Dear Texas let's talk about: Deinstitutionalization and the Definition of Crazy
Crazy is often defined as doing the same thing over and over again and expecting a different outcome. So, let's talk about how asylums of earlier days became popularly known as the snake pits of the 1940s and 1950s, likely due to the fact that public psychiatric hospitals were provided minimal resources to meet the needs of huge patient populations. These hospitals were progressively closed down, and the people who had worked there were vilified, perhaps as a way to assuage the guilt of what happened to their former residents. Kinda of like when Ann Simmons, a 62-year-old patient, died in February 2012 at Terrell State Hospital due to a pulmonary thromboembolism (blood clot).
Ann was imprisoned in mechanical restraints for 55 hours. To be clear, we know that restraining a human is extremely risky and should only be for brief periods to prevent imminent harm, with strict limits: typically no more than 4 hours for adults, 2 hours for ages 9-17, and 1 hour for under 9, with frequent checks for circulation, skin, and vital signs, and immediate removal if risks increase or the person calms down, as prolonged restraint risks suffocation, cardiac events, injury, and death. Yes, folks, you can die from being restrained even without a cop standing on your neck. Still, the hospital's internal investigation and that of the Texas Department of State Health Services initially found no fault with her treatment- weird. After another investigation by the federal Centers for Medicare and Medicaid Services (CMS), which found Ms. Simmons died from a blood clot that formed in her immobilized limbs, a condition associated with long periods of immobility and dehydration, the case led to a state-level overhaul of oversight and death review processes for all Texas psychiatric facilities. Ms. Simmons' death was also a factor in state officials exploring the privatization of the hospital's management. But how is privatization going to help? To phrase that same question differently, would capitalism (meaning selling it to a private owner who runs the hospital for a profit) provide better care? (a safer, more empathic, and kinder element to health care?)
No.
The privatization of hospitals can boost their efficiency and cut costs. This happens by reducing staff, which means fewer people to take on the heavy workload, more work mistakes (DEATHS), and longer wait times for patients. In plain English, capitalism is crappy for people who need care, yall. If the hospital were to become a for-profit business and determine that a service is not profitable, it would simply not offer it, no matter how much people need it. In fact, capitalistic healthcare is always going to choose profit over people because capitalism must exploit people to make money. Working for someone else is inherent to capitalist relations. The word capital is just a term to describe a workers labor and the the control the company owner has over that workers time, body, and wellbeing. (Privatization overworks the employees, compromises community care, and completely ignores those who cannot afford their high costs.) Now consider that our taxpayer dollars fund medical research that drives scientific. Meaning we finance the discovery of new meds and treatments, either directly or through subsidies. (A subsidy is financial aid given by taxpayers to a government or public body to help an industry, business, or individual. The point of subsidies is to supposed to be to keep prices low, promote specific activities (like medical research), ensure essential services to the people, and achieve public welfare goals. Subsidies can take the form of direct cash payments, tax breaks, loan guarantees, or other benefits.) Let's take Pfizer as our example. Pfizer alone receives massive taxpayer-provided subsidies, especially from state/local US sources (hundreds of millions in loans and tax credits) for facilities and R&D = research & development. Pfizer is worth $145.98 billion but pays significantly low U.S. effective tax rates, often near zero or even negative in recent years (like 2023). Because they used offshore subsidiaries and exploited loopholes in the 2017 tax law, despite massive revenues from products (its overall effective tax rates (e.g., 5.4% in 2019, 9.6% in 2022) were far below the statutory 21% U.S. corporate rate. The needy Pfizer company's CEO Albert Bourla received approximately $24.6 million in total compensation for fiscal year 2024 in addition to our generous donations. That seems like a large paycheck for a guy getting government welfare out of taxpayer pockets, y'all. He kinda sounds like that able bodied guy on welfare we hate having to support. Pfizer then has the gall to charge American's outrageous prices for the very medicines we paid for them to develop. But I digress... Let's get back to my main point: mental institutions are coming back!
We should all be shocked and appalled after what we saw happen to Ann alone, but let's take a moment to recognize that Ann is only one of many stories. The question is, who is going to go into these asylums Abbott is spending billions on?
