As we celebrate the 50th anniversary of Mainstay this year, it is helpful to reflect back to the mid-1970s, when the mental health care system in this state was changing rapidly as state psychiatric hospitals were closing.
“The Department of Mental Health instituted a process called Deinstitutionalization,” said Mainstay Supportive Living and Home Care co-founder Newt Levee. “It was decided that it was a bad idea to house mentally ill patients in these big state hospitals. They wanted them to be in the community, which sounds good, but they weren’t making provisions for them.”
Mainstay CEO Larry Oaks echoes those sentiments. “The idea behind releasing two million patients suffering from Serious Mental Illness (SMI) from long-term state hospitals was noble and well-intentioned, but the unintended negative consequences of this movement have been significant, and they persist to this day.”
In 2016 Boston Globe Spotlight Team took an in-depth look at the prolonged effects of deinstitutionalization, writing:
“Today, nearly all of those institutions have been bulldozed or boarded up — and many had to be, having evolved into inhumane asylums for people who are, in the great majority, no threat to anyone. But the hospitals were not replaced with anything resembling a coherent care system, leaving thousands of people with serious mental illness to navigate a fragmented network of community services that puts an extraordinary burden on them to find help and to make sure they continue getting it.”
The Boston Globe report is difficult and disturbing to read, as it chronicles case after case of individuals who had attacked family members, killed strangers, or took their own lives. These were individuals who had histories of being treated and/or hospitalized for mental illness, but were unable to receive the kind of therapeutic care necessary to allow them to live within our society.
Oaks points to four critical issues we face today because of the lack of adequate care for those living with mental illness:
- Homelessness/Chronic Homelessness – the National Institute of Health estimated that one-third of America’s homeless population are experiencing SMI. About 20 percent of our nation’s homeless are considered chronically homeless, meaning they have been homeless for a year or more or have experienced four or more episodes of homelessness in the last three years
- Criminalization of SMI – People released from supervised settings in the 1960s, 70s and 80s were referred to community-based mental health treatment programs. A large percentage found themselves incarcerated for various crimes, some violent. The 2016 Boston Globe Spotlight article found that over the prior 20 years, over 10 percent of all homicides in this state were committed by people with a “history of mental illness or clear symptoms.” The rate of SMI in the state prison system is twice the rate among the general population.
- Cycling – People with SMI have complex challenges including addiction, homelessness, chronic illness and socioeconomic issues. They are the focus of a disproportionate amount of public resources, and repeatedly cycle through public resources. The NIH estimated there are several hundred thousand of these individuals living across the country today.
- Strained Public Systems – Our jails and prisons have become de facto psychiatric hospitals. Police, fire and EMS are stretched thin daily to care for emergencies for people with SMI who aren’t receiving adequate care.
“Society suffers when someone with SMI doesn’t have the care they need, but the toll placed on families can be unbearable,” said Oaks.
It can also be deadly. The Boston Globe found that at least 18 parents were killed by their mentally ill children between 2005 and 2016, and at least 21 children were killed in this state by a mentally ill parent.
Governor Maura Healey’s proposed 2026 fiscal budget calls for the elimination of 170 state jobs which help people with SMI navigate services. It also calls for the closing of intensive residential treatment facilities for children and adults with SMI and programs for young people who are released from the hospital but still need intensive treatment before going home.
State Senator John Velis (D-Westfield), who co-chairs the Committee on Mental Health, Substance Use, and Recovery, has been quoted as saying to the Boston Globe editorial board that these cuts “risk the sustained stabilization of our most vulnerable residents, inundating our emergency rooms, and creating a greater strain overall on a system already asked to do more with less.”
While this all sounds very grim, it’s important to recognize that there are organizations dedicated to helping individuals with SMI. Mainstay is proud to be one of them.
“Since the founding of Mainstay, our organization has continually opened group homes and apartment complexes for people with mental illness in Massachusetts”, said Oaks. “Today we are proud to have 315 units for adults living with SMI or intellectual and developmental disabilities. We recognize that our work is far from over, which is why as we celebrate 50 years, we also look ahead to the work we have yet to do.”
Mainstay opened its 13th supportive housing program in 2021 in Hyde Park. It’s estimated that there are more than 150,000 units of permanent supportive housing in operation across the country today.
