From Bad to Worse to the Streets – 

April 17, 2020 – Over the course of the late 20th century, psychiatric hospitals emptied out about 1.4 million of their patients in a process of de-institutionalization. But most didn’t land on their feet. “What happened is that people weren’t de-institutionalized, they were trans-institutionalized,” said Rosenberg. “They went from one institution to another: from the asylums to the jails, and the streets.” Many patients Rosenberg follows also find themselves in the L.A. County Hospital, where overworked staff counsel, restrain, and try to treat them. For cities, the fallout of this exodus is clear. California, which led the charge in emptying its hospitals of patients, is now afflicted with some of the highest homelessness rates in the country. Not all unhoused people are mentally ill — estimates range from a quarter to more than a third —  but those who are struggle to keep up with medication, and have encounters with law enforcement that can escalate.


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