We Shut Down State Mental Hospitals. Some Want to Bring Them Back.

Is "mental illness" a fraudulent concept for locking up social deviants? Or does forced treatment free the ill "from the Bastille of their psychosis?"

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On January 3, 1999, Andrew Goldstein wandered onto a New York City subway platform and shoved a stranger named Kendra Webdale into the path of an oncoming train. As the story made national news, reporters dug into Goldstein's past and found that he had been diagnosed with schizophrenia and had a history of violent episodes. He had been in and out of psychiatric facilities, but his caretakers had repeatedly released him back onto the streets against their better judgment because of a shortage of available beds.

The murder of Kendra Webdale brought attention to Americans with severe mental health problems and inadequate treatment, a social problem that 20 years later is still ongoing. Prisons and jails are filled with inmates who exhibit symptoms of mental illness. So do many of the homeless people crowding the streets of cities like Los Angeles, San Francisco, and New York. Violent episodes, like the Webdale murder and some recent mass shootings, have brought renewed calls to entrust the state with more authority to force psychiatric care on patients against their will.

This story looks at the history of mental illness, institutionalization, and the role of coercion in psychiatry. It features an array of voices and viewpoints, including Linda Mayo, the mother of twin daughers with severe psychiatric diagnoses, who advocates for court-ordered psychiatric treatment; Richard Krzyzanowski, a patients' rights advocate who fights against coercive treatment laws; DJ Jaffe, the founder of Mental Illness Policy Org., who argues that the state should make it much easier to commit mental patients; the late Thomas Szasz, a controversial libertarian psychiatrist who fought compulsory treatment and questioned the very existence of mental illness; and Scott Zeller, a psychiatrist who's developed a new model that he hopes will reduce coercion in the system. (Disclosure: Zeller has in the past donated to Reason Foundation, the 501c3 that publishes Reason.)

Produced by Zach Weissmueller. Camera by Weissmueller, Jim Epstein, Meredith Bragg, and Alexis Garcia.

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Photos of Adderall, Credit: Kristoffer Tripplaar/Sipa USA/Newscom

Photo of Andrew Goldstein: Marty Lederhandler/Associated Press

Photo of Gov. Pataki signing Kendra's Law: Jim McKnight/Associated Press