Ukuboshwa kanye nokwenza ubugebengu kwabagula ngengqondo ... kuhle, kuyahlanya.
Ingabe ngiba nokhahlo kakhulu? Ake sibone. Abahlinzeki abakhulu kakhulu bokwelashwa kwabagula ngengqondo yi-LA County Jail, i-Rikers Island eNew York kanye nejele lase-Cook County e-Chicago. Abantu abayizigidi ezimbili ngonyaka baboshwa ezifundazweni ezingama-44 naseSifundazweni SaseColumbia, babamba iziguli eziningi kunesibhedlela esikhulu kunazo zonke sezengqondo.
Ngokusho kodokotela bengqondo kanye nomcwaningi we-schizophrenia u-E. Fuller Torrey encwadini yakhe, Out of the Shadows, Deinstitutionalization of the mentally ill is a โPsychiatric โTitanicโโ. Uthe:
I-Deinstitutionalization igama elinikezwe umgomo wokukhipha abantu abagula kakhulu ngokwengqondo ngaphandle kwezikhungo ezinkulu zikahulumeni bese kuvala ingxenye noma zonke lezo zikhungo; kube yimbangela enkulu enkingeni yokugula ngengqondo.โ
Ngokwe-World Health Organization eGeneva, eSwitzerland kunabantu abangaba izigidi ezingu-450 emhlabeni wonke abahlushwa โukuphazamiseka kwengqondo noma kwemizwaโ esikhathini esithile ekuphileni kwabo. Ukugula ngengqondo kukleliswe endaweni yesine njengembangela ehamba phambili yezifo emhlabeni. I-WHO ithi ukucindezeleka ngokomtholampilo kuzokleliswa endaweni yesibili ngonyaka ka-4.
Ngisho nalezi zibalo i-WHO iqhubeka ithi cishe u-2/3 wabantu abanesifo sengqondo abalashwa ngenxa yokucwaswa okuhambisana nalesi sifo nokunganakwa nje. โLapho kunokunganakwa khona, ukuqonda kuncane noma akukho nhlobo. Lapho kungekho ukuqonda kukhona ukunganakwa.โ
Impela sisuka kude ekuphathweni ngonya kwabantu abagula ngengqondo esikhathini esedlule. โUkwelashwaโ kwezempilo yengqondo ekhulwini le-14 kungachazwa ngokunembe kakhudlwana njengokuhlushwa. Bekubukeka njengekhasi eliphuma ku-Dante's Inferno elinemibuthano eyisishiyagalolunye yesihogo. Ngekhulu le-18 Udokotela wase-Austrian uFranz Mesmer wasungula i-mesmerism njengekhambi. Lo mbono wawusekelwe ekudonseni kwamandla adonsela phansi enyanga okunomthelela omkhulu oketshezini lwethu lomzimba, njengoba nje inyanga ithinta amagagasi olwandle. Lokhu kwamenza wakholelwa ukuthi uzibuthe kwakuyimpendulo ngakho wahlela omazibuthe ezingxenyeni ezibalulekile zomzimba.
Amakholoni aseMelika athola ukuthi ukugula ngengqondo kuwubuthakathi kodwa ngasekupheleni kwekhulu leshumi nesishiyagalombili umuzwa wokuziphatha wawudlangile njengoba abasebenzelana nemimoya babeka umsebenzi kanye nemfundo yezenkolo ukuthoba umphefumulo.
U-Erasmus Darling, udokotela ongakwazi kahle, isazi sefilosofi nososayensi kanye nomkhulu kaCharles Darwin, ukhuthaze indlela โyokuphotha usofaโ. Umqondo wakhe wawuthi ukugula ngengqondo kudinga nje ukulala kakhulu nokuphotha kwenza lokho. Akazange athathwe ngokungathi sรญna kakhulu, kodwa udokotela waseMelika uBenjamin Rush wamukela leyo nkambo eminyakeni kamuva.
Ukungafaki iphuzu elihle kakhulu kukho, umsebenzi wezempilo yengqondo usuhambe ibanga elide. Kodwa-ke, u-Newt Gingrich waseRepublican wabhala isihloko esithi, "Ukugula Ngengqondo Akulona Ubugebengu," futhi wathi "indlela yaseMelika lapho abagula ngengqondo benza ubugebengu obungenalo udlame - ukubavalela ngaphandle kokuxazulula inkinga - iyisixazululo kusukela ngawo-1800s."
