Kenneth Paul Rosenberg’s “Bedlam” examines the crisis of mentally ill Americans wandering the streets (or crowding jails) with scant services to help them. It’s a huge if under-reported issue that gets welcome if not particularly penetrating analysis in this documentary, which spreads itself too thin over too much terrain to make any great impact. Nonetheless, it’s a competently made overview that will be a solid bet for appropriate broadcast slots.
“I became a psychiatrist because of my sister, and I became a filmmaker because I wanted to understand and tell our story,” says the director early on, narrating over photos from his family’s “last happy year” when he was a teen. Shortly afterward, his beloved older sister Merle plunged into mental health woes that plagued her for the rest of her life.
But Rosenberg doesn’t return to this element until late in the film, occupying most of its first hour with less personal material. There’s a too-brief summary of 20th-century treatment methods, from “insulin coma therapy” and lobotomies to the psychopharmaceuticals of today; and a similar rush through public policies, which began dismantling the once-extensive state mental hospital network under President Kennedy. JFK’s idea was to take patients out of institutional isolation and reintegrate them into society, with treatments managed by community mental health centers. But President Reagan ended federal funding for such efforts, and states were unwilling to assume the financial burden. The result was today’s epidemic of “crazy” homeless people living on the streets for lack of the custodial care options of yesteryear.
Often, the casualties of the system land in already overburdened hospital emergency rooms, where staff routinely deal with violent psychotics and other problem patients without the resources (legal or otherwise) to hold them long enough to effect any real positive change. Rosenberg focuses on one Los Angeles ER considered among the nation’s best in handling this burden. But even there, medical professionals suffer high stress and burnout coping with the “ridiculous merry-go-round” of recidivist crisis cases.
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It’s at that location we first meet three patients whose progress is followed sporadically over the next two to three years. Johanna is a young woman diagnosed as bipolar. She stabilizes somewhat under proper medication but edges toward chaos again when her caretaker father’s health problems leave her living alone in their shared house. Monte is a mostly gentle giant with a supportive family, but as a large black man who experiences episodes of paranoia, he inevitably risks being seen as a threat by police, and arrested. Perpetually angry middle-aged white guy Todd likewise finds himself in frequent trouble with the law, and is ill-equipped to handle his long stint of homelessness. Social services are finally able to secure an apartment for him, but even that happy end can be easily be reversed.
A recurrent theme is the chronic lack of institutional support that forever increases the wait for — and odds against — real help for people whose needs are immediate. In the 1950s, half a million Americans were housed in state mental hospitals. Problematic as those places often were, the subsequent deinstitutionalization trend simply eradicated 90% of such hospitals, which also provided living quarters. Now an estimated 350,000 mentally ill sleep on the streets each night — their other principal “home” being county jail cells.
Rosenberg consults some experts and activists in the field, but “Bedlam” never quite achieves an informative or emotional impact beyond a quick pulse-taking of the complex and catastrophic situation that has become a new societal norm. When the director finally focuses on his schizophrenic sister’s sad history, his recounting feels glib, awkwardly shifting what had been an objective documentary toward the realm of subjective confessional. The one important point made in this latter part of the film is that his family’s shamed secrecy over Merle’s instability only worsened her plight, as is too often the case.
That first-person thread, as well as any of the other principal ones in “Bedlam,” might easily have floated the entire documentary to more powerful overall effect. As is, the feature functions as a decent introduction of the issues for those who are unfamiliar, but it’s likely to strike others — particularly urban dwellers who see the homeless mentally ill every day — as superficial. The disparate elements have been competently edited into a fast-moving if arguably over-compact whole by Jim Cricchi and Rosenberg.
At the close we’re told as many as 15 million Americans suffer from “serious mental illness.” At a time when a White House administration once again seems primarily interested in cutting public service programs, “Bedlam” — titled after the notorious London “madhouse” founded six centuries ago — does manage to provide incriminating evidence that we’ve become a society that considers many of its neediest citizens too unimportant to care for.