The human suffering illustrated by the lives of the suitcase owners continues today, often differing more in form than in substance from the lives of mental patients 50 or 100 years ago. Thousands are admitted to hospitals daily for treatment of emotional distress, which is often caused or aggravated by social conditions. If hospital stays are considerably shorter today, due to aggressive use of medications and the service limitations of HMOs, they are no more marked by recovery than in the days of the large state hospitals like Willard.

Today, of every 100 people admitted to a psychiatric hospital, more than 60 will go on to a life of unremitting mental distress and exclusion, despite widely heralded new drugs. While many fewer people now spend decades in hospitals, tens of thousands live in group homes, nursing homes, or board-and-care facilities, largely isolated from their communities. Thousands more languish in jails and prisons.

Many people with psychiatric disabilities now have opportunities for rehabilitation, rather than being exploited as institutional labor. But real paying jobs are difficult to find in an economy that still discriminates; people with psychiatric disabilities have a staggering national unemployment rate of 90%. Almost all receive various combinations of drugs, some with short-term and occasionally even long-term benefits. But for many, the drugs cause secondary disabilities that limit people's participation in society, and, with increasing frequency, cause early death from ailments like heart disease and diabetes.