Fact-checking Trump’s claims that 92% of mental institutions have closed

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On Tuesday during remarks with the President of Romania, Trump reiterated his belief that mental illness is a significant cause of gun violence, lamenting how many mental institutions have closed. Trump had echoed that sentiment during an exchange with reporters on Sunday, claiming, “They closed so many — like 92% — of the mental institutions around this country over the years, for budgetary reasons.”

Facts First: There is no evidence that backs up the President’s claim that 92% of mental institutions have closed. He appears to be conflating a decrease in the number of available beds at mental hospitals with the institutions themselves.

While the number of psychiatric facilities has not decreased as drastically as the President claims, the Treatment Advocacy Center, a national nonprofit “dedicated to eliminating barriers to the timely and effective treatment of severe mental illness,” found that the amount of staffed state mental hospital beds has decreased by 96.5% from peak hospital population numbers in the 1950s to 2016.

D. Imelda Padilla-Frausto, from UCLA’s Center for Health Policy Research, believes Trump has “misunderstood” the situation.

“There has never been a time period in the US where 92% of mental institutions were closed,” Padilla-Frausto told CNN. “From 1950 to 2015 there has only been a 39% reduction in state and county psychiatric hospitals — which are often referred to as ‘mental institutions.’ As of the most recent data in 2017, there has actually been about a 5% increase.”

Dr. David Cohen, professor of social welfare and associate dean at UCLA, estimates that “probably about half” of all psychiatric facilities have closed down in the US. More importantly, he says, “the number of residents of mental institutions dropped from a high of about 550,000 in state mental hospitals in the mid-1950s to about 100,000 today.”

The National Association of State Mental Health Program Directors, in a report on trends in psychiatric inpatient capacity from 1970 to 2014, noted that “the shortage of bed capacity is often attributed to the closure of state psychiatric hospitals. But the data presented in this report show that most of the state psychiatric hospital bed capacity that has been closed was actually closed decades ago, with the rate of downsizing drastically slowed in recent years.”

Cohen told CNN that this overall decline in residents of public mental institutions was due in large part to the period of “deinstitutionalization” from the mid-1950s to 1980 — not budget cutbacks.

“Institutions first started opening their back doors (releasing long-term residents) around the mid-1950s, then starting to close their front doors (admitting fewer people, especially for longer stays, and reducing the number of available beds within institutions) starting around the late 1960s and the early 1970s to the mid-1980s, then shutting down in earnest from the mid-1980s onward,” Cohen said.

Using data from state mental health agencies, the NRI found that across 22 states, a total of 62 psychiatric hospitals were closed or consolidated between 1997 and 2015. According to Cohen, the aim of deinstitutionalization was to move severely mentally ill people out of state institutions for treatment in less restrictive environments. But it left many severely mentally ill patients with nowhere to go.

“Society after World War II discovered a new passion to solve social problems and include the excluded, and all sorts of institutions (including orphanages, institutions for mentally retarded persons, homes for unwed mothers, youth detention centers, etc.) were phased out, with their residents often in effect kicked out from where they had lived for years,” Cohen said.



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