Funny though that sounds, I am torn on that very real point of view. Those asylums were inhuman and cruel, and at the time, the science and medicine of psychology and psychiatry were no where near as comprehensive as it is today. Someone who is BiPolar would have been locked up for life in 1978 but today that condition can be managed with medication and therapy.
At the same time, we have more mass shooters and crazy people hurting people because there is no place for truly mentally ill people.
That's fair. I occasionally make light, and sometimes not so light, political jabs, and of course most of these issues have 2 or 3 significant sides to them, and I can't imagine any decision on that level that doesn't have some grey area.
In example, I was talking about how the bail system just resulted in throwing everyone poor in jail and releasing anyone who was rich. Obviously that's the case. Simultaneously, you can't just catch someone robbing a store red handed, and then release them back out into the world 15 minutes later. Ankle bracelets, check ins, many possible options are available, but any of the possible decisions would both solve and create real problems. One day, the very first intelligent politician will be elected, and you will know them when they say the prophesied words "I don't know, this is really complicated, and none of us are really sure how the approaches will pan out". Conversely, if it's 2025 and the president is on tv saying, "We have everything figured out cuz we the best", you know you've elected another idiot. There is no certainty with one size fits all solutions for millions of different situations.
In the case of mental health, it's literally one of the most complicated and diverse problems out there. There isn't some gray area, it's all grey area, and as you point out, things change. We're not going to be able to go back to the constitution and find information about what we should change because Prozac was invented. That's what people do though. Q: how should we handle the issue of medication vs on site supervision of mental illness in the face of rapidly evolving mental care science? A: Big government is bad so people with brain tumors should just buck up and pull their own weight. Ummmm, I'm not sure that fully addresses the nuances of nationwide mental health issues.
The town next to me gained major financial advantages during the 70s by deregulating factories in the area, and incentivizing them to move into town to help create jobs and wealth. Of course that worked for a while, like taking cocaine to run faster. Decades later, Terre Haute was covered from end to end in the smell of toxic chemicals. I'm not talking about some mild smell, I mean when you walked down the street there was a thick smell of industrial chemicals in the air. Steve Martin once called it the armpit of America. Property values crashed, factories shut down, and here's where it gets relevant.
40 years later, this town had about 7x the national average of mental health problems. People grew up breathing contaminated air and drinking contaminated water, and the town became poverty stricken and riddled with disease, both physical and mental.
When I was a kid, I wanted to play video games instead of doing my homework. So they sent me to a doctor, one of the only ones in town. After about 10 seconds of chat, he prescribed lithium. Even as a dumb 8 year old kid I couldn't help but notice the lithium wall posters, lithium carry bag, and when I left there was a lithium bumper sticker on his car in the parking lot. Years later I compared stories with others from town, and without exception every single person, with all different kinds of issues, had been prescribed lithium by this same doctor. He was bringing in 500k a year easy, and this guy was basically an idiot, like Dr Oz. He just took bribes from the drug company, and prescribed their drug to everyone indiscriminately. Here's where it gets terrible. So this halfwit doctor that charges people in a poverty center 125 an hour to "figure out what medication they need" could have been replaced by a lithium vending machine. And he got rich, so rich in fact that he began building asylums in town, to house all the people that went crazy in this reeking minimum wage city full of religious fanatics and crack rock enthusiasts.
Today I think he owns 3 asylums, maybe it's 2, been a while since I checked. I have friends that worked as orderlies in those asylums, and they report that the multimillionaire doctor has a new miracle drug. Thorazine. When a person starts having a mental breakdown, and starts becoming a hardship, they get shipped off to one of his "recovery centers" Once there, they are physically force fed Thorazine until they become docile. Humans intentionally turned into zombies for him to profiteer off of. Like the lithium before it, one size fits all. Bad divorce, ocd, bipolar, whatever, just pop em with a tranq dart and collect the money. My friend told me a grim story about his time working there. He said that each day they march the inmates down these long white corridors to different areas of the asylum, and right at head level, there are these red lines stained into the walls. It's from all the inmates dragging their heads along the sides of the wall as they walk, until they bleed. It's happened so much for so long that the red lines are now permanently in the paint, the blood of hundreds of former people, on a comatose death march to the next white room. The doctor makes more money the longer they stay, and once on his medicine, they can barely speak to defend themselves, much less prove themselves sane enough to be released. All he has to do to keep his checks coming is make sure they never wake up from the Thorazine coma. There are girls from my high school in there, people that used to be ok, before a privatized mental health system pulled them in for post partem depression or some other temporary thing.
So are state run asylums the answer? IDK, they would probably have their share of issues as well, always did right? But one thing they wouldn't have would be a financial incentive for psychopathic businessmen to destroy lives. I expect they would be overloaded and looking to restore people to health as fast as possible so they could make room for incoming cases.
Lastly, here's the single most difficult aspect when discussing mental health policy. There is not a single person alive that's 100% sane. We grade on the curve. If someone can hold down a job and be pleasant towards others, we call them sane, even if they have a flat earth bumper sticker and talk about the underwater volcano lord Zenu. Nobody is trying to put Tom Cruise in an asylum. Belief in ghosts and spirits is about 70% in the town I described, and people earning minimum wage for skilled labor vote to lower minimum wage, but none of them are considered insane. Steve Jobs had mental health problems, and overdosed on acid 50 times, but it's no problem. So once again we have to ask ourselves, are we imprisoning mentally ill people, or just people that are too poor to justify their mental illness by making or inheriting some cash. Is anyone talking about putting MTG in a facility because she thinks Jewish people have space lasers that they use to set forest fires in republican neighborhoods? No, she's rich, so that's an opinion rather than a sign of cognitive imbalance.
Does the subject of your documentary need Jail, or pills, or to be under medical supervision 24/7? I think we don't really know yet how the system should work, and everyone is too focused on looking confident in their ideologies to bother figuring it out.
Long story, but since you're somewhat of an investigative journalist, I thought you might find it interesting.