American Debate: Should we bring back Asylums or integrate people with mental health challenges into the community?

The Commonwealth Club hosted a debate on treating mental illness by asking, should we bring back asylums?

Here is more information about the debate that occurred on July 22, 2015.

 Dominic Sisti, Ph.D., Assistant Professor of Medical Ethics/Health Policy and Psychiatry, University of Pennsylvania; Principal Author, “Improving Long-term Psychiatric Care: Bring Back the Asylum,” Journal of the American Medical Association

Renee Binder, M.D., Psychiatrist, University of California, San Francisco; Incoming President, American Psychiatric AssociationDr. Gloria Duffy, President and CEO, The Commonwealth Club — Moderator

Approximately 10 million Americans suffer from serious mental (challenges). Over the past 60 years, various social, political and economic forces have resulted in the closing of publicly funded psychiatric institutions in favor of community treatment, in which outpatient options and the ability to live independently seemed promising and in many cases less expensive than inpatient care.

Should severely mentally ill people be integrated within the community? Or should asylums be revisited? How would individuals come to be placed in such asylums? What civil rights issues come into play? How would such institutions be funded? Who would staff them and how would training and management ensure humane care? How could modern psychopharmacology and neuromedicine be applied? How could such institutions be structured to perhaps have different levels of institutionalization, from semi-independent living to more comprehensive care? How could they be made into places where people want to be, because their lives would be better than on their own?

Critics such as Dr. Dominic Sisti, principal author of a new report from The University of Pennsylvania, argue that comprehensive, accessible and fully integrated community-based mental health care continues to be an unmet promise….

Dr. Sisti says that new models of fully integrated, patient-centered long-term psychiatric care now exist in the United States and that such facilities are needed to provide 21st-century care to patients with chronic, serious mental illness.

Advocates for community treatment, such as Dr. Renee Binder, president of the American Psychiatric Association, argue that the answer to better treatment lies not in the fact that asylums have been closed but that they have not been replaced with adequate funding.

If you would like to listen to the debate that occurred on July 22, 2015, please click here.

Join an important discussion about one of the most pressing issues impacting society at large.