That’s the book I picked up off the shelf while working in Memorial Library today. It’s an book of essays by psychiatrists about failure and suboptimal function, published in 1936. In the introduction I find:
We see what a heavy toll disorders of the mind exact from human happiness when we realize that of all the beds in all the hospitals throughout the United States one in every two is for mental disease; in other words, there are as many beds for mental ailments as for all other ailments put together.
That’s startling to me! Can it really have been so? What’s the proportion now?
Mental illness was deinstitutionalized in the 1960s. The mentally ill are often institutionalized now, but in jail. At least 1/3 of the people in prison are mentally ill. Things have been written about this, but I’d have to dig for the sources. Some point out that the numbers incarcerated about equal the numbers who used to be in mental institutions and point to equivalence, but the gender and age mix of the two populations is different.
A quick bout of googling gives me the following scattered facts. The number of US psychiatric hospital beds peaked at about 500,000 in 1955 and is vastly smaller now (by about a factor of 10). And the total number of US hospital beds has fallen from about 1.5 million in 1975 to a bit less than a million now.
I assume mental disease includes dementia and Alzheimer’s.
Well one thing to point out is that at this time they didn’t know what to do with people who had mental disorders so they kept them in hospitals for their whole lives. I assume that today the number is much lower because of how much better we are with these issues.
I also want to point out that this book has a chapter called “Sex Has Thrown a Bomb into Business.”
I guess then you also haven’t read this paper. Your question is answered by the key graph on page 5.
Many people with mental illness are also now living homeless on the streets. Pharmaceuticals have helped control certain conditions like bipolar disorder and depression. I don’t think they are now, but certain behavioral manifestations of dementia may have been considered at one time to be mental illness. Were mental hospitals ever used to get rid of inconvenient relatives, like women were once forced into convents?
Lior Silberman linked to the work I was mentioning. But, as I said, follow-up work points out that the gender & age mix of those in prison is different from the gender & age & I think race mix of those who were institutionalized for mental illness. But incarcerating the mentally ill is certainly part of the picture.
In the old days it was much easier to commit people to mental institutions involuntarily. But the advent of medications and the disturbing “bedlam” conditions sometimes seen in mental hospitals caused most of the patients to be released, which accounts for most of the decline in the hospital population. Now a lot of people who would have been hospitalized are living on the outside, and many of those people are the homeless people you see wandering the streets of our cities. Before around 1980 it was rare to see homeless people. Most cities didn’t even have homeless shelters.
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