be found. Some states do a much better job than others. They used to publish rankings of state institutions and community mental health programs. To say that they don't work does not do justice to state systems with proven track records of being able to do more with less. There are frameworks in place that can be drawn upon to create a system that works. The larger states like California tended to earn the worst rankings. Ohio as the 5th or 6th largest state in the country bucked this trend for awhile and were leaders in mental health and most importantly in community mental health. There good work did however come at a great expense of human suffering when they took it too far. Many patients wound up in prison, some died of neglect when life saving services were with held due to cost cutting measures. Many became homeless and moved to places like California. During the period of de-industrialization state programs were shrunk in size and mental health was always one of the first to have funding cuts year in and year out. While increasing numbers of people in the community were denied much needed services, we were at the in-patient level, able to severely tighten our belts without collapsing the system. Funding mental health at the community level did sometimes lead to increased waste and fraud as too many people would be allowed access to a limited pot of funds. There are state models that work. California is an example of a model that should not be followed. I do wonder just how many of their homeless arrived from other states. California is an exceptional case for many reasons. Their 3 strikes law was a disaster for their forensic in-patient mental health hospital system as hardened criminals would fake mental illness in order to gain admittance and avoid a life sentence in prison. These criminals would then proceed to victimize patients and staff alike. This made an already dangerous job nearly impossible. These institutions remain active to this day and provide a much needed service for the mentally ill who are able to avoid the prison system. The severely mentally ill who are able to stay in the community need a highly skilled workforce to work with them in group homes and assisted living settings. We need to continue to train new workers and figure out which states are doing a good job and why. Your YouTube video "California was Doomed" was very good up until the end when you said the mental health safety-net had been a "disaster" and then implied that it had all gone away, There are some jobs that only a well-funded compassionate government agency is willing and able to do with any level of proficiency. They should not be discounted so easily. Their jobs frequently deserve the moniker of heroic. They often are heroic on the level of a policeman in a tough neighborhood or soldier in battle.
During your interview with Michael Shellenberger the Streisand effect was discussed. I Wonder if you have come across the Amelia meme sweeping Great Britain. Love the work you are doing thx!