…As a lifelong Democrat (of the Irish-Catholic-Labor variety), I think Reagan did some good things and other things I didn’t support. But one thing Reagan didn’t do was single-handedly “close down” mental hospitals thus triggering 40 years of mental health hell.
Two other forces actually determined the fate of mental health care in this state. You might call them acts with unintended consequences. Here’s the history.
In 1967, the Lanterman-Petris-Short Act (LPS Act) a so-called “bill of rights” for those with mental health problems passed the Democratic-controlled Assembly: 77-1. The Senate approved it by similar margins. Then-Gov. Reagan signed it into law.
It was co-authored by California State Assemblyman Frank Lanterman, a Republican, and California State Senators Nicholas C. Petris and Alan Short, both Democrats. LPS went into full effect on July 1, 1972.
The bipartisan law came about because of concerns about the involuntary civil commitment to mental health institutions in California. At the time, the act was thought by many to be a progressive blueprint for modern mental health commitment procedures, not only in California, but in the United States.
Its main purposes were:
- To end the inappropriate, indefinite, and involuntary commitment of mentally disordered persons, people with developmental disabilities, and persons impaired by chronic alcoholism, and to eliminate legal disabilities;
- To provide prompt evaluation and treatment of persons with serious mental disorders or impaired by chronic alcoholism;
- To guarantee and protect public safety;
- To safeguard individual rights through judicial review;
- To provide individualized treatment, supervision, and placement services by a conservatorship program for gravely disabled persons;
- To encourage the full use of all existing agencies, professional personnel and public funds to accomplish these objectives and to prevent duplication of services and unnecessary expenditures;
- To protect mentally disordered persons and developmentally disabled persons from criminal acts.
Initially, mental health advocates pushed for community-based mental health facilities that would replace the closed mental hospitals.
But that never happened because even though post-Reagan the legislature was still controlled by Democrats, no major funding for new community-based mental health facilities ever occurred. And that situation basically is still the case today.
The second force at work in the mental health care issue were the courts and what is known as “deinstitutionalization.”
During the 1960s, many people began accusing state mental hospitals of violating the civil rights of patients. Some families did, of course, commit incorrigible teenagers or eccentric relatives to years of involuntary confinement and unspeakable treatment. Nurse Ratched, the sadistic nurse famously portrayed in the book and film “One Flew Over The Cuckoo’s Nest,” became a symbol of institutional indifference to the mentally ill.
By the late 1960s, the idea that the mentally ill were not so different from the rest of us, or perhaps were even a little bit more sane, became trendy. Reformers dreamed of taking the mentally ill out of the large institutions and housing them in smaller, community-based residences where they could live more productive and fulfilling lives.
A mental patient could be held for 72 hours only if he or she engaged in an act of serious violence or demonstrated a likelihood of suicide or an inability to provide their own food, shelter or clothing due to mental illness. But 72 hours was rarely enough time to stabilize someone be held another two weeks for evaluation and treatment.
As a practical matter, involuntary commitment was no longer a plausible option…..