I have a theory. Involuntary commitment for homeless individuals is a subject of ongoing debate and policy discussion in Texas and nationwide. Let's be clear here, historically, people involuntarily hospitalized included those with chronic mental illnesses (like dementia, neurosyphilis), but also: the elderly, the poor, women deemed "morally insane" for having premarital sex, political dissidents (i.e., Antifa), and even children for social control and abuses common under laws permitting commitment for vague legal reasons and by family members (think abusive husbands here).
This new idea for dealing with unhoused people just happens to come amid an affordability crisis in Texas. Greg Abbott is not looking for ways to improve the lives of Texans. Nope, instead he is suddenly on a crusade to crack down on public encampments (especially in Austin) and enforce anti-camping laws (HB 1925). (The lack of housing supply is cited as one of the primary reasons for rising house prices but we all know that tariffs have created a bottleneck in new housing development due to supply costs.) Even more ironic, Abbott cites public safety as his main concern for razing people make-shift homes because these unhoused people might have weapons. How does he keep a straight face while saying that, when he also allows all Texans to open-carry without so much as a safety class (HB 1927)?
(It's the wild, wild west here, y'all and that's the perfect topic for a whole other blog about crazy I might write someday.)
How much do you suppose it would cost to house all the unhoused people in Texas? (The 2024-2025 biennium provided $2.5 billion for state psychiatric hospital expansion and $239 million in grants for new local beds, aiming to expand inpatient care. $239 million, especially for new local mental health facilities in rural areas, adding hundreds of beds for you, MAGA.) I hear you screaming at me: "Nuh uh, I work!" You should probably consider that while it is difficult to determine the exact number of people who are employed and living in their vehicles, "hidden homeless," estimates indicate that 40-60% of all people experiencing homelessness nationwide are employed. If you sleep in your car and that car gets towed, now what? Why does anyone believe a working person should have to live in their car?
AI says there are approximately 39,000 people who live unhoused in Texas, multiply that by Housing Forwards estimate of $25,925 per person to get them off the street and you get $1,011,075,000 which is one billion four hundred eighty-eight million nine hundred twenty-five thousand less than Abbott's 2.5 billion for asylums. I just saved us taxpayers over a billion dollars and prevented people from being killed in insane asylums y'all.
People are funny; they hate paying taxes to provide welfare for people, but then they will fight to their deaths to assert that people who flip burgers shouldn't make a living wage. Sit with that dilemma for a while. Everyone was born just as human as any other so it is a harsh belief that if your highest skill set happens to be bagging groceries, mopping floors, or flipping burgers, you don't deserve to live legally, y'all. Eight hours of work a day is still eight hours a day.
So, lets follow our own American logic: because we are afraid we will be taken advantage of by poor and not debilitated enough people (the able-bodied guy on the couch), and we also don't believe certain "únskilled" jobs meet the necessary requirements of owing people a living wage, our answer to this dilemma is to simply throw people into asylums that we will also, as taxpayers, have to pay for. We think throwing people into asylums against their will, asylums, mind you, that have already proven to become abusive and inhumane, are a good solution to this problem.
Hmm. It seems to me that people with these circular ideas of fixing things meet the criteria of crazy by definition. They just keep doing the same things, expecting different outcomes.
(Part 2 is coming and its called Are Conservatives Crazy, Y'all?)
Citations:
Edwards, C. (2025, March). Corporate Welfare in the Federal Budget. Cato.org. https://www.cato.org/policy-analysis/corporate-welfare-federal-budget-0
Fidler, F., & Wilcox, J. (2018, December 3). Reproducibility of scientific results. Stanford Encyclopedia of Philosophy. https://plato.stanford.edu/entries/scientific-reproducibility/
Lindsay, J. (2025, April 28). Man with three faces: Politics, pathology, and the modern selves. New Discourses. https://newdiscourses.com/2025/04/man-with-three-faces-politics-pathology-and-the-modern-selves/
Sherman, R., Boutte, G. S., Cropf, R., Hirsch, R. L., Cupp, S. E., 30, H. B., Balta, H., Saha, Dr. K., Suto, R. J., Lowe, B., Abdallah, A., Goldberg, J., Lockard, A., The Fulcrum, Nevins, D. L., Corbin, S., & Moriarty, C. E. (2025, August 30). Shared psychosis or political pathology?. The Fulcrum. https://thefulcrum.us/ethics-leadership/mental-health-of-trump-supporters
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