Title: Is the Mental Health System “Broken”? | Psychology Today
Headings: Is the Mental Health System “Broken”?
Philip Yanos Ph.D.
Is the Mental Health System “Broken”?
The oft-repeated phrase is seldom questioned.

Content: As an example, he discussed how the conventional wisdom in the United States used to be that smoking cigarettes posed no health risks, despite evidence to the contrary (in 1954, only roughly 40% of persons with a high school education believed that smoking caused lung cancer); however, as a steady stream of evidence from the research community began to reach the public’s awareness, this gradually changed, such that, by 1999 over 90% of US residents with a high school education endorsed that smoking causes lung cancer (greater than the proportion believing that the Earth revolves around the Sun!). Link pointed out that the transformation of the “conventional wisdom” in this regard has been associated with corresponding dramatic reductions in smoking behavior and increases in life expectancy in the US general public. Is the conventional wisdom that “the mental health system is broken” accurate and helpful? Taking a closer look at the phrase, implicit in it is the assumption that the mental health system was once whole. Essentially, this represents a yearning for the pre-deinstitutionalization system in which public-sector services consisted almost completely of state hospitals which confined people with serious mental disorders for indefinite periods (usually life). This represents the belief that indefinite confinement in hospitals is the best way for society to care for people with serious mental disorders. While the lives of people who lived in these institutions are generally shrouded in mystery, an impressive study was recently conducted which reviewed the abandoned suitcases of people who resided at one state institution in New York State which closed in 1995. Through an examination of letters and case notes, this study found that many individuals who lived in these settings (often symptom-free, according to case files), sometimes left behind promising lives in the community, and desperately wanted to leave but were not allowed to. Whether one considers a system that is based on indefinite confinement in hospitals to be ideal or not depends on one’s values and what one sees as the purpose of the mental health service system.