The Results of Deinstitutionalization

Suspect in Montgomery Mall Stabbing Identified: “Antoinette C. Starks, 48, who is charged with stabbing two women at a Nordstrom store in a Montgomery County mall last night, was ordered today to undergo a psychiatric evaluation. Court documents released today show that Starks, of the 6000 block of Greenbelt Road in Greenbelt, was released from prison on Tuesday after being convicted of a charge of destruction of property. They also allege that the weapon used in the attacks was two kitchen knives taped together.”

If you’re not a resident of the DC area (or a regular reader of the Washington Post) you probably don’t know about this story. This woman stabbed two people on Wednesday — the day after getting out of prison. The victims were apparently strangers to her.

Now, it may turn out that I’m wrong about this, but this sure looks like a case of a mentally ill person who’s never received the appropriate care. It would be interesting to know the details of her prior “destruction of property” conviction. I’m guessing it was another incident of unprovoked violence.

Back in the 1970s there was a big move to shut down most of the state-run psychiatric hospitals around the US. The idea was that most of the mentally ill people confined in them would do better if they were reintegrated into society and receiving treatment on an outpatient basis at community mental health centers. It all sounded really great on paper. Trouble was, when it came time to set up the community mental health centers, the states didn’t allocate enough money to do the job right. To make things worse, at the same time most of the inpatient facilities were shut down, laws were being passed making it much more difficult to involuntarily commit a person.

You can see the results of this fiasco on the streets in any major city: mentally ill people who are not able to properly care for themselves. While there might be treatments available that could help these poor souls get their lives together, there’s no effective system in place for getting the people to the clinics or monitoring their progress once they start treatment.

A lot of these folks die early from diseases related to poverty and substance abuse. A lot of them wind up in prison after having violently acted out.

The idea of deinstitutionalization was a good one. The lack of follow-through, though, can only be described as tragic.

We have failed these people. Most of the time we can just pretend we don’t see them sleeping on park benches or begging for change. Every once in a while, though, one of them is driven by her illness to behave in ways that we can’t ignore.

Will Antoinette C. Starks finally get the care she very likely needs? Or will she just wind up back in prison?