The author delivered this Article as a speech at the National Symposium on Mental Health and the Criminal Justice System, co-sponsored by Capital University Law Review and the Supreme Court of Ohio, on Thursday and Friday, April 10-11, 2003.
Executive Director, National Alliance for the Mentally Ill of Ohio.
I come before you as Executive Director of the National Alliance for the Mentally Ill (NAMI Ohio), "the state's voice on mental illness," and also as a family member of a person with a serious neurobiological disorder. On both counts, my presence here is a measure of how far we have come from that day in the not too distant past when family members of persons being treated for mental illness were completely excluded from issues related to the treatment and recovery of their loved ones. Indeed, we often were not only excluded from treatment decisions, but actually blamed for our loved one's illnesses.
In 1960, a 13-year-old boy took the school bus home from Indianola Junior High School in Columbus, Ohio. As he was dropped off, there was a police paddy wagon taking his brother out the front door to transport him to the old Columbus State Hospital. Can you imagine how embarrassed the young boy was and how cruel the other kids on the bus were after seeing this? The young boy went into his house to find his mother in the back bedroom completely distraught worrying aloud about what the neighbors would think and what the people at the church would think when they heard about this. The father was nowhere to be seen because he worked fifteen hours a day, seven days a week. He made a lot of money, but he was not working for the money. He was working to escape the mental illness that held the home hostage. The young boy was not mad at his mother or father or the state hospital. Nor was he mad at the community mental health center because there was not one. There were no such things as case managers. There were few medications. There was just the state institution up on the hill at the west side. This young boy was mad at his brother. Why would he do the things that he did knowing the pain it would cause the family and especially his younger brother?
In 1966 the young boy graduated from high school and his escape was to join the military. Upon returning from the war in 1969, he entered the Ohio State University. It was there that he dedicated his life to improving the care of individuals with mental illness.
Insane asylums were built in the late 1800s for the sole purpose of locking up the mentally ill and keeping them away from society. In the late 1940s, a movie shined light on the inhumane behavior of the insane asylums and it was nominated for an academy award. It wasn't until 1963 that President John F. Kennedy proposed the Community Mental Health Centers Act that was intended to make services available to people in the local community. In 1967, Congress passed a law creating local planning bodies to address issues of mental illnesses. The boards were unique because they could levy property tax; were required to contract with private, for-profit, or not-for-profit corporations; and were prohibited from delivering direct care. It should be noted that in the same year, similar boards were created to address issues surrounding mental retardation. They did not have this same prohibition and were allowed to provide direct services.
Something else was happening in the early 1970s. A very unpopular war was coming to an end in Vietnam. This was a period of change in our country. Young men and women were coming back from the war and they needed mental health care. Many of these young people were not poor, but came from middle class and wealthy families. This was a changing environment for our elected officials. The people who elected them were now asking for help for their loved ones.
The 1970s and 1980s were a time that will never be duplicated in the mental health arena. We went from having nothing but state institutions to having every type of mental health program imaginable in just two decades. In 1988, the Ohio Legislature passed the historic Mental Health Act that gave responsibility for all mental health care to the local communities. State hospitals were closed and funding was funneled back to the local communities. Obviously, the financing plan of that act never worked.
During the 1990s, we restructured the system fairly effectively. But the quality of life for the most seriously mentally ill is still not much better and, in fact, may be worse than when...