There has always been prejudice directed at mental patients and at those providing them with medical help. This is a curious phenomenon, but one not really surprising. When we look at those suffering from mental disorders we all see something of ourselves, something essentially human we would rather forget. For that reason we have spirited our mentally ill away behind bars, out of sight. And it matters little whether the bars enclose a seemingly luxurious private sanitarium or an old, musty public hospital that serves thousands who would otherwise go without essential psychiatric treatment. That's why the Reagan administration's plans for drastic cutbacks at St. Elizabeths Hospital are so shameful.
Those of us involved in mental health care have been alarmed by the cutbacks of the last 21/2 years. We understand that our nation's mental patients are objects of fear, and that as never before in memory they are ignored and even scorned by government. We also realize that this is rationalized by political rhetoric about budgets and cost efficiency.
But the real reason, we suspect, is that mental patients do not represent an articulate voice within the body politic. Many mental patients are unable to speak out because their illnesses prevent effective self-expression; those able to speak often would rather remain unidentifiable, and are therefore silent. Those of us who provide psychiatric care, regardless of the setting, are invariably suspected of self-interest when we speak out.
What will happen in terms of human health and life should the proposed cutbacks at St. Elizabeths take place? Our nation now includes an alarming number of homeless people, youngsters, adults of all ages, and the very old. Like those who reside in mental hospitals, these individuals cluster in areas that are often out of sight. Thus, most concerned individuals are not aware that people suffering the excruciatingly painful hallucinations of schizophrenia, alcoholic disease or Vietnam combat trauma make the streets and flop houses their hospital beds. Even caring people are not aware that countless numbers of the chronic mentally ill with a variety of serious conditions have been abandoned by this society.
St. Elizabeths Hospital has a dedicated and idealistic staff, a staff that produces far more than any of us could demand or expect, but never in my memory has the hospital had the benefit of anything near optimal staffing. Without doubt, the proposed cutbacks would make the hospital totally inadequate, render the staff totally demoralized and create a group of prematurely discharged, inadequately treated patients who would become part of the suffering, deteriorating, slowly dying homeless population.
The time is long gone when we can leave the fate of St. Elizabeths Hospital solely in the hands of government. Physicians, patients, their families and friends, and a concerned citizenry--all must demand not less, but more for St. Elizabeths to ensure that we have a mental hospital in our nation's capital city that provides appropriate care to those who suffer from mental illness. We must demand that government not create a public health crisis, not relegate mental patients to our streets. We must also hold government responsible for its actions, and let our political leaders know that inhumane treatment of mental patients will lead to the destruction of human life. This would surely result from the proposed cutbacks at St. Elizabeths and in response all should join together in outrage. At the minimum, we must work together to prevent the administration's plan to destroy St. Elizabeths.