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`Cuckoo's Nest' Revisited

November 22, 2001

The people lined up at soup kitchens and rescue missions today will get free turkey and dressing. And by dark many of them will be curled up in ragged tents and cardboard boxes, trying to sleep while their neighbors scream at imagined voices. Tomorrow, well-meaning citizens will hand some of these same people money or a sandwich, affording them the opportunity to spend yet another night on the sidewalks they call home. It doesn't need to be this way. And perhaps this day for counting blessings is as good a time as any to ponder: What went wrong? What can be done?

The answers to both questions can be found, in part, in the legacy of author Ken Kesey, who died this month. "One Flew Over the Cuckoo's Nest," his 1962 novel about a sadistic psychiatric ward that squelched individuality with brain surgery and zombifying medications, accelerated a growing reform movement against such abuses in all-too-real psychiatric "snake pits." By the early 1970s, state institutions had released hundreds of thousands of mental patients. Tragically, the housing and services that were supposed to help them flourish in their own neighborhoods never materialized, leaving many to live on sidewalks or under freeway overpasses.

This is wrong. There are ways to fix it. If legislators would now show gumption and back these fixes up with carefully prescribed laws to compel the treatment of those who cannot or will not help themselves, this civic shame could be remedied. Here's what it takes:


The Village in Long Beach, a project of the Mental Health Assn. of Los Angeles, is a model of "supportive housing." A staff of professionals and former "members" walk people with mental illness and sometimes addictions through ways to kick their drug habit, get proper medication, find a place to live and work [(562) 437-6717].

Other successful examples include the Salvation Army's shelter in Bell [(213) 896-9160] and LAMP, a downtown organization that, in addition to running a drop-in center and offering housing and treatment options, now gives a lucky few people with mental illness and addictions the chance to escape to a donated ranch near Bishop, complete with a working garden, horses, llamas and views of the eastern Sierra [(213) 488-9718]. Other worthy groups are listed at, the Web site for the Los Angeles Homeless Services Authority, which coordinates homeless services for the city and county.


Before most people with severe mental illness are ready to move into treatment and long-term housing, they need places to stay for a few nights or weeks. But many with mental illness have a deep fear of traditional shelters, some of which can be hellish even for those who don't hear voices. That's why Sheriff Lee Baca's idea of opening an open-air homeless safety center near downtown is a pilot project worth supporting.

Even in these tough budgetary times, state representatives should find the money to build Baca's center, because study after study shows that simply letting mentally ill and addicted people cycle from jail onto the streets and back is far more expensive than taking solid steps to help them find a place to live, get treatment and work.


Many mental health organizations send workers who have wrestled their own mental illnesses and addictions under control out into the streets to cajole people to make use of services. This is important. But law enforcement agencies have the most contact with people living on the streets, and can have the biggest impact.

The county Department of Mental Health has joined with the Los Angeles Police Department and the Sheriff's Department to create 30 teams of law officers and trained clinicians who work to coax people out of their encampments. One team, Deputy Craig McClelland and nurse Suzanne Newberry, is paid for, in part, by the Metropolitan Transportation Authority, whose administrators are eager to confront the problem of mentally ill indigents sleeping at bus stops and causing problems on buses. Most of the money, however, comes from the state. Legislators and Gov. Gray Davis should be encouraged to continue to support--indeed to increase funding for--bills sponsored each year by Assemblyman Darrell Steinberg (D-Sacramento). This provides money annually for the teams, supportive housing and similar mental health programs.


Los Angeles' mental health court, located in a former pickle factory north of downtown, falls far short of what it could be--and what model courts in other places have already become. To fix it, Los Angeles' judicial bureaucracy must replace conveyor-belt justice with a true "problem-solving court" designed to keep people with mental illness and addictions from being arrested for nuisance crimes, jailed and then spit back onto the streets in a sad, expensive cycle.

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