Downsizing Mercy copyright
1998 Bob Darby
The man in the soup line wore a hospital bracelet.
His skin was gray and his eyes were yellow. He took his meal
to a private corner of the park and sat down. I walked over
to talk with him.
The sick and disabled of Germany
in 1937 were
"Why are you wearing the hospital bracelet?"
He was pleased somebody cared. "I just got out of Grady."
"Why were you there?"
"I have cancer."
His discharge papers said that he had a malignancy of the liver.
A Grady social worker gave him a list of shelters, and his monthly
Social Security check for $400 could only rent him a week in
a cheap motel. Food Not Bombs referred him to the Open Door Community
for help with housing.
Once this man had a job with medical insurance, but his benefits
ran out in a year. Then he lost his job and his home. If he
couldn't get to a shelter in time and had to sleep in the park,
the police would probably enforce the "Urban Camping"
ordinance and put him in jail.
The Open Door Community and Food Not Bombs see hundreds of people
every week who are homeless for no reason other than they are
sick. People who are homeless because of cancer, AIDS, and
other "physical" illnesses are just the second and
smaller wave of America's abandoned sick. Little mercy is shown
in this country for the mentally ill, and for a long time America's
first and largest tidal wave of homeless sick people has been
made up of discharged mental patients. One-third of all the
homeless population of the United States is mentally ill. This
means that there are five thousand mentally ill homeless people
in Atlanta, and two million in the USA.
Mental hospitals have been shutting down in America for more
than thirty years. This could be a humane and liberating event,
but it isn't turning out that way. Drugs are now available to
enable most mentally ill people to successfully live outside
hospitals, but only with competent supervision in state-supported
residential care facilities. Although such "group homes"
are cheaper than hospitals, few are actually funded and maintained.
The money saved by closing hospitals is being spent instead
on jails and prisons, and the mentally ill are consequently thrown
out on the streets to fend for themselves. Despite the fact that
the violent crime rate for the mentally ill is the same as the
rest of the population, many people fear them as being criminal
About one thousand beds in Atlanta-area jails are occupied by
the homeless mentally ill, and most of these people are guilty
of nothing more than loitering or sleeping in parks. Without
lawyers, they will be kept in jail for at least a year, until
such time as they are declared "stabilized" by jailhouse
medication and their cases can finally be "cleared"
by the courts. Then they are remanded to the streets and, eventually,
another round of jail and neglect.
scorned by their government as"useless eaters."
Many of Atlanta's mentally ill are in jail
because there's no room for them in mental hospitals. Yet only
256 psychiatric adult-care beds are available at Georgia Regional
Hospital-Atlanta (GRHA), and this is the sole state mental hospital
now serving over three million people. Each adult-care bed at
GRHA costs the state of Georgia $517 a day. Jail is much cheaper,
at $50 a day, than hospitals or group homes.
Now the crisis over Georgia's homeless mentally ill has suddenly
gotten worse. In June of 1998 the Georgia Mental Health Insitute
(GMHI) permanently shut its doors, and now we have only one state
hospital, Geogia Regional, serving all of metro Atlanta...
over three million people. The Department of Human Resources
(DHR) tells us that there is a "lessened need" for
mental hospital beds because of "recent advances" in
pharmacology," and that the money saved on closing GHMI
will be spent on the "transfer of services to local communities."
But what the DHR closure booklet doesn't explain is the limited
applicability of, and the prohibitive cost of, these new drugs;
and neither does it tell us exactly what new "services"
they are planning to expand. We are expected to assume they are
acting in good faith and on the public's behalf.
Truth is abused and evaded when the DHR says that new psychiatric
medications have reduced the need for hospital beds. Most of
Georgia's mentally ill aren't being served by these mysterious
new miracle drugs because those who need them the most are homeless
or in jail. With thousands of homeless mentally ill people in
Atlanta, it is obscene for the DHR to say that we have a "reduced
need" for hospital beds. And if there really are any "new
services" planned by the DHR for local communities, it's
a fair bet that these services will be delivered behind the bars
of new neighborhood jails and prisons.
The sick and disabled of Germany in 1937 were scorned by their
government as "useless eaters." Gas chambers and crematoria
were pioneered on the grounds of mental hospitals, years before
the Nazis used them against other populations. America should
take warning. The abandonment of the sick and poor cultivates
cruelty and downsizing mercy encourages murder. For as long as
we abandon our sick and helpless to the streets our generosity
is a lie and our riches are a curse.
Resources: "Trading Beds for Bars",
by Stephanie Ramage, Creative Loafing, April 4, 1998. "Why
are There So Many Homeless Mentally Ill?" by E. Fuller Torrey,
M.D. Harvard Medical School Letter, August 1989. "A Plan
to Close Georgia Mental Health Institute..." by the Georgia
Department of Human Resources, 1998
Thanks to Jane Hannigan and Jon Farr for research
assistance. Bob Darby has a B.A. in psychology and is a former
employee of Georgia Regional Hospital. back