Presentation

Intro
Hello and welcome to my presentation about US homelessness, Mental health and drug
abuse in the 60s – 80s and now.
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In this presentation we will be covering
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1960s mental health

The 60's was an exciting time for those in psychiatry. Effective antipsychotic medicine was massively
reducing the numbers of those in asylums. New antidepressants were just coming into market and
the community mental health centres act was signed by Kennedy in 1963. Which allowed federal
funding to be put into community mental health centres and research facilities in the US. This
brought about the start of attempting to de institutionalise the mentally ill.. There were still of
course some improvements needed in terms of treatment. For example, after reading an article
written by a medical school graduate in 1960, she talks about her supervisor believing in the
Stanton-Schwartz phenomenon, which was the belief that agitated patients paralleled
disagreements between staff members. So, when the graduate was punched in the face by a patient,
she was told by her supervisor that it was probably because her and the supervisor disagreed on the
patient's treatment. But things were still looking up in the medical world.

Homelessness in the 1960’s

In the 1960s homelessness wasn't a massive issue for most of America. At least according to what I
could find archived, it was more discrimination that was an issue during this time. In 1968 we see the
fair housing act passed to outlaw housing discrimination. Though this was never really acted on,
especially in this decade. However, there was some fight put up by the government against Los
Angeles' 'Skid Row'. In which roughly half of the skid rows across town were demolished in an
attempt to build new housing. The idea to only remove half was a conscious decision by the
Government as it was a public policy to give those with extremely low incomes somewhere to live.
However, it was also treated as a containment strategy. If those with extremely low incomes are
forced to live in a particular part of town. It causes humanitarian charities to travel to those areas,
meaning those living in skid row wouldn't need to venture outside of it.

The heroin epidemic of the 1960’s

In the 1960’s we see this sudden rise of those addicted to heroin, and for a large percentage, drug
addicts who didn’t initially have access to medical heroin. According to the national Library of
Medicine, by 1964 94% of recently reported addicts were of non-therapeutic origin. This jump was
incredibly sudden, in that same year there are 328 known heroin addicts, but just 5 years earlier in
1959 this number was at 47.
This sudden increase was also interesting as many of the patients were young people, 40% of these
addicts were under the age of 35. This caused a certain fear in society as people began to worry
about ‘sudden defiant youth’ and how the carelessness of them could cause in issue in public health
in the future. So, we see the beginning of tactics used to get young people to stay away from drugs
and of course it starts with scare tactics, which tend to be ineffective due to their inability to
educate.

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1980s’ mental health

In the 1980’s the continuation of deinstitutionalising the mentally ill was well underway. We see a
massive decrease in those needing constant treatment along with many asylums being closed for
good. However, after President Regan’s signing of the Omnibus budget reconciliation act, the federal
mental health spending for the country decreased by 30%. The American psychological Association
posted an article in 2000, that did research on the anxiety levels of college students between 1952
and 1993, and again with children aged between 9 and 17. In this study they found a large increase
in anxiety levels, even suggesting that children of the 80s had a higher anxiety level than that of
psychiatric patients of the same age in the 1950s.

Drug addiction in the 1980s

Crack was a large issue in the 80s. But it actually started with pure cocaine. After cocaine was
removed from products such as Coca-Cola, wine and medicines in the 50s there was a massive
decline in the use of course. But in the 1970s it was incredibly easy to transfer the drug from
Columbia into the US, about 80% of what was shipped from Columbia would made it onto US
territory. By the mid 80s the Medellin cartel, run by Pablo Escobar, was making 4 billion dollars a
year.

Pure cocaine was massively expensive and could go for several hundred dollars a gram. This of
course made the drug extremely popular among celebrities and the wealthy. There was even a story
ran by time magazine in 1981 called ‘high on cocaine’. Which mentions how 'coke is the drug of
choice for perhaps millions of solid, conventional and often upwardly mobile citizens'. Because there
was little research on the drug, it was considered safe by most Americans. In the mid 80s it was
estimated there were 6 million cocaine users in the US.

However, crack cocaine was much cheaper to produce and so to buy meaning those in less affluent
communities began using the drug as well. Pure cocaine and crack cocaine are actually pretty similar
chemically however crack is stronger meaning that the jailtime given to those with crack cocaine
instead of pure is actually much higher. For example, the minimum time you could be sentenced was
5 years for one gram of crack or 500 grams of powdered cocaine. The epidemic of crack in the 80s
was extortionate. Hospital visits due to cocaine overdoses, unexpected reactions, suicide attempts
and chronic effects quadrupled.

