Did Reagan’s Crazy Mental Health Policies Cause Today’s Homelessness?

By | Oct 14, 2013

Regan]Recently, a 34-year-old woman rammed her car into barricades outside the White House while her infant daughter was in the back seat. The police, thinking it was an act of terror, chased her down and shot her to death.

Later, we learned she was actually struggling with mental illness.

This came not long after another 34-year-old, this one a man who heard voices and thought people were out to hurt him, walked into the Washington Navy Yard and gunned down 12 people.

It is getting crazy out there, and these two people were not even dealing with the added pressure of living on the streets. Within our country’s homeless population, a quarter of a million people—or one-third of the homeless population—struggle with some sort of mental illness.

For those of us who encounter people experiencing homelessness on a daily basis, this is not surprising. We see that man walking down the sidewalk angrily screaming at an imaginary person, haunted by some phantom or past memory, every day. We also see people steering their children across the street to get away from the potential danger.

In America’s cities, many of us are so immune to such disturbances that we just continue reading our email on our smartphones without even looking up. It is just another crazy part of our urban lifestyle.

But when I see people like this, my first thought is always the same: Why isn’t this man institutionalized? He certainly is not living a dignified life out here on the streets.

When I ask my mental health colleagues about this, the one political figure that typically comes up is former President Ronald Reagan. It’s like an urban legend in our field. People say the reason so many people with mental illness are homeless or in jail—one-third of all homeless individuals and half of all people behind bars—is because of President Reagan.

Really? What did he do? Let all of the mentally ill patients loose?

Well, yes, that’s exactly what they say he did.

Over 30 years ago, when Reagan was elected President in 1980, he discarded a law proposed by his predecessor that would have continued funding federal community mental health centers. This basically eliminated services for people struggling with mental illness.

He made similar decisions while he was the governor of California, releasing more than half of the state’s mental hospital patients and passing a law that abolished involuntary hospitalization of people struggling with mental illness. This started a national trend of de-institutionalization.

In other words, if you are struggling with mental illness, we can only help you if you ask for it.

But, wait. Isn’t one of the characteristics of severe mental illness not having an accurate sense of reality? Doesn’t that mean a person may not even realize he or she is mentally ill?

There certainly seems to be a correlation between the de-institutionalization of mental health patients in the 1970s and early 1980s and the significant number of homelessness agencies created in the mid-to-late 1980s. PATH itself was founded in 1984 in response to the significant increase in homelessness in Los Angeles.

It’s ironic that a political leader who made such sweeping decisions affecting Americans with mental health issues ultimately came face-to-face with the dangers of untreated mental illness. In 1981, President Reagan was shot by John Hinckley Jr., a man suffering from several different types of personality disorders.

Where has Hinckley been for the last 30 years? In a psychiatric hospital.

It makes me wonder just how many people living on the streets today would also be safer and better cared for in an institutional setting.

photo: by Michael Evans, 1982 (NARA/Reagan Library)

29 Comments

  1. Posted Oct 15, 2013 at 12:40 pm | Permalink

    Deinstitutionalization was no mistake. The asylums may have been more humane than chaining people up in back yard sheds, but they were never sustainable, and became horrific dumping grounds themselves. People with mental illness belong in our communities, but need care, and treatment, and support. What Reagan did was gut mental health treatment funding, as well as housing funding, the two main supports for this population, while ratcheting up drug penalties, which swept many people with mental illness into prisons where they don't belong.

    Fixing the experience of mental illness starts with adjusting the attitudes of ordinary people, focusing on what is safe for a person and what is risky, and what helps people make the most of their talents and capacities. There are humane ways to connect people with appropriate treatment, and ways to reduce the numbers of people stuck in jails and prisons, end there are even ways to get everyone into appropriate housing.

    But you know how hard it is to connect people with housing in today's America. The work is more difficult for challenging populations. Romanticizing bygone asylum days is not the way to start.

  2. Posted Jan 20, 2014 at 12:07 pm | Permalink

    It is often claimed that mental illness is a primary cause of homelessness, and that most people who are homeless have a mental illness. Many of us nod our heads at this apparently obvious truth. You do not have look too far down Melbourne's lanes to see examples of homelessness and people who are mentally ill.