Ukukhishwa kwesikhungo kwabagula ngengqondo kwaba umbono omuhle owahamba kabi kakhulu. Imibono eyaholela ekwenziweni kobugebengu nokuboshwa kwalesi sizwe yaphuma ekuthembeleni ezidakamizweni (i-Thorazine ikakhulukazi) endaweni yokunakekelwa kochwepheshe.
Ngo-1955 iCongress yakha i-Joint Commission on Mental Illness and Health eyavela "nokukhulula" iziguli zengqondo emikhawulweni yezibhedlela. Ilungu elasinda laleyo khomishini kamuva lathi ikhomishana yathatha lesi sinyathelo esibi ngenxa โyohlobo lokwengamela olwenzeka cishe kuzo zonke izinguquko phakathi kwesayensi nohulumeniโฆ
Umbiko we-Action for Mental Health ka-1961 owaphuma kuKhomishani wakhuthaza uhlelo olusekelwe emphakathini โlwezinsizakalo ezididiyelwe zesibhedlela kanye nezokuthwala abantu.โ Ochwepheshe kuzwelonke kanye nezinhlangano ezisiza umphakathi bawukhuthaze lo mbono kwezokwelapha, kwezemfundo nakwezombangazwe. E. Fuller Torrey wathi, โEqinisweni, cishe amaphesenti angu-92 abantu ababeyohlala ezibhedlela zikahulumeni zezifo zengqondo ngo-1955 ayengahlali lapho ngo-1994.โ
Ngo-1963 i-Community Mental Health Centres (CMHC) ACT yasungulwa ngaphansi kukaMongameli uJohn F. Kennedy. Lokhu kuhlinzeke ngoxhaso ukuze kuxhaswe izikhungo zezempilo zomphakathi. I-Young Minds Advocacy Projected igubhe iminyaka engama-50 yalo mthetho.
Ngokusho kwabo "kusize ekusunguleni uguquko olukhulu ohlelweni lwezempilo yengqondo lomphakathi ngokususa izinsiza ezikhungweni ezinkulu ziye ezinhlelweni zokwelashwa kwezempilo yengqondo ezisekelwe emphakathini." Batuse igxathu elihanjiwe mayelana namalungelo eziguli ezigula ngengqondo, nokudalwa kwezindlela ezingasetshenziswa emphakathini esikhundleni sokulaliswa esibhedlela.
Ngizophakamisa ukuthi lowo mgubho ubengaphambi kwesikhathi.
Kamuva uMongameli uCarter washayelwa ihlombe ngokusungula iKhomishana yakwaCarter, eyokuqala yalolu hlobo, okwaholela kuMthetho Wezinhlelo Zezempilo Yengqondo. Iqhubekile nokuxhasa ngezimali izikhungo zezempilo yengqondo zomphakathi. Umthetho weMental Health Systems Act usabonakala unombono omfushane ngoba awuzange wenze ngcono kakhulu ukunakekelwa kodwa ulungise izinkinga zesistimu ye-bureaucratic. Iphinde yaqhubeka nokuxhasa ngezimali izikhungo zezempilo yengqondo zomphakathi kanye nokuhlinzeka ngezibonelelo zikahulumeni "kumaphrojekthi okuvimbela ukugula ngengqondo nokukhuthaza impilo enhle yengqondo."
U-E. F. Torrey uncoma izinjongo zeKhomishana kaCarter Yezempilo Yengqondo ngokuba nenhloso enhle ezinhlosweni zabo - โukugcina izinga elikhulu lenkululeko, ukuzikhethela, ukuzimela, isithunzi, nobuqotho bomzimba, ingqondo, nomoya womuntu ngesikhathi yena noma uyahlanganyela ekwelashweni noma athole usizo.โ Uthe le ndlela yokwelapha isisebenze ingxenye enkulu yabathengi bezempilo yengqondo. Kodwa futhi uthi:
โUkuzinqumelaโ ngokuvamile kusho ukuthi umuntu unokhetho lwamakhishi esobho. "Isilungiselelo esikhawulelwe kakhulu" ngokuvamile siphenduka ibhokisi lekhadibhodi, ijele, noma ukuphila okugcwele ukwesaba okuhlushwa yizitha zangempela nezicatshangelwayo.
Ekhuluma โngezilungiselelo ezingakhiqizi kakhuluโ kanye nokungabi nakhaya kwelanga elivulekile, umongameli uRonald Reagan uyafika engqondweni. "I-federalism" yakhe entsha, ukudluliselwa kwamandla e-federal kuhulumeni, kwabaxosha abagula ngengqondo ngaphandle kwezibhedlela futhi baqhubekele emigwaqweni ngokushaywa kwepeni. Wathi, โAbantu abalala emasangweni . . . Ngakho akukhona nje kuphela ukuthi akukho emthethweni ukugula (njengasejele), kuwukuzikhethela.
