In the mid-San Fernando Valley middle and upper class suburbs, I regularly see homeless. I have some training in evaluating people and I would estimate that more that 50% of the homeless I see have some mental problems. It is not just economic. In addition the "mainstreaming" of mental patients pre-dates the Reagan administration. I remember a 60 Minutes segment in the middle of the Carter administration that was basically calling into question the practice of "mainstreaming" mental patients. It was, in fact, the first time I had heard of that term. This excerpt from a study written by The Kaiser Foundation illustrates some of this history.
kaiser commission Medcaid and the uninsured
Learning From History:
Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform
"These issues led to plans for major change. President Carter established the President’s Commission on Mental Health, which called for a new national priority for adults and children with serious mental disorders and recommended an orderly phase-down of state hospitals through performance contracts that would integrate federal and state funding. Congress responded by enacting the Mental Health Systems Act, with numerous changes to the federal CMHC program, including, importantly, a shift in emphasis to increase the priority of this population and to expand services beyond clinical care alone. In addition to the Commission report, the Department of Health, Education and Welfare produced a blueprint for further policy change in the most significant federal human services programs (Medicaid, Medicare and SSI) to better support individuals with mental illness in the community. With the CSP program reorienting state planning, and plans to make changes to the major federal programs to reinforce those efforts, deinstitutionalization policy entered a new stage, focused on successful integration of people with mental illnesses into their communities."
President Reagan then accelerated it by cutting Federal mental health spending by upwards of 25%.