With the proliferation on the streets of psychosis-inducing drugs such as methamphetamine, the United States has more cases of serious mental illness than ever before-and less capacity to treat and manage them.
The question now is not, "What happened to the asylums?" but "What replaced them?" Following the mass closure of state hospitals and the establishment of a legal regime that dramatically restricted involuntary commitments, we have created an "Invisible asylum" composed of three primary institutions: the street, the jail, and the emergency room.
In 1962, Washington State had 7,641 state hospital beds for a total population of 2.9 million; today, it has 1,123 state hospital beds for a population of 7.6 million-a 94 percent per-capita reduction.
Bruce Gage, lead psychiatrist for the Washington State Department of Corrections, estimates that 20 percent to 30 percent of state prison inmates suffer from serious mental illness.
Even the old flagship, Western State Hospital, has become a predominantly carceral environment, planning to accept only "Forensic patients" who can no longer be held safely in state prisons.
The people on the streets, most of whom have gone through repeated evaluations, have rehearsed the answers that will get them immediately released: "I'm not a danger to myself or others, I know where I can sleep, I know where I can get food." When I ask the team how difficult it is to get a long-term involuntary commitment at Western State Hospital, their response is unanimous: "Impossible."
It's easy to condemn the horrors of the old state hospitals, but the horrors of the invisible asylum may exceed them.
https://www.city-journal.org/olympia-washington-mental-hospitals
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