For more than 30 years, progressives and conservatives have differed over how to think about mentally ill homeless people. Progressives have argued that the fundamental problem is the lack of funding for mental health services, while conservatives have argued that the problem is the unwillingness of progressives to mandate care.
Now, a new book, Conservatorship: Inside California’s System of Coercion and Care for Mental Illness, by New York University sociology professor Alex Barnard, who I interviewed for this week’s podcast, argues that progressives and conservatives are both partly right and partly wrong.
Progressives are right that America has far fewer psychiatric beds per capita than other developed nations.
But conservatives are right that we also mandate psychiatric care less than many other developed nations.
Barnard’s insight is that if you improve mental health care, fewer people require hospitalization, which is the most expensive part of the system. Witness the decline of psychiatric beds in Europe in general and the Netherlands in particular.
As such, Barnard’s argument scrambles the older liberal-conservative divide on mentally ill homelessness. If we had a better care system, we wouldn’t have to mandate care as much. But if it were easier to mandate care, people with mental illness would not become so sick or homeless at such a high rate.
