1. The Modern Mental Health
System
Psych Final Project
Andrea Vale
B Period
“I am generally cautious in my use of the word ‘crisis,’ but as best I can tell, the
current
situation in the mental health system qualifies for that label.”
-Paul Appelbaum, 2001-2003 President of the American Psychiatric
Association

2. “After decades of deconstructing our psychiatric hospitals and
demanding that they pay only for social workers and nurses
to treat even the most extremely mentally ill and potentially
violent individuals (rather than including psychologists and
psychiatrists) we now have a mental health care system
that simply ignores those among us who suffer with
incapacitating symptoms of psychiatric illness -
Today, even a mentally ill young man with a known
propensity for violence, or even a history of serious
violence, is likely to receive just an hour a week of
counseling (if that) by a social worker… he will likely be
triaged quickly through an often-incompetent “tune up” of
medications that might accomplish nothing and then be
sent back home as soon as he “contracts for safety”—
simply promising a social worker that he won’t kill anyone “
-
Dr. Keith Ablow, “Why can’t America care for the mentally
ill”

3. Massachusetts Mental Health
Facilities
• There are currently 22 psychiatric hospitals in MA, some
owned by the state and some privately run
• Notable institutions experienced by the family
interviewed for this article include:
• Taunton State Hospital – Formerly known as the “State
Lunatic Hospital at Taunton”, known for its housing of
Lizzie Borden during her trials – Hospital now
demolished, though other buildings in use. Future
unknown.
• McClean Hospital (Privately owned)– Originally “Asylum
for the Insane”. Is known as basis for memoirs “Girl,
Interrupted” and “The Bell Jar”. Is ranked 2nd
among all
psychiatric hospitals in America;

4. • There, despite being a young, intelligent, 20 year old
woman suffering from trauma-induced disease, she was
one of the only females on her ward. The men were
“mostly from the Bridgewater correctional facilities, many
of whom were from the sexual crimes unit.” When
complaints were made to the psychiatrist about this
situation, her parents were told that being confined with a
number of sex offenders was “good preparation for the
real world, where she might encounter a sex offender in
class at college.”
• The “last month she was there her deterioration was so
bad that they essentially kept her by sedating her
constantly. She was like a zombie for a month. She was
pretty much kept in a room by herself. That’s not treating
somebody.”
• - Accounts by parents of a patient of Taunton State
Hospital

5. A Last Resort
• The terrible conditions of mental institutions may deter those who need help from
seeking it – with no other choice than to be institutionalized in an unkempt, isolating
facility, many who need treatment are not receiving it
• More than one-half of people living with serious mental illness received no services in the
previous year
• “The gunman may have snapped because his mother was planning to commit him to a
psychiatric facility… A senior law enforcement official involved in the investigation
confirmed that Lanza's anger at his mother over plans for “his future mental health
treatment” is being looked at as a possible motive for the deadly shooting.” – Jana
Winter, “”Fear of being committed may have caused Connecticut gunman to snap”
• “It seems like the United States is using prison as the solution of choice for mentally ill
people. According to Human Rights Watch, the number of mentally ill inmates in U.S.
prisons quadrupled from 2000 to 2006, and it continues to rise -- in fact,
the rate of inmate mental illness is five times greater (56 percent) than in the non-
incarcerated population. With state-run treatment centers and hospitals shuttered, prison
is now the last resort for the mentally ill – “I Am Adam Lanza's Mother': A Mom's
Perspective On The Mental Illness Conversation In America”
• “It was recalled by my parents as ‘An old, creepy state hospital. It wasn’t dirty, but old
and not kept up. Walls were not painted. They did their best, but it was dark, Gothic –
half the buildings were empty, and it was in a horrible, dilapidated area. The grounds
were depressing, they had 20 foot high fencing with barbed wire tops. It was like a
prison.’” – Recollections of Taunton State Hospital, 2007

6. • New England was once the most
renowned region for psychiatric
treatment, during the early 20th
century
• Today most remaining functioning
facilities are a blend of run-down
buildings in use among shut-down,
abandoned buildings

7. Not addressing teenage mental
illness
• The Virginia Tech and Tucson tragedies both appear to be
examples of young people who manifested the signs of possible
severe mental disorders during their secondary school years but
were not properly identified and not linked with services and
supports – National Alliance on Mental Illness, “State Mental
Health Cuts: A National Crisis”
• "The problem is that right now kids in particular get very poor
services nationwide," said Robert Bernstein, president of the
Bazelon Center for Mental Health Law, an advocacy organization
based in Washington. If you want solid, flexible services, you can
get them only after you've been hospitalized multiple times,
Bernstein added.
• Preventative approaches are not taken – the problem is only looked
to be solved after it has manifested itself in tragedy

8. Lack of Funds
• A lack of funding towards the DMH may contribute to the lack of
appropriate mental health care offered
• “Even during the best of economic times, youth and adults living
with mental illness struggle to access essential mental health
services and supports. Services are often unavailable or
inaccessible for those who need them the most.”
• “From 2009 to 2011, massive cuts to non-Medicaid state mental
health spending totaled nearly $1.6 billion dollars. And, deeper cuts
are projected in 2011 and 2012. States have cut vital services for
tens of thousands of youth and adults living with the most serious
mental illness. These services include community and hospital
based psychiatric care, housing and access to medications.”
• Massachusetts, with a $63.5 million cut, is one of the top ten states
to have cut the most in funds from their mental health budgets
between 2009 and 2011
• “Lack of services often fosters worsened conditions and adverse
consequences that cost communities dearly”
• - National Alliance on Mental Illness, “State Mental Health Cuts:
A National Crisis”

9. The DMH’s Response
• “ After hearing the family’s story, the final report was ‘used to say
what they had done right. A client of theirs had died while in their
care, and they were only looking to make sure they had met all of
the legal requirements, not if they had helped her on a personal
level.’ The father’s appeal of the report was rejected. After several
complaints he finally received a letter ‘expressing sorrow without
accepting responsibility. I was disappointed that what we thought
was going to be a legitimate attempt to analyze their own job in
treatment and correct mistakes, in protection of the interests of the
patient, instead, in our opinion, demonstrated a desire to protect
themselves from accusations of wrongdoing.’” – Recollections
from a family whose child died while in the care of the DMH
• Communications representatives for the DMH declined to comment
for this article.

10. The DMH’s Response
• “ After hearing the family’s story, the final report was ‘used to say
what they had done right. A client of theirs had died while in their
care, and they were only looking to make sure they had met all of
the legal requirements, not if they had helped her on a personal
level.’ The father’s appeal of the report was rejected. After several
complaints he finally received a letter ‘expressing sorrow without
accepting responsibility. I was disappointed that what we thought
was going to be a legitimate attempt to analyze their own job in
treatment and correct mistakes, in protection of the interests of the
patient, instead, in our opinion, demonstrated a desire to protect
themselves from accusations of wrongdoing.’” – Recollections
from a family whose child died while in the care of the DMH
• Communications representatives for the DMH declined to comment
for this article.