Op-Ed: A Modern Psychiatric Hospital Could Help Some of Silicon Valley’s Homeless

Thomas Bigbee’s picture haunts us all.

On April 5, the Mercury News reprinted an article with a booking photo of a 62-year-old Santa Cruz man with big eyes that seem to glisten like an imp. Driving under the influence, disorderly conduct, public drunkenness, petty theft and forgery are some of the many crimes for which Mr. Bigbee has been arrested all told more than 100 times.

Mr. Bigbee haunts us because he seemingly can’t be helped. His endless cycle of intervention, addictive behavior, intervention, addictive behavior and so on, is one that we seem powerless to stop.

What to do with the chronically mentally ill and alcoholic man? It’s not a new problem, but it’s one that desperately needs new solutions.

Thomas Bigbee.

In the year 1900, for example, Agnews State Hospital and others like it housed 3,000 mentally ill, alcoholics, and drug addicts. In the Santa Clara Valley, the state bought 323 acres of land in 1855 from Abram Agnew, and on October 30, 1888, the California Hospital for the Chronic Insane opened seven miles north of what was then San Jose. Seventy-five patients were transferred from the Napa State Hospital which had been overcrowded. In 1897, the name of the hospital changed to Agnews State Hospital.

Agnews’ beautiful buildings were designed by Jacob Lenzen and his son, Theodore, the architect who designed the San Jose City Hall, the University of the Pacific and other important structures in the valley. Grazing fields for dairy cattle, vegetable gardens, and fruit tree orchards made for an inviting landscape. Shade and ornamental trees added to the beautiful grounds. Treatment was similar to other parts of the country. Morphine, tonics, and stimulants were used, and restraints such as straitjackets were employed at times. By 1906, some 1,070 patients lived at Agnews.

The 1906 earthquake destroyed the hospital, and 117 staff and patients lost their lives. Most of the surviving 956 patients would see completion of the new hospital building in 1911. Agnews was designed in the Mediterranean Revival style popular at the time with tile roofs, decorative tile, rustic wooden balconies, porch columns and banisters. It resembled a college campus with a blanket of grass covering acres of grounds.

Dr. Leonard Stocking, hospital superintendent and medical director, employed progressive techniques including parades, camping excursions, and plays with patients as the actors. He sought to create a “cheerful” place, with treatment plans tailored to the individual needs of the patients. Community and family guests were invited to join the patients in social programs with music and dancing.

In 1966, people with developmental disabilities were accepted into the program. But in 1967, the Lanterman-Petris- Short Act, signed by Gov. Ronald Reagan, returned the mentally ill to the community or other facilities.

Although the closing of Agnews has indeed returned the mentally to the community, it has not been in the way policymakers envisioned. The mentally ill and chemically addicted make up a majority of the chronically homeless. People who sleep on the sides of freeways or on the banks of the creeks often lack hygiene, clothing and food. Many, due to their mental illness, contribute to the pollution of our streams and waterways. Most live in squalor.

In 2017, the San Diego Union-Tribune reported infectious disease (hepatitis) among homeless people was creating a societal health risk. Reporter Lauryn Schroeder wrote, “The spread of the liver infection (hepatitis A) has been attributed to a lack of access to basic sanitation for San Diego’s growing homeless population, which was the fourth largest in the country in 2016.”

Daniel Wheaton, another Union-Tribune reporter, clarified who was being infected.

“The San Diego County health department reports that the majority of those sickened are either homeless or illicit drug users,” he wrote. “Still, 35 percent of infections aren’t part of those populations.”

In 2015, Santa Clara County spent an average of $500 million a year on costs related to homelessness (Roundtable Report, Santa Clara County, 2015). The 2016 Measure A, a $1 billion bond measure, was supposed to solve the homeless problem by providing permanent housing. In 2018, more than 7,000 people remain unhoused in Santa Clara County—one of the largest unsheltered populations in the U.S.

People younger than 40 may not believe it, but there were days before homelessness was a problem in our state and country. Agnews State Hospital, and others like them, closed its doors in 1972 to all but the developmentally disabled, who continued to be housed at a smaller Agnews until it was closed in 2009.

Dr. Stocking’s innovation in therapies for his patients, such as music and dancing, were intuitive and inventive. Since 1970, the field of recreational therapy has established itself with colleges offering bachelors of science degrees and master’s degrees in recreational therapy. Music therapy, art therapy and other therapies have seen growth in numbers and quality. Rather than straitjackets, new strategies are used for people who are at risk to do danger to themselves or others.

With the latest in methods in care for the mentally ill and addicts, with minimal use of restraints and drugs, would a modern state hospital be a means to address the root problem of homelessness?

Isn’t the true insanity that reasonable minds can devise no better means of resolving homelessness than spending billions of dollars while the problem only grows worse?

Thomas Bigbee’s glistening eyes say it all.

