Review: Back to Bedlam

by Marcia Purse

DATELINE: 03/13/99

The March 12, 1999 NBC News special, "Back to Bedlam," an investigative report by Geraldo Rivera, offered us a chilling look at the state of modern-day mental health care in the United States.

The statistic that 40 to 60 percent of people suffering from mental illness in America get no medical treatment is shocking. Worse still is learning that on any given day there are more mentally ill people in jail than in hospitals!

Geraldo discussed the shameful history of America's treatment of those vulnerable citizens with some form of mental illness. After the outcries and exposés of the late 1960s and early 1970s, the huge "snake pit" institutions were phased out, with promises of massive reform, better individual and group care: promises that were not kept. Persons without insurance have little hope of obtaining quality medical care, and even less of receiving any type of mental health care; and most health insurance policies have strict limits on mental health coverage.

Deinstitutionalization - the process of eliminating the old-time "snake-pit" mental hospitals - has led not to better mental health care, but to the criminalization of the mentally ill.

"Back to Bedlam" followed the stories of three people who, because they could not get proper treatment for their illnesses, were imprisoned. Scenes of prison guards forcing mentally ill prisoners into restraints for offenses such as yelling or banging on a door were described as being proper procedure by the Sheriff overseeing the jail. But how can these be proper procedures when the "felons" cannot appreciate that their behavior is wrong?

One thing this program did not do was refer back to President Clinton's campaign promise, before he was first elected, to provide universal health care to all Americans. Clinton tried; Congress refused to cooperate; the promise was broken. The conditions we saw in "Back to Bedlam" could have been at least partially alleviated if Congress had taken action to relieve the plight of the uninsured.

The issues spotlighted by "Back to Bedlam" are ones that desperately need attention, but a single television news program cannot make all the difference. It remains to be seen whether there will be enough public outcry, enough pressure on legislators at the state and federal levels, to bring about much needed reform in America's treatment of the mentally ill. The article "Deinstitutionalization: A Deadly Debacle" (no longer online) suggested four crucial changes required in order to begin correcting the situation. And there is no question that change must occur, when a mother has no choice but to give up her mentally ill child to the state in order to obtain treatment - and the child STILL ends up imprisoned!

Geraldo goes "Back to Bedlam"
NAMI's report on the Geraldo Rivera special.