Homelessness in the 1980s

In the 80s we see the effect of deinstitutionalisation as a study done in Ohio in 1984 shows that 30%
of those suffering from homelessness, struggle with mental health issues. It can also be said that the
HIV/AIDS epidemic effected the numbers of homelessness as during these times there was an 80%
reduction in federal investments in public housing, along with cuts to social safety programmes.
Homelessness was particularly an issue in New York at this time, in which we see the largest
homeless population possibly in the country.

However, the 1981 Callahan vs Carey case established a right for shelter for those in New York.
Following this, some mayors in New York knew it was their responsibility to care for those in need,
for example, Edward Koch in 1985 ordered police to forcibly move those sleeping on the street on
freezing nights into shelters. Possibly saving hundreds of lives during the cold winters.

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The issue of opioids now

In 2015 more Americans died from opioid overdose than Car crashes and Gun violence. It killed more
people than the 1995 HIV/AIDS epidemic. However, unlike the 1960's these overdoses came from
therapeutic painkillers.

In the 1990s the need to treat pain more seriously was brought forward to many doctors. This was
an understandable request as millions of Americans were suffering with chronic pain every day. And
so, the need to find solutions was prevalent. So pharmaceutical companies pushed for new powerful
painkillers and found themselves with opioids. More well known as their brand names, Oxycontin,
Percocet and Vicodin.

These drugs didn’t have the same relation to the scary word of heroin and other strong drugs. They
were even marketed as a safer kind of painkiller. Because of this, prescription numbers of the drugs
increased massively. In 2012 US physicians wrote 259 million prescriptions. To put that in
perspective. Thats enough to give a bottle to every single adult in the US.

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As you’ve probably realised, this was all a lie. Prescription painkiller misuse numbers soared and
when doctors realised these numbers and pulled back, federal data states that a lot of addicts didn't
stop altogether but moved onto cheaper opioids; heroin and even Fentanyl.

There were 33,000 dangerous drug overdoses recorded in 2015, two thirds of them involved opioid
use.

Purdue Pharma, the producer of Oxycontin ended up paying hundreds of millions of dollars in fines
for their false claims

How about now?

Well, the percentage of Opioid pills being shipped to the us has decreased by 45% between 2011
and 2019, and the shipments of strong 80 milligram oxycodone pills dropped 92% in 2019, from their
peak almost a decade earlier. However, drug overdoses are now even more prevalent in America. In
2022 more that 110,000 people died of drug overdose this was the first time the number exceeded
100,000 in US history. Two thirds of these succumbed to synthetic opioids such as Fentanyl. Fentanyl
is now Americas leading killer for those between the ages of 18 – 47, It still surpasses car accidents,
Gun violence and now suicides.

Now mental health

In this century we seem to be falling into a bit of a mental health crisis. The number of beds for
psychiatric patients have fallen 14% from 2005 – 2010. That year there were only 14 beds per every
100,000 patients. And for those privileged enough to find a well-run private psychiatric hospital, they
can cost over $30,000 per month and do not accept health insurance. In 2019 – 2020 it was found
that 20.78% of adults were suffering from mental health issues. Thats equivalent to 50 million
Americans. Over 1 in 10 youth of the US are experiencing depression so severe it is affecting their
ability to function in school or work settings.

However now a days we have a massive amount of help and prevention available online. If in need
of emergency help of course there is 999, or 911 in America, but also crisis lines specifically for
mental health such as 988 the suicide and crisis prevention helpline, which is available in call form
and text form. And of course, now there is university and employee assistance which are services
that offer guidance in many forms including mental health advice.

Homelessness now
Homelessness now is as bad as it's ever been in the US. Especially in New York, A study done in 2021
found that there were 60,000 homeless people in New York. It is believed that the issue largely
stems from deinstitutionalisation and the opioid epidemic happening right now. In 2023 the annual
homeless assessment report stated that on a single night in the US there was an estimated 653,000
homeless people. Of this number, 24% of them have also experienced issues related to chronic
substance abuse. So how are we combatting homelessness now? Well, there are many sites
explaining things you could do to help, for example the Crisis campaign which mentions; writing to
your local MP, signing open letters to politicians and even sharing your own story to get involved.