When I was young, mental hospitals sprinkled the countryside. My parents read Freud in hypochondriac mode and neuroses were part of growing up – indeed, nurtured in certain groups (say among drama majors & yes, creative writers). I don’t know what percentage of the population was housed on those wards, but considerably more than today.
Update: Jonathan Kellerman, a man who went through med school as these changes were taking place, describes the arguments for de-institutionalization by doctors & ideologues such as R. D. Laing and Thomas Szasz. That in this case even those of us on this blog, non-experts, could see the problem indicates how extreme are the problems in contemporary treatment. As Kellerman notes
That is not to say that anyone who pens violence-laden poetry or lets slip the occasional hostile remark should be protectively incarcerated. But when the level of threat rises to college freshmen and faculty prophesying accurately, perhaps we should err on the side of public safety rather than protect individual liberty at all costs.
De-institutionalization was the effect of many causes. I’m no expert, but having lived through those years, I know some: better and more specific medications; patients’ rights groups, especially the ACLU, argued decisions (which were sometimes at a family’s or community’s convenience) should rest with the patient; better and more numerous half-way houses; more clinics specifically aimed at drug & alcohol dependency. I suspect more prisons have a mental health wing; in those days some mental hospitals had prison wings. No matter how minimal the psychiatric help and spartan the conditions, these institutions were expensive. They had few defenders & have disappeared across the country. But homeless street waifs and thirty-two dead in Blacksburg may indicate the need, if on a smaller scale, remains; some then housed on those wards are vulnerable – as are those of us living beside them. (Two blogs with repeated posts on the illness of the shooter are neo-neocon’s and Dr. Helen‘s; the latter links to an article on de-institutionalization.)