  3. Carrie
    Posted Jul 5, 2014 at 8:36 pm | Permalink

    Better to put the mentally ill on streets so they can shoot us @pkomarek

  4. Austin Jones
    Posted Mar 28, 2015 at 5:51 am | Permalink

    Liberals are responsible for the mentally ill being on the streets. They should be made to pay for the institutionalizing of ALL of the mentally ill living on the streets. It is impossible for the average mentally ill person to seek help as they are not aware of their condition.

  5. Ann W
    Posted May 14, 2015 at 8:04 am | Permalink

    Uhhh, why are liberals responsible?

  6. Jay
    Posted May 23, 2015 at 2:31 pm | Permalink

    Because LIBERALISM is a MENTAL ILLNESS!

  7. LoriC
    Posted Jun 23, 2015 at 2:43 am | Permalink

    Kennedy was the first President to start the process. The plan was set in motion by the Community Mental Health Act as a part of John F. Kennedy's legislation & passed by congress in 1963, mandating the appointment of a commission to make recommendations for "combating mental illness ".The deinstitutionalisation movement was initiated by three factors: a socio-political movement for community mental health services and open hospitals; the advent of psychotropic drugs able to manage psychotic episodes; financial imperatives specifically, to shift costs from state to federal budgets.

  8. Jonj
    Posted Jul 6, 2015 at 3:23 pm | Permalink

    Then Reagan gutted the federal spending on Health care. Leaving no state or federal spending. So he is the cause not Kennedy. Kennedy wanted federal spending so states where they had no spending, people with mental health problem could find care.

  9. Sue
    Posted Jul 23, 2015 at 11:45 pm | Permalink

    NOT TRUE! JFKennedy's "New Frontier" law, in1963, led to the deinstitutionalizing the mentally ill. Included in that law was to close down the states mental hospitals and open community based mental health clinics. The Committee on Mental Health Act of 1963 provided federal grants to pay for these clinics. As it turns out only 1/2 of them were built in large cities. The clinics were not funded by the feds and only larger cities, like LA and San Francisco could afford to support them. Former Governor Pat Brown didn't want to participate in closing down the mental hospitals because he didn't want to fund these clinics and community based housing for those who would be turned out of the state hospitals and ignored it. When Governor Ronald Reagan was elected, the ACLU sued Reagan's administration to shut down the hospitals and put the patients out in community based homes and open the street clinics. There was no preparation for these people but the judge ordered Reagan to comply! Reagan did exactly as the court order said! With no funding he sent it down to individual counties to provide whatever they could do. but most counties didn't have the funding either. MH people went to the larger cities where they could find treatment and housing. It all started with Kennedy and Gov Brown – Reagan got the blame for the mess!

  10. Guest
    Posted Aug 6, 2015 at 11:20 pm | Permalink

    And two of the symptoms of conservatism are greed and hypocrisy.

  11. Seth
    Posted Sep 8, 2015 at 4:33 pm | Permalink

    If you think about it Kesey's "One Flew Over the Cuckoos Nest" was published around the same time as JFK's New Frontier. There was a common conception that the state institutions were dehumanizing the mentally ill by just feeding people tranquilizers all day. I think the intention of the act was to fund community health clinics to provide treatment and public housing so that the mentally ill had a more humane system of being a part of society but still getting the treatment they need. However, Ronald Reagan axed a lot of the funding that was supposed to be channeled into this program so basically the community facilities were either never built or shut down. They just were turned out into the streets.

  12. Posted Oct 2, 2015 at 9:52 pm | Permalink

    I've worked the larger part of the past thirty years in the mental health field, much of it in community care of those with serious and persistent mental illness.

    They have never NEVER followed people out of the institutions, which were hell holes and torture chambers, with anything near the amount of resources spent on institutionalized care. The cuts to community care have been relentless and persistent in every election cycle at both the state and federal level since Kennedy and Reagan passed laws that made it a prerogative to treat people in their own communities as opposed to huge asylums.

    Every state and federal body that has had any control over funding for mental health care, regardless of party, has consistently defunded support services and direct and auxiliary care options designed for those with mental illness. The spin that has always been employed to get buy-in from those well-meaning people inside the system implied that the care was moving toward more independence, when in fact it has made those periodic hospital stays that have been an essential part of care for those chronically afflicted more and more cost prohibitive and harder to get, all while they have sunk untold millions of dollars into prisons and forensics centers used to house those who, with the right allotment of resources, might have avoided being managed by law enforcement as opposed to appropriate levels of community support.