Paul Boehm is a writer, teacher, clean creeks advocate and a volunteer at local faith-based homeless shelters. The opinions expressed in this article are the author’s own and do not necessarily reflect those of San Jose Inside. Interested in writing an op-ed? Email pitches to [email protected].


  1. I have myself wondered why this is not considered. There is a man on Santa Clara street I see everyday when I get my afternoon coffee. He stands, always, facing a doorway of an abandoned building with a mattress or sleeping bag over his head. He is disheveled and unkempt, and, obviously, in need of serious help that is beyond the abilities of everyday people. Spending money on housing is not going to help him. Medical treatment would.

  2. > Spending money on housing is not going to help him.

    The best place for a person like this is an institution. Call it a mental hospital. Call it an insane asylum. Whatever.

    And the taxpayers would willingly pay for it.

    > Medical treatment would.

    Unfortunately, there is probably not much that medical science can do for these people. Give him a lifetime supply of medical marijuana and he’ll be happy, AND the progressive moonbats will be happy, too.

  3. As long as Lanterman-Petris-Short remains as it is, the problem of the mentally ill homeless will only get worse.

    • > As long as Lanterman-Petris-Short remains as it is, the problem of the mentally ill homeless will only get worse.

      Elaborate, please.

      I know that Ronald Reagan signed the L-P-S act and is therefore blamed for “emptying out the mental institutions” and creating the “homeless problem”, but my understanding that there is more to the story.

      Supposedly, Governor Pat Brown started the ball rolling and put Reagan in the position of having to sign the bill.

      What’s the “full truth”?

      I know. I know. It’s silly to expect the “full truth” in one-party California.

  4. What’s the matter with the government? Why don’t they immediately remodel and build more mental hospitals? This homeless of mentally ills is completely out of control!!!!! In the 1940’s and 1950’s, they would rush to get these people off the streets immediately and put them in mental hospital or require them to take medications. They were conservative and wouldn’t put up with this. This is an extremely permissive society that allowed all these mentally ills roaming around with no help and let them make the downtown area dirty and terrifying pedestrians.

  5. What’s the matter with the Government? Why don’t they immediately remodel and build more mental hospitals? This homeless of mentally ills problem is completely out of control!!!!! In the 1940’s and 1950’s they would rush to get these people off the streets immediately and put them in mental hospital or require them to take medications. They were conservative and would not have put up with this problem. This is an extremely permissive society that homeless mentally ills to roam the streets of downtown and neighborhoods and make streets dirty. They also terrify residents and workers alike.

  6. I spent probably nearly half of my career working in the parts of town most affected by homelessness. Please understand that my comments on this subject reflect personal experience and observation, but not statistical data.

    In my experience, there seem to be four broad causes of homelessness, with considerable overlap:

    1. people who embrace a sort of countercultural lifestyle who have rejected a more conventional lifestyle involving work, housing, etc.
    2. people without sufficient education or skills to successfully participate in the workforce or earn sufficient income to afford housing/food/utilities in the bay area (substitute whatever region happens to apply)
    3. people who suffer mental illness of one kind or another who are, effectively, incapable of participating in society in the manner that most others do
    4. people whose substance abuse/addictions preclude productive participation in society

    For the first category, there is really nothing to be done and no reason to involve the general public i their lifestyle choices. Just as I would never presume to tell someone how to live, enjoy a relationship, etc. I would not choose to tell a person to embrace a conventional lifestyle.

    For the second category, a combination of job skill training and short-term use of housing assistance would help considerably. Sometimes people do need a second shot in life. And, I would submit that the first category can often become the second.

    For the third and fourth categories – probably the most numerous among the homeless, I would suggest that many can and should be evaluated for involuntary commitment. There are plenty of mentally ill persons who simply cannot function independently. As well, there are plenty of people who are so hopelessly addicted, they cannot function independently. I would also submit that – particularly in the cases of those addicted to drugs like meth and ecstasy – addicts can often develop neurological damage that can often present as psychological disorders, but which cannot be treated in the same ways as bipolar disorder or schizophrenia ) for instance).

    It is for these, latter two, categories that a dedicated hospital – or chain of hospitals – would be of the most benefit. An added benefit would be that the most disabled/addicted could be removed out of the numerous board and care facilities which currently operate throughout various communities. I cannot count the number of these facilities I have had reason to visit and there is not a single one that I would wish on anyone – even someone I genuinely hated. Calling them ‘humane’ treatement options does more than merely stretch the definition of ‘humane’.

  7. > In my experience, there seem to be four broad causes of homelessness, with considerable overlap:


    Facts on the ground informed by common sense.

    Category 1: tribalists who belong to the wrong tribe and can’t change.

    Category 2: tribalist foragers who are trying to make a living in a corner of the forest overpopulated with better foragers. Starvation is nature’s way of telling them to forage in a different forest.

    Category 3: damaged human beings who belong in institutions

    Category 4: self-damaged human beings who belong in institutions

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