After the school shootings in Parkland, Fl., President Trump has called repeatedly for building or reopening mental institutions. He has echoed an argument made by some experts who study the mental health care system. It’s not that they believe that having more institutions would prevent spree killings, as Trump apparently does. The majority of these murderers appear to be angry, antisocial individuals with access to guns whom the mental health system probably could not have spotted in advance. The proposal to bring back asylums is very much alive for other reasons among some policy experts, psychiatrists and bioethicists, the New York Times reports.
A modern incarnation of asylums does not impress advocates for people with mental disabilities, who want the idea dead and buried, along with transorbital lobotomy, insulin-shock therapy and other cruelties visited on people with mental disorders in times past. The intensity of the debate provides a guide to the maze of the mental health care system. “When people are going back and forth from prisons to hospitals, that’s a sign they might have benefited from longer-term treatment options,” said Dominic Sisti, a medical ethicist at the University of Pennsylvania School of Medicine and co-author of a 2015 paper subtitled “Bring Back the Asylum” in the journal JAMA. “For this really seriously mentally ill population, our resources have dried up, and I find that to be an ethical social-justice violation.” Jennifer Mathis of the Bazelon Center, which litigates for people with mental disabilities, called the idea offensive. “It took a lot of effort to move away from the practice of warehousing people,” she said. “Locking people up long-term is no treatment at all. The idea that we could be going back to those days — we did this before, and it failed and failed badly — it’s crazy and discriminating.”