Ngenkathi uReagan esenguMbusi waseCalifornia, inani labantu bezikhungo zezempilo yengqondo lehla lisuka ku-37,500 ngo-1959 ngaphansi koMbusi u-Edmund G. Brown, laya ku-22,000 ngaphansi kweReagan.
Ngaleso sikhathi uDkt. Robert Felix, umqondisi weNational Institute of Mental Health, wayengomunye wabaningi ababekhuthaza ukunakekelwa komphakathi kwabagula ngengqondo esikhundleni sokulaliswa esibhedlela. Wathi nokho:
โIningi lalezo ziguli ezashiya izibhedlela zikahulumeni kwakungafanele neze zenze kanjalo. Thina odokotela bengqondo sabona okuningi kakhulu komgodi wenyoka omdala, sabona abantu abaningi okwakungafanele babe lapho futhi sasabela ngokweqile. Umphumela awukona lokho ebesikuhlosile, futhi mhlawumbe asibuzanga imibuzo obekufanele ibuzwe lapho sakha umqondo omusha, kodwa odokotela bengqondo bangabantu, nabo, futhi sizame okubi kakhulu.โ
UMongameli uReagan unqamule isabelomali seSikhungo Sikazwelonke Sezempilo Yengqondo (i-NIMH) esidale ukwehla kwabasebenzi bezengqondo abaqeqeshiwe futhi ochwepheshe abaningi abasele babelwa imisebenzi ephansi engahlobene nokunakekelwa kwesiguli. Ngaphansi kukaReagan kwavela uMthetho Wokubuyisana Kwesabelomali se-Omnibus (1982) owahlanganisa izinsiza zezempilo yengqondo zaba yizibonelelo ezivimbela izifundazwe ezibavumela ukuthi babone ukuthi bawabeka kuphi amadola abo. Izifundazwe eziningi zavele zaxhasa ngezimali izinhlelo ezikhona zempilo yengqondo ezazivele zihluleka.
U-Reagan, umlingisi wefilimu owaba ngumongameli, uhlonishwa njengomkhulumeli omkhulu nesithixo se-Republican Party. Nokho, kwabagula ngengqondo, wadlulisela uhlobo lomlayezo othi โbayeke balale emigwaqweni yomgwaqoโ. Futhi benza.
Kodwa ukuze sikhulume iqiniso, asikwazi ukubeka icala ezinyaweni zobumba zikaReagan kuphela. Uhulumeni ubephendula ezinkingeni zezimali ezibhedlela zikahulumeni ezinezimo ezimbi. Ngokufika kwemithi yokuphatha amaklayenti, ochwepheshe bezempilo yengqondo baqala ukuthembela kakhulu ekwelashweni kwezidakamizwa kunokunakekelwa komtholampilo. Umyalelo wabo wawuthi umphakathi uthathe lapho wehlulekile khona. Khona-ke izinsiza zomphakathi zehlulekile.
Namuhla ngenxa yokuwohloka komnotho okuqhubekayo kweMelika, izinto ziye zaba zimbi kakhulu. Ngokusho kweNational Institute for the Mentally Ill, NAMI, "Kusukela ngo-2009 kuya ku-2011, ukuncishiswa okukhulu kwezindleko zezempilo yengqondo okungezona ezeMedicaid kwaba ngaphezu kwamaRandi ayizigidi eziyizinkulungwane ezingu-1.8."
Lapho izimali ziphambukiswa ezinsizeni ziye kwabagula ngengqondo, amajele, izinhlaka zomthetho, izindawo zokukhosela ezingenamakhaya kanye nezinkonzo eziphuthumayo ezithwele kanzima ezibhedlela kufanele zibambe iqhaza.
UDkt Torrey, ebhala ngezimo ngeminyaka yawo-1990, uthe ngenxa yokuthi abameli benkululeko banqoba impi yokuthola amalungelo amaningi kwabagula ngengqondo, kwaba nzima ukuthi bathole ukwelashwa. Uthe, "Kungenzeka ukuthi ubulale ijaji noma uzame ukuzibulala ngaphambi kwebhentshi." Ubuye waveza ukuthi incazelo yokugula ngengqondo iguquguquke yaba yinhlanganisela yezifo, hhayi eziqondene nabagula ngengqondo.
