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What is it with all these new institutions being built? I thought the move was to get rid of institutions. Evidently not. A story from San Francisco Business Journal tells of that city's bullheaded plan to rebuild the aging Laguna Honda city institution to the tune of nearly $750 million.

On the heels of that outrage came news on Tuesday that not only was Kentucky committed to keeping open its troubled Oakwood institution, despite repeated citations for abuse of residents (Ragged Edge news items here and here and here) -- but that it was going to spend "up to $1 million a month" to do so -- at least for the next several months. ( More about that here.)

Not to be left behind by the re-institutionalization bandwagon, tomorrow VA Gov. Mark Warner plans to unveil a new budget that includes "$290 million to fully replace two aging psychiatric hospitals and two institutions that house people with intellectual disabilities." (Read  story about that.)

What's behind it? Jobs?

The San Francisco Business Journal has this telling paragraph:

... the Service Employees International Union has provided the political juice. The facility has nearly 1,600 full-time-equivalent employees, and 1,357 -- 85 percent of them -- are affiliated with SEIU, one of the city's biggest political players. The union denies that its motive is protecting jobs, but says the city can find the money to both rebuild Laguna Honda and improve care in the community.

Sources close to the Oakwood circus lay the blame very nearly at the same spot.

Oakwood is the largest employer in the small Kentucky town of Somerset. Over a thousand folks have jobs at Oakwood. And they like those jobs. They pay well, and they want to keep them. The state wants them to keep them, too. Good employment for a small Kentucky town.

There are only about 300 residents, so this translates to close to 4 staffers per resident.

If I had a household staff of 4, my home would be on the cover of Architectural  Digest. Not to mention that my clothes would be ironed (and the missing buttons sewn back on!), my gardens the envy of BHG readers, my parties constant and to-die-for.  Sorta makes you wonder what all those staff are doing at that institution.

My source tells me that very few folks other than the state's Protection and Advocacy agency are calling for the closure of Oakwood. There are hardly any disability rights groups in Kentucky. There are some parent organizations, and frankly, it seems, they get money from the state themselves and don't want to jeopardize it by saying anything. And then, a lot of the folks in those groups are "professionals" -- as in "mental health professionals," you know -- and they work for the state. So their lips are sealed, even if they believe in their hearts that Oakwood should be closed. Which maybe they don't. I don't know, since they don't talk about it.

I believe that many of the Oakwood employees, like the Laguna Honda employees (and no doubt the Virginia institution employees) are members of SEIU. SEIU is a big national union.

Unions  have certainly been known to fight for what are reactionary social practices in order to protect jobs, but in most cases they've lost. While I would generally like to be supportive of the labor movement, these people pressing to keep institutions open so they can have jobs are taking a position I simply cannot stomach.  I know that with SEIU that disability activists have worked with them, and so I know that SEIU can "talk the talk and walk the walk" -- except they don't. (Ragged Edge has run stories on SEIU in the past -- here and here.) Or they do so selectively. Very selectively. They want it both ways -- jobs in "the community" and jobs in institutions, and most people see nothing wrong with that. Which is why stuff doesn't change.

The big problem, as with most stuff when it comes to disability, seems to me, is lack of public outrage. The public by and large  doesn't really care whether institutions exist or not. They don't know the indignity -- hell, the horror (let's be exact here ) -- of institutional life. They seem not to believe it when it's told to them, or they figure that the real horror is just the disability and that no life is ever going to be good for Those People, so what difference does it make whether they are in an institution or a group home (which also abuses them -- see my diary entry on that )

The SF Business Journal article gives a good example of this kind of thinking, in a way. Reporter Chris Rauber's coverage begins with the story of Gerald Scott:

Gerald Scott has been a resident at Laguna Honda Hospital for roughly half his life, ever since he was jumped and severely beaten as a young man 25 years ago. Now he hopes to leave.

Scott's attorneys say he's significantly disabled, with both cognitive and physical impairments, but would be capable of living in an apartment as long as he had an attendant to help with things like cooking, managing money and getting to doctor's appointments. ...

Note that Scott is a "patient" -- but also credit Rauber for referring to the man in subsequent references by his last name, which is standard for news journalism, rather than calling him by his first name only, as do so many news stories when reporting about disabled people. (This is a very small point and it doesn't really belong in this blog entry, but it's such a telling thing that I wanted to alert you to it as you watch and read the news.)

But then here comes the next sentence from Rauber:

Scott has had a sad life, and there's not much Laguna Honda or any other institution could have done to deal with much of his pain since Friday, June 13, 1980, when he was assaulted on a Tenderloin street, on the way to pick up his daughter.

There you have it: the pain of the disability is  so great as to make other issues -- such as where and under what conditions one lives -- simply pale into insignificance.  You'll see this all the time, too, in coverage of disabled people if you watch for it.

For most people,  the idea of Those People living in their own homes with things under their own control is simply too much to even fathom.Granted, not every person with a severe disability also has the cognitive and emotional ability to control their lives but you can bet your sweet patootie that far more of them can do it than are believed to be able to do it. And almost none of them (we're speaking statistically here) get that chance. That is to say the powers of society are arrayed against that. Including the SEIU, which could be the solution, if they put on a big national drive themselves to close the institutions where they worked and pressed for in-home services, where they could work as well.

Originally posted to mjohnson on Thu Dec 15, 2005 at 12:14 PM PST.

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Comment Preferences

  •  shades of gray here (none)
    Had you ever seen Chicago's Uptown neighborhood in the late '70's/early '80's?  It was home to the highest per-square-mile concentration of formerly institutionalized patients in the US.  And it was not a pretty sight.  What began as a well-meant effort to free people turned quickly into dumping them into substandard housing and taking their Medical Assistance checks.

    At the end, what matters is how well we do something, even something well-meant.  Good intentions, well, there's this road, see...

    If you vote Republican, you vote for corruption.

    by MN camera on Thu Dec 15, 2005 at 12:39:48 PM PST

  •  Wasn't it Reagan (none)
    who pushed/promoted de-institutionalization?  

    net result: many mentally ill people ended up homeless out on the streets.

    Obviously abuse is a major concern which needs to be investigated and addressed, but the push to create new institutions is not in and of itself a bad thing.  There ARE mentally ill people in this country, and facilities that can house/take care of them would seem on the surface to be prefereable to having them wander the streets.

    Although I admit, I have never really weighed the pros and cons of the issue. So kudos to your diary for at least making me think about it.

    The revolution will not be televised - on FOX

    by Uranus Hz on Thu Dec 15, 2005 at 12:45:59 PM PST

    •  The push to create new institutions ... (none)
      "... is not in and of itself a bad thing," you write.

      I think it is a bad thing. If one believes that institutions can be made "good,'" then surely one can also believe that smaller community settings can be made "good." And surely that is better for the people involved. Maybe not for the rest of us, though. There's the rub.

      De-institutionalization in and of itself did not create the mentally ill people on the streets; the lack of funding and community housing and programs to replace institutions is what created that problem. Lack of political will, in other words. People in institutions often get horrid care (read the links in my diary) but they're locked away and most of the time we can convince ourselves that the institutions are "doing a good job."  Homeless mentally ill people on the streets are noticed; thus the big stink. The problem is that our society does not care enough to truly fund programs to help people live with dignity. Re-institutionalization is not the answer. Funding the right kind of dignified services is the answer, I truly believe. But people want institutions.
      Virtually any study you want to look at shows that funding institutions is more expensive than offering community-based services. The math is straighforward. It's our desires that are conflicted and confused, I think.

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