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August 23, 2023

Vermont Needs a New State Mental Hospital

Deinstitutionalization turns out to be a cruel alternative.

My friend Bill Shubart wrote a wise and kind essay on the need for a new institution for those who are homeless. He lists some of the institutions which used to fill this role including the Vermont Asylum for the Insane (Waterbury), the Weeks (reform) School, and the many poor farms.

The book and movie One Flew Over the Cuckoo’s Nest helped turn America against large “mental hospitals”. The horror of some of these institutions had long been documented. We decided to shut these places down and end the misery and abuse of patients. The theory was that modern psychiatry and drugs would allow the inmates to lead lives in the community or in pleasant local institutions. Deinstitutionalization became the rule; large institutions like Waterbury were emptied out and not replaced as they fell into decay.

The problem is that the theory was wrong. The community institutions were never built, largely because of community resistance. People with acute mental problems are not very good at taking the drugs prescribed for them – and are easy marks for those selling drugs which make their problem worse. Psychotherapy is hardly a quick or certain cure. Housing is hard enough to obtain and maintain for those with moderate income; it is impossible for those with severe mental problems. Our cities are spotted with filthy homeless encampments. Emergency rooms are increasingly dangerous for both patients and staff because the mentally ill are bought there and then remain far too long.  Although most people with untreated mental illness are more danger to themselves than others, too much violence is committed by mentally ill people who are known and repeated offenders. The streets of Burlington, VT are increasingly scary at night.

“Let us imagine,” Bill writes, “a new institution, a dignified but modest communal home for the many Vermonters struggling with mental illness, alcohol and drug addiction disorders, extreme poverty, or who are simply unhoused.”

I agree with Bill that we need “a new institution” but think it should specifically be and only for those “struggling with mental illness, alcohol and drug addiction…”. Those who are suffering from “extreme poverty or simply unhoused”, including those who were recently displaced by flooding, will be much safer and better off in housing which already exists or congregate housing if they don’t have to share these facilities with people who ought to be either incarcerated or institutionalized.

Decker Towers in Burlington provided subsidized housing in the city’s tallest building. Two stories on WCAX (here and here) document the problems residents are facing:

“I see drug deals happening in the parking lot. I see them at the side door. I see them all around the building,” said one resident.

“The drug dealers, the people that steal all these goods, they know that Decker Towers is open for business,” said another.

“Residents have sent photos of needles scattered inside and outside the property, as well as bodily fluids and people sleeping in the stairway,” reports WCAX.

Steven Murray, the director of the Burlington Housing Authority, says “It’s not just Decker Towers, it’s just about every major apartment building in town.”

Those housed in motels around the state both before, during, and after the pandemic as well as the motel owners and neighbors, complain about rampant crime and drug use in their accommodations. The pods recently sited in Burlington for the homeless are now greatly resented by their neighbors because of the lawless crowds they attract. Neighborhood resistance to low-income housing is inflamed  because the housing is used not only for those who need shelter for economic or other misfortune but also for those who cannot live safely outside of institutions.

Bill Shubart is right that incarceration should not be the only option for those who cannot safely live with others and who don’t belong on the streets, although he and I probably disagree on how often incarceration is appropriate. Everyone suffers from the lack of an institution, a modern Waterbury Hospital, where those with currently uncured mental problems can safely and humanly be cared for by professionals. Existing congregate shelters and subsidized housing – and emergency rooms - will be better and safer alternatives for those who need them if they are not dumping grounds for the mentally ill.

See also:

Burning the Ships After Landing

Bill Schubart: A new asylum for our communities (VTDigger)

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