Omunye umthengi wezempilo yengqondo wembula:
Nginenkinga ye-schizo-affective. Ngangivame ukuba nomuntu osebenza naye, ukufinyelela kumeluleki kanye nokwelashwa kweqembu, konke okwakuyingxenye yohlelo lwami futhi kwangisiza ukuthi ngihlale nginempilo futhi ngiphilile. NgoJulayi ka-2010, ngenxa yokwehliswa kwesabelomali, umtholampilo walapha edolobheni wavalwa, base bediliza bonke abasebenzi. Angisenaye umphathi wecala futhi ngisekelwa ontanga kanye kuphela ngenyanga, uma nginenhlanhla. Angazi ukuthi ngizohlala kanjani kahle ngaphandle kokunakekelwa kwezempilo nokwelashwa engikudingayo.
I-NAMI ingummeli oqinile wabagula ngengqondo, kodwa ababodwa. Ukuvikelwa kanye Nokumela Abantu Abakhubazekile, et al, bafake icala enkantolo ngokumelene noMnyango Wezimilo Wesifunda SaseCarolina. Ijaji kuleli cala kwakunguMichael Baxley owasho ngokungagunci ukuthi emacaleni angu-70,000 XNUMX awahlulele, leli cala โlaliyinkathazo kakhulu.โ
Emyalweni wakhe onamakhasi angu-45 wabhala, โUbufakazi kuleli cala buye bafakazela ukuthi iziboshwa zifile eMnyangweni Wezokuhlunyeleliswa Kwezimilo e-S. Ngaphezu kwalokho, wabalula okulandelayo:
- kwakukhona "ukusetshenziswa kwamandla ngendlela engafanele nokuvalelwa uwedwa"
- ukulinganiselwa kokufinyelela ezinsizeni zempilo yengqondo okube nomthelela "engozini enkulu yokulimala okungathi sรญna..."
- ukugadwa kwezidakamizwa ezinamandla ze-psychotropic kwakungagadiwe kakhulu
โ amarekhodi okwelashwa anganele
Abameli u-Nelson Mullins, uStuart Andrews kanye no-Don Wesbrook bathi iJaji u-Baxley ngokuyisisekelo lithole โukunganaki ngamabomuโ kohlelo lwezobulungiswa bobugebengu okwalingana โnesijeziso esinonya nesingavamileโ ngaphansi komthethosisekelo wezwe. Umbuso uyakhanga.
Kodwa uhlelo lwezobulungiswa kwezobugebengu akulona kuphela olunecala kule nkinga ekhulayo. Abaphenduli abaphambili kubantu abagula ngenxa yezifo ezithinta umphakathi sebephenduke amaphoyisa abopha abantu abagula ngengqondo bengaqondile ababa yizisulu zohlelo lwezobulungiswa bobugebengu. Ukuncishiswa okujulile kwezimali kulaba bantu abasengozini akuyona isikhalazo sabathengi kuphela, kodwa nabomthetho, futhi.
Lapho uGandhi ebuzwa ukuthi ucabangani ngempucuko wathi, โNgicabanga ukuthi kungaba umqondo omuhle.โ ngiyavumelana; nokho, unya lomuntu aluyona imbangela eyinhloko yobudlova bomuntu kumuntu noma inkinga yempilo yengqondo. Ukube ukuhlushwa okumpofu futhi ngezinye izikhathi kobugebengu โkwabancaneโ bakaNkulunkulu kube lula kangako. Kunabasebenzi abaningi abazinikele ohlelweni lokunakekelwa kwezempilo yengqondo, kodwa le nkinga inezingxenye eziningi ezahlukene ezihambayo.
Kulula kusigaba esiphakathi esivikelwe ngokwepolitiki โsamaMelika asebenza kanzimaโ ukuthi abukeke ngenye indlela. Ukugula ngengqondo nokungabi nakhaya kuyinhlamba ephindwe kabili. Sonke siyalingeka ukuba sicabange ngabangenamakhaya njengamavila angenzi kahle nezidakwa. Nokho, kunoma ibuphi ubusuku obuthile basebusika kunomakadebona abangu-76,000 XNUMX abaye bakhonza lelizwe balala kulawo โgrateโ uRonald Reagan akhuluma ngawo. Ingxenye eyodwa kwezintathu yabangenamakhaya igula ngengqondo.
Ingabe ukwelashwa kwabagula ngengqondo kuyahlanya? Ukubavalela e-Rikers Island esikhundleni sokubanakekela ezibhedlela ezinochwepheshe abaqeqeshiwe? Kuzwakala kuhlanya kimi. Ngiyazi nje ukuthi singenza kangcono.
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