Mental Health: Our Useless Rights

For this post’s purpose, I define a severe mental illness as a chronic medical condition that affects behavior, insight and judgment.

Picture it:

A filthy young man, confused and raging on Market Street, collapses at an intersection and rolls into traffic.

The police arrive.

An officer drags him to the curb and asks him if he has plans to hurt himself or anyone else. The young man shakes his head no.

The officer asks if he knows his way to the local soup kitchen and homeless shelter.

The young man shakes his head, yes.

Because he affirms that he is not an immediate danger to himself or others and claims he knows where to get food and shelter, the officers have no legal basis to mandate treatment.

The police drive off, and the young man rolls back into traffic.

The police cannot stop a sick and confused young man from obstructing traffic because it would violate his rights.

In 1963, President Kennedy signed the visionary Mental Health Centers Act, which authorized funding for a community-based care system in every state and county.

“I am proposing a new approach to mental illness and to mental retardation. This approach is designed,   in large measure, to use Federal resources to stimulate state, local, and private action. When carried out,  reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability. Emphasis on prevention, treatment, and rehabilitation will be substituted for a desultory interest in confining patients in an institution to wither away.” President John Fitzgerald Kennedy

In 1965, Congress approved the Medicaid Act, which offered higher reimbursement rates for community-based care, later the Supplemental Security Income (SSI) program provided financial support for people with mental illness who were trying to live in the community.

Passed in 1967, the Lanterman Petris Short Act prohibits involuntary civil commitments for the mentally ill in California unless a person is an immediate danger to himself and others, or is gravely disabled, generally defined as unable to access or make use of food and shelter.

The Community Mental Health System was supposed to replace or serve as an adjunct to State Hospitals.

By 1967 most cities in the United States had an active community mental health system.

That changed in the 1980’s.

The Lanterman-Petris Short Act fails in seven of its nine intents.

It does not end the inappropriate involuntary commitment of persons with mental health disorders because inadequately staffed for-profit prisons replaced the State Hospitals.

It does not provide prompt evaluation and treatment of mental health disorders because treatment resources are underfunded or don’t exist.

It does not guarantee or protect public safety.

It does not protect persons with mental health disorders from criminal acts because homelessness increases crime risk.

It does not provide services in the least restrictive setting appropriate to the needs of each person receiving services because there are no services.

In theory, people with mental illnesses have the ‘right’ to the services and supports we need to live like people without disabilities, but we can’t access services and supports that don’t exist.

For people with serious mental illnesses, the Lanterman Petris-Short Act is an excuse to deny treatment, and the Americans with Disabilities Act is a joke.

We don’t need access ramps; we need access.

Schizophrenia and Alzheimer’s disease have a similar set of symptoms, but no one would say an Alzheimer’s patient has a human right to wander our cities in a daze.

No one would say an Alzheimer’s patient deserves to suffer.

Mental illness is not a civil rights issue.

Mental illness is not a moral failure.

Mental illness is not a result of toxic thinking.

Mental illness is not a choice.

© Rob Goldstein 2020

13 thoughts on “Mental Health: Our Useless Rights

  1. All excellent points but I think this one hit me hardest. “In theory, people with mental illnesses have the ‘right’ to the services and supports we need to live like people without disabilities, but we can’t access services and supports that don’t exist.” #Truth


      1. Sorry Robert certainly not your thesis Robert. I find that mental health care is the poor sister of medical care in all countries. That is what I was referring to when I said it’s all wrong. I am sorry for the confusion 💜

        Liked by 1 person

      2. n the United States, our refusal to recognize mental illnesses as real is getting us killed. We were warned by Psychiatrists in early 2017; they issued a ‘Duty to Warn’ statement. Even now, our news outlets look for a trump strategy when there is no strategy. We had the power to invoke the 25th Amendmendt but couldn’t use it because acknowledging Trump’s illness is considered impolite.


  2. I agree on all points! Locally it’s just now being recognized that we need a way to deal with mental illness or breakdowns differently than being put in jail. It’s such a difficult situation between personal rights and when a person isn’t capable of making a decision on their own. I’m not sure how we solve the problem, but we have to start taking steps to recognize and prevent or treat people how may not have access to or are to sick to get help.
    I can tell you are doing well. Your writing is very clear and sounds very confident. I’m so happy to see that your doing better. I hope your spouse is back home, I know that will make a big difference. Thanks for sharing with Survivors.

    Liked by 2 people

    1. Thanks, Melinda, and yes, I’m having a good day today. No, my partner is not back, but we agree that the wisest course of action is staying put. The virus is surging in California along with the heat and relentless fires. I started two pieces for Mental Health Week but lost time so I’m pubishing them now. Kennedy did not envision a population of homeless people, in fact, Kennedy did envision Americans voting to restore the horrors of predatory capitalism. Kennedy’s Community Mental Health System was premised on the idea of a strong federal government with a mandate to protect the rights of all of our citizens. Kennedy wanted to extend thise protections to people with developmental and psychiatric disabilities. Kennedy never intended to shut down the State Hospitals. His goal was to increase federal oversight of them while transferring the healthiest people to supported housing in the community.

      Liked by 1 person

Comments are closed.