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April 1, 2025 - Lionel Nation
21:23
Why It's Time to Bring Back Mental Hospitals and Psychiatric Wards Before Chaos Takes Over
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Anybody who's walked around, anybody who's paid attention recently knows that the world is insane.
And that's just not an expression.
It's not just a colloquialism.
It's true.
It's absolutely true.
And this is about the case for reinstating mental institutions.
That's what I'm talking about.
This is a necessary response, the part of society, to rising insanity, but insanity that we have not seen before.
Insanity that's not just, you know, benign, but that's dangerous, and that affects the welfare of the country.
In the late 20th century, The United States and much of the Western world kind of embarked on a grand experiment.
Deinstitutionalization.
Try saying that three times fast.
To deinstitutionalize people and to shut down mental hospitals.
And it was championed as a humane reform.
It promised to liberate.
You know, individuals with severe mental illness from the confines of often grim and horrible psychiatric hospitals.
You know the word bedlam comes from a psychiatric hospital in the UK or England called Bethlehem, but the way they pronounced it was bedlam.
And it was integrating or trying to integrate them into Communities with outpatient care and support, yet, yet, yet, as we stand in 2025, the streets of cities like San Francisco, L.A., New York, not so much now, but certainly here, L.A., name it, they tell a different story.
One of unchecked psychosis, homelessness, insanity.
And a society that's collapsing under the weight of untreated mental disorders.
And the data are stark.
The National Alliance on Mental Illness, NAMI, NAMI, let's call it NAMI, reports that 20% of U.S. jail inmates have a serious mental illness.
While the Department of Housing and Urban Development estimates that 40% of the homeless population suffers from similar conditions.
So, to de-institutionalize what once heralded as compassionate has instead unleashed a torrent, a crisis, a tsunami of insanity that demands an immediate, bold, A brave reversal, President Trump.
The reinstatement of mental institutions to remove the severely, not the quirky, not the depressed, not somebody with a, you know, with a, with a, some kind of a therapy ferret or something, but the severely mentally ill to remove them from the streets and to restore order to our communities.
Now look.
We've got to look at the historical context.
You know, this is a well-intended or well-intentioned failure.
Now, to understand why this shift is urgent, listen to me.
First, we've got to revisit the deinstitutionalizing, I can't say deinstitutionalization, but you know what I mean, the roots.
It emerged in the 1950s and accelerated through the 60s and 70s.
And it was a movement...
That was driven, in essence, by a mix of idealism and pragmatism.
You know, there were all these exposés on squalid conditions in state hospitals, like the 1946 Life magazine piece, I'm sure you remember that one, on Willowbrook.
Willowbrook, exposing abuse and neglect.
Fueling public outrage and concurrently new antipsychotic medications like Thorazine promised to manage symptoms.
Miracle, an elixir.
To manage these terrible symptoms outside institutional walls.
And then there were legislative milestones such as the 1963 Community Mental Health Act under President Kennedy.
And it aimed, I think admirably, to replace asylums with a network of community-based clinics.
And by 1980, the U.S. mental health population had plummeted from a peak of 560,000 in 1955 to under 130,000, according to the American Psychiatric Association.
So the intent was noble.
It's good for you.
Thank you.
To treat people with dignity a lot like animals caged and penned.
Right?
Dignity, not confinement.
But the execution faltered.
You see, funding for community mental health centers never materialized at scale.
You see, Congress allocated only a fraction of the promised billions.
So let them out!
And then we got nothing to replace it with.
So states, eager to cut budgets, of course, shuttered the institutions.
Hey, thanks!
Get rid of them.
Without ensuring viable alternatives.
Be nice if they talked and coordinated, wouldn't it?
So the result of all this?
A mass exodus of patients into communities unprepared, unable.
And unwilling to handle severe disorders like schizophrenia, bipolar disorder, delusional states, but accompanied with violence.
Not that all of those people are violent, but in some cases they are.
So by 2025, the Treatment Advocacy Center estimates that, by the way, that's now, that three and a half million Americans with serious mental illness receive no Three and a half million.
Okay?
Think about that.
Many cycle through the streets and the jails and the shelters and the halfway homes and the subways and the parks and bless their heart but it's scary and there are consequences.
Insanity unleashed is what we're talking about.
