New data upends common beliefs about asylum closures, deinstitutionalization, and rates of psychiatric coercion.

Many people who know almost nothing else about the mental health system can nevertheless recount the story of the “failure” of “deinstitutionalization” in America. The story is repeated so often that it’s widely accepted as if it were a famously indisputable math formula:

Large state hospital asylums started closing decades ago, but promised community beds and services never came. As a result, today, there’s a disastrous bed shortage and huge populations of untreated, severely mentally ill people are homeless or in prisons.

Any numbers provided are close to these:

In the 1950s, there were about 550,000 state hospital psychiatric beds, or 330 beds per 100,000 people. Today, there are only 37,000 state hospital psychiatric beds, or about 11 beds per 100,000 people.

For the past two decades, this story has been regularly re-told everywhere from popular right-wing periodicals like The Wall Street Journal, National Review, and Breitbart, through mainstream and left-liberal sources like The New York Times, NPR, PBS, The Daily Beast and The New Yorker, to investigative news outlets like Mother Jones and Kaiser Health News. The story also plays a central role in political lobbying by mental health organizations and providers, in Democrat and Republican platforms, and in public education by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Essentially, this deinstitutionalization disaster story has become a culture-wide dominant narrative. It has fueled beliefs that compassionate improvement of the mental health system—and help for the unhoused and imprisoned—requires bringing back more psychiatric beds and coercively treating more people. Even those who critique pro-force sentiments in outlets like The Nation nevertheless frequently echo the dominant narrative’s basic elements.

However, in 2017, the U.S. National Association of State Mental Health Program Directors (NASMHPD)—the people who actually oversee America’s mental health systems—quietly fact-checked this dominant narrative. Their resulting report showed that these oft-repeated bed numbers are not only inaccurate but wildly misleading.

And from the real numbers, there emerges a fundamentally different portrait of America’s mental health system, its impacts on society, and what’s gone wrong. It’s a picture of an America where there’s never in history been more psychiatric beds per capita, or more widespread psychiatric monitoring and coercion.

Click here to read the rest of the article at Mad in America.

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