    I was part of the earliest part of this exodus and could tell you horror stories about people who spent decades institutionalized for everything from being deaf to having a primary diagnosis during much of their lives that was "demon possession". Don't try to convince me that, institutionalization, done again, would be approached any more humanely or better: these are voiceless people with no power and are already being ignored and dehumanized in the new asylums, our prison system.

    Community care is indeed the correct direction for re-integration of those saddled with these painful and long-lived conditions, but community care unfunded or deferred in a way that criminalized extreme sadness and the aftermath of trauma and community isolation due to thought and mood idiosyncrasies is not better and in the end just as expensive as housing people in dungeons and drugging them out of their own existence and only into sedation.

  13. Joe Sharp
    Posted Oct 4, 2015 at 2:05 pm | Permalink

    Both parties bear equal blame for the mental health fiasco in the United States today. This fact is painfully obvious to anyone who studies the issue. The pharmaceutical companies sold our leaders a bill of goods and they gladly gobbled up their money and lies. Well meaning activists pushed for more liberty for mentally ill individuals and as usual, the brush strokes were just to wide to get the details right.
    Out of sight, out of mind. It is painful to see patients in a mental health facility, It is much easier to ignore them when they are dispersed and diluted in the general population. In America, we have a great knack for ignoring problems or blaming them on something or someone else. We are a young country and we need to grow up. When are broadsided with another mass murder or a senseless act of violence in America we tend to blame the tool instead of the user, I guess it is just easier. I don't believe in right or left wing conspiracies, but I do believe in mistakes in judgement on both sides. Gun shows are open markets in the U S and they need to be subject to all the background checks available but all the checks in the world can not stop sociopaths from getting guns unless we know who they are. We are reaping a bitter harvest.

  14. Blofeld
    Posted Oct 4, 2015 at 5:14 pm | Permalink

    Conservatives don't want to pay to deal with the mentally ill and they don't want any restrictions on purchasing guns. They do seem to favor a civil war where they can pick off the mentally ill like fish in a barrel conveniently located out in the open.. on the street.

    They offer no viable solutions. Sounds crazy to me.

  15. mrjohn
    Posted Oct 28, 2015 at 11:41 am | Permalink

    What we need is mental health reform, not gun control. Guns are NOT the problem. Guns do not kill people – people kill people. In tragedy after tragedy the pattern has been the same – the shooter was mentally imbalanced and often off meds. We need to set a policy in place that closely monitors the whereabouts and activities of these people and restrict them from living near schools, etc, just as we do with sex offenders. And IF there is an episode and it is found that they were under a psychiatrist's care who discontinued their meds and or discharged them with no follow up, that psychiatrist should be held accountable and subjected to prosecution and loss of their license to practice. Enough is enough!

  16. jomom
    Posted Nov 13, 2015 at 7:37 pm | Permalink

    That is offensive to me as a conservative. It's the liberals that "feel" like eveyone should be able to LIVE as they choose even if they are mentally ill and out on the streets. Liberals want the money to pay for services, just not THEIR money of course.

  17. Steve
    Posted Jan 4, 2016 at 7:14 am | Permalink

    Good

  18. Axmiii
    Posted Jan 4, 2016 at 9:30 pm | Permalink

    False. It has been statistically proven that the mentally ill are far more likely to be victims of violent crimes than to commit them. Many times, criminals will hide under the guise of being mentally ill. That does not mean that they are, nor should it be assumed that mental illness is the cause of a crime. It very well may be, but mental illness is a spectrum that varies so greatly.

    Your proposed policy is critically flawed and assumes too much. Should we monitor anyone who is "mentally ill"? So the three year old autistic boy who is my neighbor? The gentleman dealing with depression? The vet who suffers from PTSD? The spectrum is too wide to make sweeping assumptions. Not everyone who is mentally ill is hearing "voices" or seeing "demons", and segregating them from living near schools like they're sex offenders assumes that they're going to be criminals. That's infringement of their equal protection under law and their due process rights. Might as well start handing out yellow stars so the populace can monitor them…

  19. soberwascrazy
    Posted Jan 22, 2016 at 1:27 am | Permalink

    good as in do it ?

