This is actually my first post on that ever-controversial subject of HOUSING, Fair,
Affordable, Subsidized, call it what you will.
It won’t seem that way, because the immediate subject is a specious "threat" to housing in Norristown.
I begin with it because that allows me to dismiss the threat as nonexistent, freeing me in later posts to focus on the relevant
issues. Doing it this way also allows me
to demonstrate that even “authoritative” sources should be viewed with a
skeptical eye, and I never miss a chance to make that point.
Deinstitutionalization is the word used to
describe a period when society concluded that treatment of needy individuals is
better accomplished in a community setting than by incarcerating them in
institutions. It is considered to be an
outgrowth of the Civil Rights movement. Until
1963, standard policy had been to send the mentally ill or the mentally
retarded away, to “institutionalize” them, due to the cultural stigma
surrounding both conditions. In 1963
President Kennedy signed the Community Mental Health Centers Act, which
initiated a new national policy to serve people in the community, in “the least
restrictive environment,” and not isolated in hospitals. The Commonwealth of Pennsylvania followed in 1966 with the
Mental Health/Mental Retardation Act.
The state’s plan was to grow the community based services the former
patients being released needed.
At least that was
the way it was supposed to go. The release
of people judged capable of living in a community environment with varying
levels of assistance proceeded apace; by the late 1960s Norristown State Hospital (NSH) was releasing people in accordance with the directive. This is not well understood locally; most
date deinstitutionalization after “the Broderick Decision” in Halderman v. Pennhurst, which was issued
in 1977. The Pennhurst case contributed
to the local wave of deinstitutionalization, but Pennhurst was a state hospital that
housed only persons suffering from mental retardation. Norristown State
Hospital housed only patients with mental illness. There were many court decisions involved in
the overall process, but they became subsumed into a national advocacy movement for
several groups of people.
Unlike Pennhurst, Norristown State Hospital was not closed down, but it
did discharge many patients judged capable of living in the community with
assistance. The subsequent
experience of both the individuals themselves and the Norristown community into
which they were inserted provide a microcosm of what happened nationally. Neither the Federal Government nor the
Commonwealth (nor any other state, for that matter) ever provided the funds
necessary to properly establish, let alone grow the community services that
both the mentally ill and the mentally retarded needed so desperately. The level of support some of these people
needed was underestimated, as was their economic situation. These people were not only poor, most had
little or no experience in the commonplace events of holding down a job or
living in a community.
Deinstitutionalization was yet another
example of a good idea that suffered greatly in its execution. It was a national disaster, pretty much all
the way around. What should have
improved the conditions of its intended beneficiaries did for some, but
consigned far too many to homelessness and life on the streets. Locally, it removed NSH as a community asset
it had always been, one of Norristown’s largest employers. The exact number of how many people moved
into some form of assisted living—as well as where they were moved to—is
lacking, although an attempt was made to reintroduce as many as possible back
into the communities from where they had come.
Even if the
numbers could be pinned down, they would not convey the perception that
arose about the damage being done to Norristown. The chapter about Norristown in Montgomery County The Second Hundred Years,
the county’s official bicentennial publication in 1984, contains a telling quote
(on page 470) about the effects of deinstitutionalization on the community:
“Quite
a few residents, still on government assistance, were once under treatment
at
Norristown State Hospital, Eagleville Hospital and Rehabilitation Center, or
some other
nearby institution. In 1980 about
sixty-five halfway houses were
scattered about the borough to the dismay and annoyance of many a citizen."
The quote is twice unfortunate; unclear on actual numbers and confusing in its use of
terminology. How many constituted “quite
a few”? This would have been useful to
know, because sixty-five halfway houses is a large number, particularly as
halfway house sounds suspiciously like “group home”. The phraseology certainly leads you to
believe that rather more than sixty-five individuals were causing “dismay and
annoyance” in Norristown that year.
Even greater
confusion arises from incorrect terminology.
A “halfway house” is one housing alcohol or drug patients on a temporary
basis. They do not house those with mental illness or mental retardation extensive enough to have hospitalized them in the first place.
Besides, the assistance needed by such people is permanent; there is no
“halfway” involved. “Halfway house” had already assumed the status of all-inclusive buzzword, and its use only serves to
confuse, not enlighten.
This conflation
of separate subjects has assumed the status of conventional wisdom among those
that lived in Norristown during that era, and left a residual fear that it
could happen all over again. This is why
the numbers do not matter; the perception does.
A document
entitled: “2012 Analysis of Impediments to Fair Housing Choice for Norristown,
” prepared by Urban Design Ventures, of Homestead, Pa., stokes that fear. It is the kind of official document one sees frequently these days, a combination of American bureaucracy and Maoist
“self-criticism,” wherein municipalities or programs sum up what they have
failed to accomplish and lay out how they are going to correct their
shortcomings in the future. It was
generated, I suspect, by the mounting complaints about how housing choice
vouchers are being distributed in Montgomery County (more about that
fascinating subject next week!). It can
be found on Norristown’s website. I will
reference it again, on the subject of “fair housing choice” itself, but
the document also addresses the possibility that mental patients might be
released into Norristown once again, perhaps even replicating the town’s
previous experience with deinstitutionalization. This must be disposed of before we move to
actual problems.
Impediment Nine
(there are more) is “Deinstitutionalization of Norristown State Hospital
Patients”. This is what follows that
title:
“With the reduction in the number of inpatients that will be housed in
the state
mental health care facility in Norristown, there is a possibility that the
dispersal
will be into the surrounding neighborhoods, where there are more
rental units
than single family homes, and the area is already impacted.”
There are two problems with this statement. First, it appears to assume that a reduction
in the number of mental patients at NSH is actually being planned. There is no—repeat no—evidence that such a
move has even crossed anyone’s mind.
Norristown State Hospital is a mere shadow of its former self, but it remained open when several other State hospitals were closed, and is now an integral
part of a regional program of health services.
Second, the
sentence’s tone seems to indicate that there are many mental patients still in
NSH, enough for their release to impact the municipality’s housing market. This is also not true. Although NSH now serves the entire eastern
half of Pennsylvania, its mental population is capped at eighty-six beds, with
each county allotted a specific number.
There are actually some 130 people housed there at present, the result
of other counties exceeding their caps, as ordered by different courts. These
are actually patients from the criminal section, which is a cause for
concern. Of these 130 however, only
twenty-two beds are allotted to residents of Montgomery County. Even if some court were to order NSH closed (a
more than far-fetched proposition), only those twenty-two people would be
released into Montgomery County, and not all into Norristown. The remainder would be sent to their home
counties. But that's not going to happen anyway.
Deinstitutionalization in Norristown is over, and it's not coming back. It is long past time to focus on real issues.
Deinstitutionalization in Norristown is over, and it's not coming back. It is long past time to focus on real issues.
(My thanks to Nancy Wieman, Montgomery County Deputy
Administrator for Mental Health Services, for much of the information contained above)