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Trump's call for more mental institutions dismays advocates

Mourners pause at a makeshift memorial outside Ned

Mourners pause at a makeshift memorial outside Ned Peppers bar in Dayton, Ohio, after the Aug. 6 mass shooting there. Credit: AP/John Minchillo

WASHINGTON — President Donald Trump’s latest idea to tackle the nation’s growing number of mass shootings calls for a resurgence of mental institutions such as those he recalls being shuttered and downsized in New York State over several decades.

“I remember, growing up, we had mental institutions,” Trump told reporters last Sunday when asked about his support for new background check legislation in the wake of back-to-back mass shootings this month. “A lot of them were closed. And all of those people were put out on the streets. And I said — even as a young guy, I said, ‘How does that work? That’s not a good thing.’ And it’s not a good thing. So I think the concept of mental institution has to be looked at.”

Following the shootings in El Paso, Texas, and Dayton, Ohio, the president has moved from voicing support for tougher background checks on gun purchases, a concept opposed by the National Rifle Association, to focusing instead on mental health programs as a preventive solution. Mental health professionals say the president’s call for more mental institutions ignores the decades-old movement away from such institutions and makes a scapegoat of millions of Americans living with mental illness.

The president repeated his call for more mental institutions on Tuesday, telling reporters in the Oval Office: “We’re looking at mental institutions, which we used to have … where I come from in New York, they closed up almost all of their mental institutions, or many of them, and those people just went onto the streets. And they did it for budgetary reasons. Well, New York is not unique, they’ve done that in many places.”

State mental health advocates say Trump has mischaracterized the history behind the closures, ignoring advancements in psychiatric medicine that helped spur a “deinstitutionalization” movement in the 1950s. They say the president’s remarks also ignore the widespread abuses that plagued massive mental institutions for centuries that also led to the push to close them in favor of smaller facilities.

Industry experts say large campuslike mental facilities such as Long Island’s Kings Park Psychiatric Center and the Central Islip Psychiatric Center — which each housed nearly 10,000 patients at their peak before both closed in 1996 — were shut as part of a broader movement to reintegrate those with mental illnesses into the community and to offer more personalized care through smaller community-based mental health centers.

The number of New Yorkers institutionalized in state facilities dropped from about 93,300 in 1955 to about 2,300 in 2017, according to an analysis of state data last year by the Manhattan Institute, a conservative policy think tank. 

Glenn Liebman, chief executive of the nonprofit Mental Health Association in New York State, said many patients discharged from institutions in the 1950s struggled with reintegrating into society because of a lack of support programs, leading President John F. Kennedy on  Oct. 31, 1963, to sign the Community Mental Health Act aimed at providing federal funding for community mental health programs. 

Liebman said while local mental health centers have long struggled with obtaining adequate funding, the move toward smaller facilities freed patients from “being warehoused in these horror hospitals.”

“Do we need more funding for mental health? Of course,” said Liebman. “But the funding for mental health shouldn’t be going back to the past and saying that we should be building more institutions. We need less institutions and more community money.”

Mental health advocacy groups across the board have come out in opposition to Trump’s call for more mental institutions, saying the president is conflating the issue of gun control with mental health.

“It’s much more than mental health,” Liebman said. “Mental illness is unfortunately used as a scapegoat issue. It passes the buck. The issues are a lot more complex than that. You have to look at things like history of violent behavior, domestic violence, family history of abuse, those are much more mitigating factor.”

Angela Kimball, chief executive of the National Alliance on Mental Illness, said in a statement, “The president should be talking about better care and earlier access to intensive treatment, not revisiting the shameful institutions of our past.”

Other groups have argued that several of the nation’s most recent mass shooters have been motivated by racial animus and white nationalist ideology, which should be addressed as separate issues, rather than solely being labeled a mental health issue. 

"First, hate is not a mental illness. And people who hate should never be allowed to hide behind people with mental illnesses,” said Paul Gionfriddo, president of the national advocacy group Mental Health America. "Second, violence does not come hand-in-glove with mental illness. Some people who are violent have a mental illness. But most people with mental illnesses will never have a violent thought in their lives. And most people who engage in acts of violence don't have a mental illness.”

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