Did Reagan’s Crazy Mental Health Policies Cause Today’s Homelessness?

Recently, a 34-year-old woman rammed her car into barricades outside the White House while her infant daughter was in the back seat. The police, thinking it was an act of terror, chased her down and shot her to death.

Later, we learned she was actually struggling with mental illness.

This came not long after another 34-year-old, this one a man who heard voices and thought people were out to hurt him, walked into the Washington Navy Yard and gunned down 12 people.

It is getting crazy out there, and these two people were not even dealing with the added pressure of living on the streets. Within our country’s homeless population, a quarter of a million people—or one-third of the homeless population—struggle with some sort of mental illness.

For those of us who encounter people experiencing homelessness on a daily basis, this is not surprising. We see that man walking down the sidewalk angrily screaming at an imaginary person, haunted by some phantom or past memory, every day. We also see people steering their children across the street to get away from the potential danger.

In America’s cities, many of us are so immune to such disturbances that we just continue reading our email on our smartphones without even looking up. It is just another crazy part of our urban lifestyle.

But when I see people like this, my first thought is always the same: Why isn’t this man institutionalized? He certainly is not living a dignified life out here on the streets.

When I ask my mental health colleagues about this, the one political figure that typically comes up is former President Ronald Reagan. It’s like an urban legend in our field. People say the reason so many people with mental illness are homeless or in jail—one-third of all homeless individuals and half of all people behind bars—is because of President Reagan.

Really? What did he do? Let all of the mentally ill patients loose?

Well, yes, that’s exactly what they say he did.

Over 30 years ago, when Reagan was elected President in 1980, he discarded a law proposed by his predecessor that would have continued funding federal community mental health centers. This basically eliminated services for people struggling with mental illness.

He made similar decisions while he was the governor of California, releasing more than half of the state’s mental hospital patients and passing a law that abolished involuntary hospitalization of people struggling with mental illness. This started a national trend of de-institutionalization.

In other words, if you are struggling with mental illness, we can only help you if you ask for it.

But, wait. Isn’t one of the characteristics of severe mental illness not having an accurate sense of reality? Doesn’t that mean a person may not even realize he or she is mentally ill?

There certainly seems to be a correlation between the de-institutionalization of mental health patients in the 1970s and early 1980s and the significant number of homelessness agencies created in the mid-to-late 1980s. PATH itself was founded in 1984 in response to the significant increase in homelessness in Los Angeles.

It’s ironic that a political leader who made such sweeping decisions affecting Americans with mental health issues ultimately came face-to-face with the dangers of untreated mental illness. In 1981, President Reagan was shot by John Hinckley Jr., a man suffering from several different types of personality disorders.

Where has Hinckley been for the last 30 years? In a psychiatric hospital.

It makes me wonder just how many people living on the streets today would also be safer and better cared for in an institutional setting.

photo: by Michael Evans, 1982 (NARA/Reagan Library)