Mental Health Care

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By Jackie Smith

Oregon has a morbid past concerning the history of its mental health care. The practice of Eugenics from the nineteenth and twentieth-century adopted stigmas that remain attached to those affected today. In the U.S., people of non-minority and from various ethnic backgrounds may share different cultural norms and beliefs than the majority population, but they are identified as being a part of a “whole” in regards the mental health system. In 1907 and through the peak of the 1940’s, up until 1983 in Oregon, doctors performed forced sterilized castrations in the name of Eugenics as a way to control a population from certain ethnic backgrounds, habitual behavioral problems or those born with abnormalities. For a long time people lived this way, it was socially accepted to house people in terrible conditions because of their ethnic or hereditary background. Towards the end of Jimmy Carter’s presidency in the 1970’s, he enabled people with disabilities to regained their rights (Rehabilitation Act). Mental health services were incorporated through federal funds which reintegrated people back into community half-way houses, transit shelters and treatment centers. His goal to deinstitutionalize people from hospitals and within a year, it resulted in a 90% drop from 3000 patients at the Oregon State Hospital in Salem to less than 500 in 1979 (SubCity).

As the federal tides shift gears with each presidential election, so do the benefits granted toward social services. In 1980’s, Reagan came into office and altered Carter’s Mental Health Systems Act by having individual states cover the costs of mental health care instead of the federal government. It was the “new federalism” of the mid-80’s when healthcare funding started gradually chipping away-cutting corners to save on costs or used elsewhere. Over time Oregon, social services and programs became less pertinent and often left those in the most need of services without coverage.

In 2009, the United States was given a D for an overall evaluation for mental health care. The states are graded on “health promotion, measurements of financing, family empowerment, and Community Integration and Social Inclusion” (U.S Report). Oregon received a C. Due to individual state budgets and lack of support from federal funds many states see and feel the effect in the mental healthcare system. The mental health documentary Subcity: Out of Sight and Out of Mind, brings to light a lot of the important issues that crowd our justice system and our current need for stability within our mental health system which tends to build until the aftermath can no longer be ignored. It becomes apparent that without the funding resources, our mental health system and people with disabilities will continue to suffer the consequences and taxpayers ultimately foot the bill due the long term ripple effects. This in turn created larger problems with the overcrowding of hospitals and shelters to increasing amounts of unpaid emergency room bills. These consequences tend to fall into the hands of tax payers for those seeking help or treatment when needed. More often than not, people with mental health issues are often placed in jails and prisons (SubCity).

There is really no place for them to bring those with mental health issues. With the continuous cuts to mental health services and taxpayer favoring building prisons, it leaves little options for those in need, especially when resources are limited or full. Each time that a person with mental illness is picked up by police and brought to the Emergency room, it is costing Oregonians $3,390 per day to treat and release them. The imprisonment of inmates (with mental illness) at a correctional facility cost $140 per day without treatment, while a Community Center or Transitional Shelter its only $12 a day. From recent voting turnouts, local tax payers would rather pay into the prison system that deals with habitual criminals rather than effectively and efficiently “deal” with mental health services. This outcome leads to many not having a place to go when the shelters are full. It is estimated that roughly 45% of the inmate population suffer from mental illness and 75% from alcohol or substance abuse. The problems continue as prison or correctional facilities do not offer treatments needed to break their cycles, their behavior continues, repeats and worsens until their needs are met (Subcity).

What was once funded by the federal government is now in the hands of voter and taxpayers of individual states. The funding for the mental health sector is sacrificed to cover more impeding issues and placed on the back burner. For a very long time, services for mental health have been a social problem. When the economy is declining, jobs become scarce and the media focuses its attention to the life that lead to the death of a homeless person that had history of mental illness-or worse…Unfortunately, it would probably take a national epidemic of similar tragic scenarios before government aid would step in. But as pieces of history repeat itself, as does the ebbing tide come back just to take it all away again.
Work Cited

1.) SubCITY: Out of sight out of mind. Firefly Studios Production. 2010. [Video] March 2011. <>.
2.) U.S. Report Card. NAMI. <>. Feb. 2011.
3.) The Rehabilitation Act of 1973. Center for Psychiatric Rehabilitation. Boston University. Updated 2009. <>.

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