This month marks the 60th anniversary of one of the most dreadful pieces of legislation in American history. It was the Community Mental Health Act, signed by President John F. Kennedy on Halloween, Oct. 31, 1963.
The plan was to replace giant state psychiatric hospitals with 1,500 community clinics. As miracle drugs emerged to treat schizophrenia and bipolar disorder, reformers argued there was no longer good reason to keep so many people in locked psychiatric facilities.
Community centers could provide their care, ensuring that they would take their meds. People who were formerly hospitalized could join the general population. It was all sold as a compassionate new approach to caring for the mentally ill.
But most of the community centers weren’t built, so those afflicted with serious mental illness ended up on the streets. And that’s the origin of the horrors committed by people who shouldn’t be out and about.
Devin Kelley had a long history of mental illness. In 2017, he shot to death 26 people at the First Baptist Church in Sutherland Springs, Texas.
In 2022, Martial Simon pushed a young woman to her death in front of a moving New York subway train. Diagnosed with schizophrenia, he had been in and out of hospitals, jails and outpatient programs. In 2017, he told a psychiatrist at a state-run hospital of his desire to commit that very crime. He was let go.
Then New York Sen. Patrick Moynihan later felt great regret at having helped draft the bill. In a letter to The New York Times years later, Moynihan wrote of a city “filled with homeless, deranged people,” and wished someone had told Kennedy, “Before you sign the bill you should know that we are not going to build anything like the number of community centers we will need. … The hospitals will empty out, but there will be no place for the patients to be cared for in their communities.”
Had the president known, Moynihan wrote, “would he not have put down his pen?”
Back in 1963, support for “freeing” the inmates grew from diverse ideological quarters. Progressives backed community centers as a far more humane place for treating the mentally ill than the giant hulks with bars on the windows. On the far right, the John Birch Society saw psychiatry as a Communist plot to lock up conservatives.
Some argued against there even being a thing called mental illness. They held that diagnosis and imprisonment were ways to enslave those who ignored society’s norms.
“If you talk to God, you are praying,” the libertarian psychiatrist Thomas Szasz famously said. “If God talks to you, you are schizophrenic.”
Ken Kesey’s novel, “One Flew Over the Cuckoo’s Nest,” portrayed the mental ward as a means of social oppression. It came out the year before the Mental Health Act was passed.
About 20% of the homeless living on the streets of America suffer with severe mental illness, according to the U.S. Department of Housing and Urban Development. And with psychiatric hospitals no longer an automatic option, they fill the prisons.
A quarter of the inmates in the Los Angeles County Jail, the Cook County Jail in Chicago and New York’s Rikers Island have been diagnosed with a serious mental disorder. That makes them America’s three largest mental health facilities.
Armies of “unhoused” people now wander and sleep under America’s bridges and in parks. They haunt transportation facilities. Most are not dangerous, but even their lesser crimes, like public urination, add to a sense of civic disorder.
Bring back the psychiatric hospitals. They don’t have to be the hellish storage rooms of yore. They can be clean and well-staffed. Just make sure they are locked.