  20. Margaret Blaine
    Posted Mar 8, 2016 at 2:17 am | Permalink

    Yes, it is always better to put them out on the streets. It's cost affective.

  21. Michael T Angelo
    Posted Mar 20, 2016 at 12:34 am | Permalink

    Thank you for clarifying these crucial facts. I live in downtown San Francisco where I constantly contend with scores of tourists deriding the homeless as a pollutant for an :"otherwise beautiful city.". I hear, "It's a a shame (we) can't do something about the homeless,". I was born in San Jose, CA in 1973 and adopted a year later My biological parents met as a result of the aftermath that ensued in the wake of shuttering the (Agnew) asylum in San Jose. Because the circumstances surrounding the origins of my very existence occurred in the trickle down effect of deinstitutionalization, I have always felt a kinship and empathy for the scores of individuals making up the said population. My bio mother was a schizophrenic ward of CA state who had been released after the gavel fell on the Lanterman, Petris and Short Act. With newfound freedoms that included the right to forego medication, she fostered an on-again, off-again relationship with an itinerant romantic that resulted in my birth and acquiescence to foster care and adoption. I grew up in a hermetically sealed, homogenous bubble of suburban safety separated by the literal and figurative bridge and tunnel factor. Today, I live a block from the Powell BART station in San Francisco, a microcosmic combo of mall shoppers and mentally ill meandering among one another without mixing. One of the few times I was able to spend with my bio mother before she died 9 years ago happened to be Mother's Day. As we wandered around the Civic Center plaza, I was amazed at the way she interacted with the people I would have hurriedly passed by or viewed as a pox. She was relating on a peer level with a subset I had seen sitting on the sidelines in the shadow of statues covered in seagull shit. This was her element,; vicereine to the vice-ridden. Although the physical surroundings were familiar, I was finally able to view them without the filter of fear and fortune previously fogging my lens. Considered from where she was sitting, the scene seemed less simplistic. The disparity between her reality and the one that I was raised with came into full focus the next day when I learned she had died. At her memorial service the following week, I met her (my) extended family and was able to gain a better sense of the tragedy her mental illness and its wreckage had invoked. An 8×10 b&w glossy of a would be cinema siren akin to Sophia Loren or Elizabeth Taylor was situated on the altar. "That's when she was normal," said her brother. Her family simply didn't know how to handle the person they saw her dissolve into as her schizophrenia took hold. "We had a terrible time with her," he said, as he recounted an Eisenhower era European trip taken at the behest of their Sicilian immigrant mother that failed to produce a change in her behavior. "Behind the gates of Agnew (asylum), at least she would be safe," he said. And we'd be safe from her. That's really what we thought."

  22. Yohannan Bernays
    Posted Mar 22, 2016 at 6:35 pm | Permalink

    I live in the Tenderloin, in Mercy Senior Housing. I am 66 Years old, my Family were Mental Health Professionals. Do Not Accept Historical Revisionist Propaganda to Belie the Catastrophic Ruin to America caused by Corporate Greed, and Yes, the Horrors of Homelessness is A MONSTER caused by Reagan's Handlers. Read this Piece from 1984, http://www.nytimes.com/1984/10/30/science/how-rel… The Blame is on Greed & Corporate Backers of Right Wing Idiocy .

    ""MH people went to the larger cities where they could find treatment and housing. It all started with Kennedy and Gov Brown – Reagan got the blame for the mess! "" Is Total False. President Carter had Passed a Mental Health Community Center Act, to Provide Housing & Continuation of Care to the Mental Ill who NOW WANDER HOMELESS.

    REAGAN REVOKED THIS LAW UPON TAKING OFFICE! Therefore Historically, Factually and According to The Congressional Record, & Presidents.gov where all Acts of Presidents are available, THE REAGAN REVOKING of ALL FEDERAL CARE for BACK WARD CHRONIC MENTAL PATIENTS is a FACT.

