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Massachusetts: Third-World Mental Health Care

Massachusetts: Third-World Mental Health Care?

There are few states that have a more broken mental health care system than Massachusetts. You’d probably think of poorer, more rural states when you think of low-quality healthcare. After all, Massachusetts is home to some of the nation’s best universities (Harvard, MIT) and renowned hospital systems (Mass. General [Partners], Brigham & Women’s, Beth Israel).

Yet none of these local institutions, nor the state itself, appear to have given much thought to the mental health care of their most vulnerable citizens. Instead, I live in a state that appears to offer the equivalent of third-world care for those with chronic mental illness.

The Boston Globe’s Spotlight team published an in-depth piece on Sunday about the patchwork quilt of services that substitute for an actual system of care in Massachusetts. If you are seriously mentally ill in this state, chances are you’re just as likely to end up in prison, become homeless, or worse. And your chances of accessing any kind of regular, long-term, evidence-based treatment are minimal.

Sadly, the pessimistic, one-note (negative) article couches its entire argument in the threat of violence — something that only a tiny percentage of people with mental illness pose to others. In taking this perspective, the Spotlight Team of journalists does a great disservice to all of those with mental illness by posing the problem as primarily a public safety issue, rather than what it really is — a crisis due to a lack of services.

Fifty years ago, Lee Chiero might have been treated — and locked away — in one of the public psychiatric hospitals that once dotted Massachusetts.

Today, nearly all of those institutions have been bulldozed or boarded up — and many had to be, having evolved into inhumane asylums for people who are, in the great majority, no threat to anyone. But the hospitals were not replaced with anything resembling a coherent care system, leaving thousands of people with serious mental illness to navigate a fragmented network of community services that puts an extraordinary burden on them to find help and to make sure they continue getting it.

Even those beset by the most ferocious inner demons, such as Lee Chiero, are routinely pinwheeled from hospital to hospital, therapist to therapist, court to court, jail to jail, then sent off into the world with little more than a vial of antipsychotic medications and a reminder to take them. Chiero was hospitalized at least 10 times in a half-dozen hospitals over two decades before he killed his mother.

And that’s the real problem — there are little to no services for people who have chronic mental illness in Massachusetts. There is nothing approaching a comprehensive care system. This in one of the richest, most-educated states in America.

Who’s to Blame?

While we can blame “the state,” it’s actually the people of Massachusetts who are to blame. We elect our legislators, and they seem unable to take up and address the problem in any meaningful way. We don’t hold them to change this problem, because these people who are suffering aren’t us.

Until they are. One day we wake up and find our adult son or daughter needs help, needs to access the mental health care system in the state. That’s when we discover there’s really no such thing — the kind of care he or she will receive is less than they’d receive in many third-world countries.

Where would your adult son or daughter go? I don’t know the answer either, because as the article makes clear, it’s unlikely there’s any actual place for them to go.

How Can We Fix the Problem?

The state needs to reallocate the resources it has taken away from people with mental illness with the closing of nearly all of its state hospitals, and put them into new facilities (or tax credits and grants, to encourage new privately-run psychiatric hospitals to open) like the modern, successful Worcester Recovery Center and Hospital. One hospital for the entire state is clearly not enough.1

Articles like this one by the Spotlight Team illustrate that despite the advances we’ve made in being able to talk about mental health issues in America, we still have a long way to go in treating them on equal footing with physical health.


Read the full article: Spotlight: The mental health care system in Massachusetts is broken

Massachusetts: Third-World Mental Health Care?


  1. I was a little saddened to see the approach this article took to discussing the complexities of accessing mental health care in the state, with only a passing mention of the crown jewel of the state’s system, the Worcester Recovery Center and Hospital. I’m not sure why the journalists took such a slanted, one-sided perspective. []

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is a psychologist, author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

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APA Reference
Grohol, J. (2018). Massachusetts: Third-World Mental Health Care?. Psych Central. Retrieved on October 30, 2020, from
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Last updated: 8 Jul 2018 (Originally: 27 Jun 2016)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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