JANUARY 23, 2026 MENTAL HEALTH Deinstitutionalization of insane asylums: good or bad? THE CONFUSED CLOUD Groundcover contributor Let me begin this article by saying I’m biased. Having lived with a severe mental illness most of my adult life I am very grateful for the deinstitutionalization of insane asylums and/or long-term mental hospitals. I have never been confined to a hospital for more than three weeks. Only once do I remember being continually hungry. The place I was at had three meals a day but they were small meals and I was twenty-three years old. I was only at that place for less than a week. Every other hospital I have had, had very good meals and some places had 24-hour access to food. I always had access to a bathroom and shower. I never felt too hot or too cold. I always had either clean hospital clothes or my own clothes. I always had a bed and never had more than one roommate. I have never been hit, much less beaten, by staff. The medications can have bad side effects and can be difficult to get used to. But overall they have been very helpful and much less tortuous than classic treatments. I have never been forced into a chair and spun until I threw up or passed out (Rotational therapy). I have never been forced into an ice bath for several hours to the point of hypothermia (Hydro-therapy). I have not been castrated. I have never had a great deal of my blood drained (Bloodletting). I have never been forced to take insulin until I went into a coma on a daily basis (Insulin Coma Therapy). And I have not had an icepick shoved into my eye socket and swished around to scramble my brain. (About 50,000 lobotomies were performed in the US, 10,000 of which were icepick lobotomies.) I am kind of leaving out electroshock therapy on this list because it is still infrequently performed. Unlike the past, now it is used as a last resort, with the addition of muscle relaxants and anesthesia, and only with the patient's or their guardian’s consent. It wasn't just the stopping of these barbaric treatments that made me in favor of deinstitutionalization. Medications, beginning with thorazine, rapidly started to replace them in the 1950s. The asylums and long term mental hospitals were terrible nightmares for their patients/victims. The hospitals were overcrowded. There was nowhere near enough toilets, beds, or places to bathe. Patients slept on cold floors sometimes in bedless rooms, and were often covered in filth. Poor hygiene led to disease outbreaks. Then, there was the food. Nellie Bly, an investigative journalist who went undercover in 1887 for ten days in Blackwells Island, a lunatic asylum in New York City, said the food was rotten meat and bread so hard it would chip your teeth. She also said patients who complained were beaten. Many victims starved to death in the old long-term hospitals. Because of all these factors I was shocked to hear that there are people against deinstitutionalization. When I search for it on Google or YouTube, it is usually referred to as a failure. The primary reason is that many severely mentally ill people cycle in and out of jails and prisons while others swell the ranks of chronically homeless. My gratitude comes from a positive experience with the community mental health system and the fact that I have been housed for over twenty-three years. I am not an anomaly. I know many people, some who I am very close to, that are in the CMH system and have been housed for years in the same place. They have also either never been to jail or prison or haven't been there for years. I know CMH clients who work part time. I also know people who graduated from the CMH system. Several work as peer supports for CMH. When long term mental health hospitals were open there were whistleblowers and several attempts at reform. Besides Nellie Bly who I mentioned there was Dorthea Dix, Albert Deutsch, Mary Jane Ward and several others. I consider all the whistleblowers and reformers personal heroes. I owe them and every victim of the old hospitals my freedom. To all the victims of Danvers Lunatic Asylum, Trans Allegheny Lunatic Asylum, and every victim of the old asylums and long-term hospitals who, often covered in filth, screamed endlessly — I wish I could tell you that your screams weren't in vain. I am free today because of their suffering. I can go to the movies, drink soda, visit friends and family, walk in the park, read any book I want in the library, sleep in my own bed, shower daily, write for and read Groundcover, and many more things the victims of the old asylums could only dream of. To people who want to lock us up again long-term, without due process, including President Trump and Health and Human Services Secretary Robert F. Kennedy, my question is: Why? Do you really want to help us or do we make you feel uncomfortable in public? Do you want us out of sight out of mind? To do this would probably require overturning court decisions. On June 26, 1975, the Supreme Court ruled in O’Connor vs Donaldson that keeping people committed requires that they are a danger to themselves and/or others. Before this case people could be committed involuntarily for a variety of reasons by a doctor and a family or community member, such as acting weird or having weird beliefs or being socially eccentric. If we got rid of the precedent that in order to commit someone they must be a danger to themselves or others, from what I can see, it puts anyone seeking mental health help in danger of being committed, possibly long-term. In my opinion we could reinstate a phase where it’s dangerous to complain of mental health symptoms. I want to, in a crisis, be able to go to a psych ER for help, and not be in danger of losing my freedom for years or the rest of my life. People advocating for more long term facilities say this time will be better. I’m thinking of a video by Micah Caldwell on the You-Tube channel that he shares with his wife called "Neuro Transmission.” It’s titled “Bring Back Asylums … But Better.” Here’s the thing. After President John F. Kennedy signed the CMH Act in 1963, only half of the promised CMH centers were built. With heroin and cocaine in the 1970s. Then crack, meth and the opioid epidemic in the 1980s, 1990s and 2000s took their toll and our country's mental health became much worse. Continued wars, economic changes contribute to this. With the shrinking middle class, September 11 terrorist attacks, the COVID-19 pandemic and the polarization of social media isolating us, statistics show our country's mental health has become worse than ever since the CMH act was signed. President Ronald Reagan and more recently President Trump with “The One Big Beautiful Bill Act” in 2025 have made more cuts to mental health funding. Also, there are many other reasons for the increased incarceration rate and homelessness in the United States. So, if we can't fund the current community mental health system, why would the government be able to fund much more expensive long term care hospitals without bringing back the over crowded horrible nightmares of the past? When the old insane asylums were GROUNDCOVER NEWS 11 "If we can't fund the current community mental health system as is, why would the government be able to fund much more expensive long term care hospitals without bringing back the over crowded horrible nightmares of the past?" open, every attempt at reform was short lived. So for people who say, “Let’s try again to commit many people long term” and who really believe this time it will be done "right" and "really help" us mentally ill. I’d like to remind you of a classic definition of sanity — insanity is doing the same thing over and over expecting a different result.
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