    When the Governor of Michigan Shut Down Ypsalanti State Hospital 10,000 SEVERELY MENTAL PATIENTS WERE DUMPED on the DETROIT SKID ROW, 1500 Were Murdered for Their Monty before Winter, another 5,000 Were Found Drowned in the River next spring….The Propaganda Machine said they committe Suicide, no They Were CAST INTO RIVER by Detroit Rouge Police…REMEMBER THIS TIME the AFRICA FAMILY in Philedelphia were FIREBOMBED by POLICE with FBI-CONSTRUCTED BOMBS! America was NOT a nice place.

    Like most other mental hospitals in America Ypsilanti began declining in both quality and quantity by the 1960s, which would continue until it closed. The Michigan Daily also said that a survey of Ypsi's patient buildings was done in 1969, finding that they were obsolete because they "were all designed for custodial care of the insane and are not well suited for a therapeutic program of care and treatment for the mentally ill." In 1972 the State of Michigan revamped the names of all its mental hospitals and Ypsilanti State Hospital became Ypsilanti Regional Psychiatric Hospital (YRPH).
    Michigan Governor John Engler went on a crusade cut state spending on mental health by closing all the state psychiatric hospitals. Ypsilanti Regional Psychiatric Hospital was one of the first to go, closed in 1991, though the "C-Building," and the various service buildings on the property obviously stayed in partial use until early March of 2005 under the title CFP, or, "Center for Forensic Psychology"—meaning it was a hardcore detention facility that housed the 210 State of Michigan inmates who were either unfit to stand trial by reason of insanity, or who pleaded innocent to murder by reason of insanity.
    Governor Engler's biography on michigan.gov does not mention any crusade against mental hospitals in his list of accomplishments, and instead classifies it as "serving an additional 45,000 patients annually with mental health services." I wasn't aware that Governor Engler was also qualified to administer such care (a little sarcasm there). Anyway, according to a September 2012 report by the Detroit Free Press, the rapid dismantling of Michigan's once-vast state hospital system in the 1990s perhaps did not achieve quite the positive outcome that was hoped for–at least partly because the "community-based" resources that were supposed to pick up the slack were never given the proper funding they were promised.
    As the state hospitals closed, tens of thousands of patients who didn't have family to make sure they got proper care were literally turned out on the streets, "with a bus ticket to Detroit, and one bottle of pills," as the local saying goes. After that, they just ended up homeless and untreated. Many could not afford their pills, could not get a ride to go get their pills regularly, didn't want to take their pills anymore, sold their pills for narcotics that were more fun, or just did not have the mental stability to do anything on their own. Naturally many of these people ended up back in the prison system for vagrancy or other crimes, or froze to death under an overpass. The Michigan Daily said that the Washtenaw Housing Alliance did a survey around 2005 that estimated 42% of homeless people in that county were mentally ill.
    Yes, the state hospitals were essentially corrupt dungeons where patients were imprisoned and abused on the taxpayer's dime, but the alternative was so poorly executed that it hasn't proved any better. The Free Press said that "tens of thousands" of former mental hospital inmates have merely been shuffled around to the jails, prisons, and homeless shelters of the state–maybe that's what Engler meant by "serving 45,000 patients"? Kind of asinine, seeing as the state hospitals were originally created for the very purpose of getting the mentally ill out of the overcrowded jails and off the streets. I guess the solution now is to just keep spending our money building more jails, because more jails = less crime, right?
    A psychology article written in 2013 by Terry Axelrod, a former intern at Ypsilanti State Hospital, recounts her personal memories of working there in its last days :http://www.nailhed.com/2014/01/the-three-christs-of-ypsilanti.html

  23. Yohannan Bernays
    Posted Mar 22, 2016 at 6:40 pm | Permalink

    No you suffer from a Propaganda False Ideation. The Jimmy Carter Administration has Passed Laws & a Community Mental Health act to House & Treat these patients,, Ronald Reagan REVOKED the LAW and FUNDS TO HELP these people. http://www.nytimes.com/1984/10/30/science/how-rel

    Right Wing Conservatives are THE SINGLE REASON that HOMELESSNESS and MENTAL HEALTH PATIENTS Die On The Street DAILY.

    Go away with you Untenable Trash, please.

