Deinstitutionalization and Homelessness

By Rabbi Azriel Hauptman

Homelessness is a growing problem in the United States and as of 2018 over half a million people were homeless. Of those, about 200,000 homeless people suffer from mental illness such as bipolar disorder or schizophrenia. Amongst the prison population, it is estimated that approximately 300,000 inmates in the United States are suffering from mental illness. It didn’t used to be this way. There used to be government-run “insane asylums” that provided long-term or lifelong care for individuals with severe mental illness. In the 1950s, there were over half a million beds nationwide in these institutions. This article will explore the causes of the closing of these institutions and what it means for us today.

Before we begin, we must note that until the 1950s there were no medications at all for treating mental illness and therefore the presentation of an individual living with chronic mental illness bears no resemblance to what we see today. The advent of medications that can treat psychotic disorders and other mental illness has transformed the landscape of psychiatric disorders.

In the 16th and 17th centuries, we begin to find a rise in institutions that housed individuals with mental illness. The costs were covered by families, who were often too ashamed to have the individual living with them. Patients were often restrained with shackles, and abuse and neglect were rampant. In the 19th centuries, the public began to recognize the abuse that occurred in these facilities, and many asylums started to treat their residents more humanely and shackles became less common.

At this time, we start finding the creation of government-run institutions. These buildings tended to be majestic and therapeutic. Additionally, many were located on large grounds where residents could take walks and even tend the gardens. Nevertheless, many abuses remained. Overcrowding was rampant, and this led to poor living conditions, lack of hygiene, abuse of residents, and even starvation.

In the 1950s, partially as a result of the publicity of the horrific conditions in these institutions, the sentiment of the public changed dramatically. Until that point, it was common to believe that mentally ill individuals should live out their lives in an institution. Additionally, at this time medications were discovered that were able to treat many individuals who until then were considered untreatable, and governments became unwilling to pay for the high cost of life-long institutional care.

A movement, known as deinstitutionalization, emerged that called for the closing of the long-term care facilities and treating patients through short-term stays in the hospital, homebased treatments, and halfway houses that helped them integrate into society.

Deinstitutionalization has its pros and cons. The pros are that rather than having society send the mentally ill into lifelong institutions, they were forced to develop ways to treat them in their home environment and to allow them the opportunity to be a productive member of society. New legislation that made it extremely difficult to commit someone against their will meant that individuals struggling with mental illness did not have their rights stripped from them.

The cons are that there is a subset of individuals who need more help than just a few weeks in a hospital or a halfway house and their needs are not being met. The result has been a sharp rise in the homeless and prison population.

As a society, we have made tremendous strides in the care of mental illness. However, we still have a long way to go. Innovative ideas are needed to develop interventions that have the best of both worlds; allowing every human being to maintain their dignity and self-respect, and interventions that can treat and care for individuals with severe mental illness.

This is a service of Relief Resources. Relief is an organization that provides mental health referrals, education, and support to the frum community. Rabbi Yisrael Slansky is director of the Baltimore branch of Relief. He can be contacted at 410-448-8356 or at yslansky@ reliefhelp.org

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While here in Baltimore, exciting preparations are underway for the upcoming May 21st, Ishay Ribo Unity Concert, on Motzae Shabbos, February 5th, at the Yad L’olim, Ishay Ribo Concert in Jerusalem, Frank Storch, director of The Chesed Fund & Project Ezra, actually met with Ishay Ribo. “It was a great sold-out show,” said Frank, “the joyful energy and achdus at an Ishay Ribo concert, where there are so many different types of Jews, is unique and we are so excited to bring him to Baltimore.”

More importantly, however, is the focus of Frank’s trip to Israel, which was to increase safety and security for American and English-speaking students and tourists. The Chesed Fund & Project Ezra provided free and informative Stay Safe in Israel workshops to many yeshivas and seminaries based on the guide distributed to thousands

By Dr. Edo Lavi

Our sages teach us that “when the (Jewish month of) Adar arrives, we increase our happiness, when Av arrives, we reduce our happiness.”

On the surface, the psychological implications of this statement seem impractical. How can we be expected to control our level of happiness?

Are we even capable of modulating our emotions that way? Fascinating research indicates that most healthy people can control their mood, and it’s easier than you would imagine. All it takes is a smile!

In 2002, Professor Daniel Kahneman received the Nobel Prize in Economic Sciences for the work he did with his partner Amos Tversky at the Hebrew University in Jerusalem. Amazingly, Daniel Kahneman wasn’t even an economist! He was a psychologist, but his research was so fundamental in explaining human behavior that it was applicable to any field of study, including behavioral economics, hence the Nobel Prize in economics.

Kahneman published the essence annually. Frank also had the opportunity to distribute thousands of free Stay Safe in Israel emergency cards, which list emergency phone numbers for first responders and has already proven to be a life-saving resource. An Aish Hatorah student, Shmulie Vladimirsky, whom Frank randomly ran into, shared about a frightening incident where his friend who was having a severe allergic reaction stopped breathing. Because of the pressure of the moment, he did not know how to respond. He then suddenly remembered he had the emergency card in his wallet and was able to call first responders. They came immediately and saved his friend’s life!

Additionally, after the shocking and deadly terror attack in Neve Yaakov on Friday night, January 27, Shomrim of Neve Yaakov and community leaders reached out to Frank to review their security measures and discuss important ways to tighten the security at their institutions and shuls. They were very appreciative of the meeting and the extensive list of ideas provided which detailed simple and cost-efficient immediate steps to take. The meeting was then followed up with another meeting with Neve Yaakov policemen to discuss various ideas to implement as well.

Frank also met with representatives of several major Israel-American organizations to further The Chesed Fund & Project Ezra’s reach in Israel. One dedicated advocate he met with was Rabbi Nechemya Malinowitz, Director of the Eretz Hakodesh Party and the Igud for Yeshivas and Seminaries, who helped thousands of international yeshiva and seminary students enter Israel during the Covid-19 pandemic. They discussed their shared interest in keeping seminary and yeshiva students as safe as possible and plan to