When we deinstitutionalized, the fallout was visible today!
Take San Francisco, please!
Where the Tenderloin District has become an open-air asylum!
And we're not talking about drugs, we're talking about serious mental illness.
A 2023...
San Francisco Chronicle investigation found, listen to this, that 60%, 60% of the city's homeless population exhibited signs of severe mental illness.
Stop calling it homeless!
They're homeless because they're crazy.
They're also toothless and shoeless and jobless, but that's not the issue.
They had hallucinations, paranoia, self-harm, yet fewer than 10% received consistent care.
Think about that.
And across the country, the numbers are equally grim.
The U.S. Department of Justice reports that individuals with psychosis are 16 times more likely to be killed by police, often during chaotic, psychotic episodes and encounters, born of untreated delusion.
And you can see all the social media posts from urban residents.
They say this guy is screaming at invisible people on my block.
You see it all the time.
Where's the help?
And you've seen this.
I mean, it's just incredible.
Look at Kensington.
Yeah, that's drugs out of Philly, or in Philly, but it's a different story.
Somebody wrote one time that the streets have become really a de facto mental ward, but without structure or treatment.
A 2024 UCLA study found that 25% of Los Angeles' unsheltered population engaged in disruptive behaviors, public defecation, violence, or erratic outbursts.
All of this linked to untreated psychiatric conditions.
This isn't freedom.
It's abandonment.
And the humane vision of community care, which is what I guess was the purpose of this, has devolved into this nightmare where the most vulnerable are left to fend for themselves.
Often self-medicating with drugs like fentanyl, which the National Institute on Drug Abuse notes, exacerbates psychosis.
Exacerbates, as in makes it worse.
Moreover, deinstitutionalizing these folks.
Has strained public safety.
The Bureau of Justice Statistics reveals that 15% of state prisoners and 24% of jail inmates have a history of serious mental illness.
Numbers dwarfing the general population's 4%.
What do you think about this?
Sometimes it's the institution itself that actually breeds this and churns this.
High-profile cases like the 2022 New York subway shooting by Frank James, a man with untreated paranoid schizophrenia, underscored this risk.
Critics argue that these incidents are outliers, but the pattern is clear.
Here in New York, we see these people throwing people in.
Look, I'm an expert in this.
I've got a front-row seat to this.
Trust me.
I'm not exaggerating.
Without some kind of intervention, a subset of the mentally ill poses a very serious, real, and present danger to themselves and others.
And mental institutions are the answer.
I'm not trying to be mean.
Reinstating mental institutions isn't about reviving the horrors of the past and cuckoo's nest.
It's about building a modern, humane system, which is cheaper than what we have here.
A humane system to address a crisis that community care can handle.
Severe mental illness often requires more than outpatient therapy or medication.
This is serious business, my friend.
You know, especially for those in acute psychosis or lacking insight into their condition, a phenomenon called anosognosia.
Say it with me again.
An anosognosia.
One more time.
I know so.
It affects up to 50% of schizophrenic cases.
Think about that.
This is according to the Treatment Advocacy Center.
Now, these individuals don't volunteer.
And they volunteer for help.
They don't say, hey, I need help.
They need to be pushed sometimes.
They need structured intervention.
First, institutions would get the dangerously ill off the streets.
A 2023 report from the California Police Lab found that 70% of San Diego's chronically homeless had mental health issues severe enough to warrant inpatient care.
Yet beds were scarce, if not available.
Modern asylums, clean, regulated, and focused on treatment could house these individuals.
Reducing urban chaos, crime, protecting us, and imagine fewer encampments, less public urination, less defecation, and fewer police calls for erratic behavior.
People, there was, on X, there was people, users, In cities like Portland, who were lamenting, you know, we need a place for these people that isn't jail or the sidewalk.
And that's a common refrain.
Institutions are that place.
Second, there's two, right?
There's more.
They provide tailored care, impossible in fragmented community systems.
See, outpatient clinics, underfunded and overstretched, often offer...
50-minute med checks.
Not the intensive therapy or stabilization.
Severe cases demand.
And remember, whatever this costs, it's cheaper than what happens on the street.
A 2024 JAMA, Journal of American Medical Association, psychiatry study, showed that patients with schizophrenia in structured inpatient settings had 40% lower relapse rates than those in community care.
