Where Should People Live: A Modern Therapy Collides with "NIMBY"
By Michael Rosberg, Ph.D.

Providing innovative, community-based treatment options for the mentally ill is becoming almost impossible. For example, we recently attempted to open a new residential treatment center and day services program in the city of San Fernando. However, our efforts were defeated. In a classic example of "Not In My Backyard" (NIMBY), the neighborhood and zoning commission overwhelmingly rejected our proposal. Interestingly, this proposed environment was not new to that community. In fact, the property had operated for almost 30 continuous years as a treatment center. It appears that the agendas of the local residents, politicians, and perspective treatment staff and clients were complicated, politically intertwined, and in considerable conflict. This defeat was unfortunate, as the new center would have represented a wonderful opportunity for the mentally ill clientele to live in a vibrant neighborhood.

NIMBY arises out of the ignorance and fear generated by misinformation. For example, it is erroneously believed that neighborhoods that welcome community-based treatment centers will experience a rise in crime rates, a decline in property values, and an unsafe environment for its citizens. What follows are some facts. Nearly one-fourth of all hospital beds in our country are occupied by the mentally ill. These individuals are also grossly over-represented among the homeless. Because many people with a mental illness are not strong advocates for themselves, their needs (for such things as innovative, community-based treatment centers) often times go unheard. Even today, these unfortunate people are frequently hidden away on backwards of hospitals and rarely allowed to live in the very communities where they were raised.

People often fear what they do not understand, and for many of us, mental illnesses falls into that category. This fear is amplified by the usage of words such as "insane". Many people do not understand that this is a legal term and not a psychiatric diagnosis. The term "insane” suggests that all mental illnesses have similar symptoms, and that all the people who suffer from them are the same. In addition, individuals with a mental illness rarely make the news unless a sensational story arises that perpetuates the outdated and one-dimensional stereotypes that appear to be so popular in the media. For all of the recent advances in medical science, there still rages the most incredible misconception of the mentally ill.

Research has shown that the vast majority of people who are violent do not suffer from a mental illness. Public perception has assumed mental illness to be linked with violence. However, violent behavior in persons with mental illnesses represents only a minor contribution to all violent crimes. In a recent study by the NIMH, it was estimated that the incidence of violence amongst persons with a current mental illness is no greater than that in our general population. This is further supported by the American Psychiatric Association, which reported that although people assume the mentally ill behave more violently than others, the studies do not support this belief. Bruce Link, a psychiatric epidemiologist at the Columbia University School of Public Health in New York stated, "If you want to protect yourself from violence, you would do just as well to avoid men and teenagers as you would to avoid people with mental illness."

So, why should we demand that people with mental illnesses be allowed to live in communities? The answer is simple. All individuals, regardless of their disabilities, deserve the right to live with dignity within the community. Deinstitutionalization must be more than just a "good idea". We must all fight to make it a reality. With our failure to create a new center in San Fernando, our community has, unfortunately, only reinforced the stereotypes and denied countless people the opportunity to live and be treated in their own neighborhood. Finally, let's answer the proposed question, "Where should people live?" They should live where they wish, and we should help them to do so.