  24. yohannan bernays
    Posted Mar 22, 2016 at 6:51 pm | Permalink

    No you suffer from a Propaganda False Ideation. The Jimmy Carter Administration has Passed Laws & a Community Mental Health act to House & Treat these patients,, Ronald Reagan REVOKED the LAW and FUNDS TO HELP these people. http://www.nytimes.com/1984/10/30/science/how-rel

    Right Wing Conservatives are THE SINGLE REASON that HOMELESSNESS and MENTAL HEALTH PATIENTS Die On The Street DAILY.

    Go away with you Untenable Tras

  25. yohannan bernays
    Posted Mar 22, 2016 at 6:55 pm | Permalink

    Right, but you FORGOT to add, President Passed Laws to Support Community Health and Regan revoked It upon entering office!

  26. yohannan bernays
    Posted Mar 22, 2016 at 7:00 pm | Permalink

    I guess you have learned the Liberal Mantra…"That is offensive to me" It Is NOT about YOU….please Mary! It is about Helpless People DYING in the WEATHER, Homeless and Insane.

    You think you are a conservative, The "I Find That Offensive" was a Buzz Word in the 1980's. Please grow up, Money Is NOT more important than Human Lives.

  27. Posted Mar 22, 2016 at 7:07 pm | Permalink

    Michigan Governor John Engler went on a crusade cut state spending on mental health by closing all the state psychiatric hospitals. Ypsilanti Regional Psychiatric Hospital was one of the first to go, closed in 1991, though the "C-Building," and the various service buildings on the property obviously stayed in partial use until early March of 2005 under the title CFP, or, "Center for Forensic Psychology"—meaning it was a hardcore detention facility that housed the 210 State of Michigan inmates who were either unfit to stand trial by reason of insanity, or who pleaded innocent to murder by reason of insanity.
    Governor Engler's biography on michigan.gov does not mention any crusade against mental hospitals in his list of accomplishments, and instead classifies it as "serving an additional 45,000 patients annually with mental health services." I wasn't aware that Governor Engler was also qualified to administer such care (a little sarcasm there). Anyway, according to a September 2012 report by the Detroit Free Press, the rapid dismantling of Michigan's once-vast state hospital system in the 1990s perhaps did not achieve quite the positive outcome that was hoped for–at least partly because the "community-based" resources that were supposed to pick up the slack were never given the proper funding they were promised.
    As the state hospitals closed, tens of thousands of patients who didn't have family to make sure they got proper care were literally turned out on the streets, "with a bus ticket to Detroit, and one bottle of pills," as the local saying goes. After that, they just ended up homeless and untreated. Many could not afford their pills, could not get a ride to go get their pills regularly, didn't want to take their pills anymore, sold their pills for narcotics that were more fun, or just did not have the mental stability to do anything on their own. Naturally many of these people ended up back in the prison system for vagrancy or other crimes, or froze to death under an overpass. The Michigan Daily said that the Washtenaw Housing Alliance did a survey around 2005 that estimated 42% of homeless people in that county were mentally ill.
    Yes, the state hospitals were essentially corrupt dungeons where patients were imprisoned and abused on the taxpayer's dime, but the alternative was so poorly executed that it hasn't proved any better. The Free Press said that "tens of thousands" of former mental hospital inmates have merely been shuffled around to the jails, prisons, and homeless shelters of the state–maybe that's what Engler meant by "serving 45,000 patients"? Kind of asinine, seeing as the state hospitals were originally created for the very purpose of getting the mentally ill out of the overcrowded jails and off the streets. I guess the solution now is to just keep spending our money building more jails, because more jails = less crime, right?

  28. Wildrose
    Posted Apr 19, 2016 at 7:02 pm | Permalink

    You are so right Sue and I stand behind your report. I am 68 and when they shut down state mental health facilities and Community care nothing came trickling down to help. People tried their best but their family members and neighbors ended up in jail,with little or no representation when Ronnie dumped them into the streets and thousands were unemployed. No, they were not always good places either, but the smaller ones were watched by the communities. . Hillary is listening to the people that is more than any of the candidates. They just tell us what we should have.

  29. Mary
    Posted Aug 22, 2016 at 10:23 pm | Permalink

    so you are saying he didn't deserve blame for UNFUNDING clinics? Sorry, as a retired teacher, we are taught the LEAST RESTRICTIVE environment for special needs children…and that would seem to be outpatient clinics whenever possible over "asylums."