184. "No Place for Troubled Teen-Agers" Pittsburgh Post-Gazette, (April 1, 1989). Also published as "Teen Lock-Ups a Scandal; Sally Just Needed Parents" Atlanta Journal-Constitution, (August 22, 1989).
Sally, 16, used to spend entire weekends with an older man in bohemian Greenwich Village in New York City. For a while, she was sleeping with two guys.
When her more traditionally minded, single mother tried to put an end to these liaisons, Sally told her to buzz off, using a less printable term.
Her outraged mother felt she could not “control” Sally and had her committed to a mental hospital with the help of a psychiatrist she knew. Because Sally tried to escape by breaking down a door, she was declared “violent” and heavily sedated. Now she drifts between docility and disorientation.
Sally is one of a growing number of unfortunate teen-agers. A combination of social and economic forces is driving up the admission of adolescents to mental wards. The number who passed through their gates increased by 43 percent from 1980 to 1987 (discharged patients rose from 126,000 to 180,000 for those aged 10 to 19).
There is no reliable information about the proportion of patients who are truly out of control, but experts agree that the country is not experiencing a mental-illness epidemic. As the cases of Sally and many others clearly illustrate, other forces are at work.
The demise of the traditional American family, the large increases in the number of single parents, preoccupation with careers or the “good life,” all have contributed to massive under-parenting. Many parents are so busy, overworked and overcommitted to making a living or to advancing their careers that they do not have the time, energy or inclination to cope with troublesome teenagers.
Some parents - a growing number - “solve” their problems by committing their kids to institutions, in which they do receive some counseling, but in the main are locked up, “medicated,” “controlled.”
Sadly, there is a growing industry that makes its profit partly by pushing parents to institutionalize their children. James R. Ochiffman of The Wall Street Journal, who reported on the role of greed in unnecessary incarceration of the young in mental hospitals, gave the following account.
Mental hospitals, he explains, are under budget pressure because the government is cutting back on payments. Moreover, profit-making chains have entered the field once dominated by non-profit hospitals. Drawing on the fact that mental-health charges (which can be very costly) are covered by many health-insurance programs, they push parents and mental-health professionals to hospitalize many youngsters who could be treated in a doctor’s or counselor’s office - if they need treatment at all. Hospitals mount subtle advertising campaigns that hep to legitimize incarceration in the eyes of the parents, suggesting, for example, that interest in “dirty pictures” is a sign of a disturbed mind.
Even a society that has grown increasingly permissive about family life and parental duties, and that allows the profit motive to play a key role in all areas of human services, must draw the line somewhere. The institutionalization of youngsters who need little more than firm, loving mothers and fathers, regular parental presence and attention, is a new outrage that practically screams out for attention.
Community leaders, ministers and rabbis, editorial writers and all others who speak for and can reach the society’s conscience, should condemn these practices. City and state social-service agencies and voluntary associations must dedicate more resources to counsel “normal” parents on how to deal with troubled teen-agers in their homes. And insurance reimbursements for such hospitalization should be limited to cases approved after careful scrutiny by a panel of professionals who are not tied to the industry. (There are, of course, some legitimate admissions.)
The time to act is now, before the fad catches on. We already delegate the care of more and more of our elderly to nursing homes and our children to often poorly equipped and poorly supervised child-care institutions. The last thing we need is to lock up a growing number of the next generation of Americans in mental institutions, whose track record in curing the disturbed is rather poor, but who have proved quite competent in turning those who function quite well into basket cases.