Ta-da!
Institutions could, we would hope, integrate psychiatrists and social workers and nurses and occupational therapists under one roof, offering a continuum of care, you know, medication and counseling and skills training, that could theoretically reintegrate these patients into society when stable.
Number three, I hope you're keeping track of this, to reinstitutionalize these folks would break the jail-to-street Jails have become America's largest mental health providers, largest psych ward.
This is a role they're ill-equipped for.
The Vera Institute of Justice notes that 80% of incarcerated mentally ill individuals reoffend within five years.
And the reason for that is because most of the time they're released without treatment plans or too early or because of no beds and institutions could serve as a bridge diverting non-violent offenders into care rather than punishment.
States like Texas, with pilot programs for court-ordered psychiatric holds, have seen a 30% drop in recidivism among the mentally ill since 2022.
Now, we must address the counter-arguments.
Opponents, of course, will argue that reinstating institutions risks repeating history's abuses.
And that's a good concern.
Lobotomies, lobectomies, overcrowding, torture, civil rights violations, right?
Civil libertarians like the dread ACLU warn of, and you should be listening to them, warn of forced confinement, eroding personal freedom.
And these worries, listen, these are valid, but not surmountable.
Think about this.
Modern facilities must, must be governed by strict oversight.
Independent boards, patient advocates.
Transparent reporting.
It sounds like a lot of bureaucracy, but it's necessary.
All of this required to prevent neglect.
Technology like AI-driven monitoring.
And by the way, one day the use of bots, and the use of bots for therapy too, believe it or not, they could ensure human conditions, humane conditions, while tracking outcomes.
And freedom for someone screaming at phantoms or hearing voices in a gutter.
Liberty without care is a hollow promise.
That's not freedom.
Remember, freedom in the form of abandonment.
Cost is another objection.
You know, building a staffing institution isn't cheap.
That's true.
Estimates from the National Association of State Mental Health Program directors suggest $250,000 per bed annually.
But compare that.
I sound like Doge.
I sound like Elon.
Compare that to the $31 billion the U.S. spends yearly on homeless services.
That's according to HUD.
And $15 billion on incarcerating the mentally ill.
That's according to the DOJ.
By the way, in cycles.
By redirecting funds from these kind of band-aids to a real solution could break even within a decade.
Especially if somehow we paired with private investment or federal grants.
And finally, my friends, listen to me carefully.
Some people say that community care just needs more funding.
Sound familiar?
But decades and decades of underinvestment.
And then community mental health budgets have flatlined since 1990.
Read what the Kaiser Family Foundation says.
This all proves that this is a pipe dream.
Even with money, the system lacks the capacity and the determination to compel treatment for those people too ill to seek it.
Institutions fill that gap.
Now, here's what we plan for 2025 and beyond.
Picture this, okay?
A network of regional mental health campuses, each with 500 beds, Serving 150,000 severely ill, now on America's streets.
A conservative estimate from NAMI.
Patients enter via court orders or family petitions.
They're assessed by multidisciplinary teams.
Stays range from weeks to years, depending on progress, with clear paths to discharge.
That there's housing and job training and outpatient follow-ups and all this other kind of stuff.
And then by 2030, urban blight recedes, jail populations shrink, families reclaim, loved ones lost to madness, and the failure of deinstitutionalization isn't its intent, but its outcome.
You see, Insanity, listen to me, I'm sorry to say this, crazy, festers and produces, not because we lack compassion, but because we've misdirected it.
You see, letting the severely mentally ill languish in public squares, this isn't humane, it's abandonment!
It's neglect!
Masquerading as some kind of progress, and it's sick.
It's got to stop.
We have to reinstate mental institutions now, offering this, I think it's a pragmatic fix.
Remove this chaos.
Treat the illness, and maybe rebuild the society overrun by a problem it once knew how to solve.
The streets are screaming for it.
It's time, my friends, that we listen.
And I thank you for listening, but this is...
This is a pet thing, a project of mine.
I can't say it enough.
We must do something now.
So do me a favor, my friends.
Please like the video.
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Please hit that little bell so you're notified of live streams and new videos.
And I've got five questions for you to answer, one or all, to address what we need to fix this problem.
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