Attending a meeting near Union Station in Washington, D.C., requires me to park a few blocks away and then walk under a bridge to an office building. People in business attire, like me, step carefully around the homeless men and women who have pitched tents under the bridge. They look filthy and miserable, especially in winter.

The persistence of large numbers of homeless Americans is one of the signal policy failures of the past two generations. A 2015 survey found that more than half a million people are homeless on any given night. According to, about 45 percent of them are suffering from mental illness. When they are not on the street, many severely mentally ill people wind up in even worse surroundings. Jane Brody of The New York Times reports that “the country’s three largest facilities housing the mentally ill are jails: the Twin Towers in Los Angeles, the Cook County Jail in Chicago and Rikers Island in New York City.” More mentally ill people are in jails and prisons than in hospitals.

Some homeless people are on the streets or in shelters due to misfortunes that no human society ever completely eliminates, but most are afflicted by mental illness or have substance abuse problems or both. According to the Substance Abuse and Mental Health Services Administration, 60% of the chronically homeless have mental health issues.

Governments at every level spend billions on the homeless, yet the numbers sleeping on the streets remain high. In Republican and Democratic administrations, in liberal and conservative regions, thousands of disabled people, some veterans who have served their country, sleep under bridges and in abandoned buildings, and eat out of trash bins.

This is the long tail of the de-institutionalization policy adopted in the 1960s, when America closed down most of its mental hospitals, dumping the mentally ill onto the streets and calling it compassion. Films like “One Flew Over the Cuckoo’s Nest” cemented the public perception that mental health treatment (especially electroshock therapy) was thinly veiled torture. Since 1955, there has been a 95% reduction in the number of psychiatric beds available. To be sure, there were abuses in asylums, but our experience over the past 50 years has shown that we cannot do without them entirely without paying a price. It costs more to house a mentally ill person in prison than it would in a mental hospital, and prisons are ill-equipped to meet the needs of people whose minds are their worst enemies.

While we certainly need more beds for psychiatric patients, mental hospitals are not the only option for helping these needy people. Programs like Assisted Outpatient Treatment permit judges to supervise patients’ compliance with drug and therapy regimens and have been shown to reduce harmful behaviors, arrest rates, homelessness and victimization among the severely mentally ill.

Governments have also failed to prioritize treating the severely mentally ill. Many research and treatment dollars go to the “worried well” rather than to those with schizophrenia, bipolar disorder and major depression. The National Institutes of Mental Health, for example, released a draft of its five-year plan for research in December 2019. It was heavily weighted toward basic brain research at the expense of more pressing research needs.

Dr. E. Fuller Torrey of the Treatment Advocacy Center, while acknowledging that some basic brain research is called for, listed a number of areas that cry out for research. A few examples: 1) Patients complain that when they are prescribed generics, they don’t do as well. Study is needed into the efficacy of generic drugs for psychiatric cases. 2) Many drugs prescribed for mental disorders have only been studied for acute effects. More research is needed into their long-term effects. 3) Electroconvulsive therapy is underused in the U.S. compared to other advanced nations (thanks, “Cuckoo’s Nest”). Evidence from other nations suggests that it is safe and effective. Controlled, randomized trials are needed. 4) Probiotics have shown promise for the treatment of mental disorders. More study is needed. 5) Four studies have shown a significant connection between cat ownership in childhood and schizophrenia. Studies of toxoplasmosis are needed.

In the 1960s, we persuaded ourselves that closing down mental hospitals was the humane solution to a problem. Today, we are arguably tolerating an even less humane model. The mentally ill, so vulnerable and in need of care, are crowding emergency rooms, languishing in prisons and sleeping under bridges. It’s a cliché to say that this should not be the case in the wealthiest country in the world, but it’s true.

Monday, February 17, 2020
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IN THE SEVEN presidential elections since 1992, the Republican presidential nominee has won the popular vote exactly once. The lone GOP candidate to receive a majority of the national vote was George W. Bush in 2004. Bush’s election-day victory over Democrat John Kerry, who had, in most obse…

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MATT SCHLAPP, chairman of the American Conservative (cough) Union, which hosts the annual CPAC conference, tweeted that he was disinviting Mitt Romney from the confab this year because he “could not guarantee his physical safety” after the senator voted to convict Donald Trump in the impeach…

Saturday, February 15, 2020
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FROM the day he entered the race, Joe Biden was the great hope of the Democratic establishment to spare them from the horrifying prospect of a 2020 race between The Donald and Bernie Sanders.

Friday, February 14, 2020
Thursday, February 13, 2020
Wednesday, February 12, 2020
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“SHOUT OUT, do not hold back! Lift up your voice like a trumpet!” said the prophet Isaiah, which we read in church on Sunday, but nobody shouted. We are flatlanders, brought up to be still and behave ourselves and listen to instructions, but if the instruction is to shout out and raise your …

Tuesday, February 11, 2020

LAST MONDAY’S Iowa caucuses were an epic failure for Democrats. Thanks to a star-crossed ballot-tabulation program written by alumni of the Obama and Hillary Clinton campaigns, final results were still unavailable as of early Thursday morning. The party that is desperate to control every Ame…

It’s comforting, no doubt, to believe that Donald Trump has survived the impeachment trial because he possesses a tighter hold on his party than did Barack Obama or George W. Bush or any other contemporary president. In truth, Trump, often because of his own actions, has engendered less loya…

During his floor speech explaining his vote to convict Donald Trump, Mitt Romney was overcome by emotion and paused to compose himself. The intense moment came when he spoke of his devotion to God, saying: "I am profoundly religious. My faith is at the heart of who I am." Lump in throat. Lon…

Sunday, February 09, 2020

JUST AS he has done throughout his business career and personal life, Donald Trump bullied his way through being only the third President in history to be impeached. He was not removed from office by the Senate — not because he was found “not guilty”, but because he threatened, stonewalled a…

Saturday, February 08, 2020
Friday, February 07, 2020

Mona Charen is a senior fellow at the Ethics and Public Policy Center. Her new book is “Sex Matters: How Modern Feminism Lost Touch with Science, Love, and Common Sense.”