Deinstitutionalization is reduction in the size of populations held in institutions of involuntary confinement. Deinstitutionalization is primarily to reduce the number of people in mental hospitals and prisons. Deinstitutionalization movement began in the 1970s and was very successful in reducing the size of mental hospitals. Community mental health programs and community corrections are developed in response to the desire for deinstitutionalization, but community corrections has come to be seen as an aspect of net widening. Deinstitutionalization poses immense challeges to society and service systems.
There have been unintended consequences of deinstitutionalization, like the increase in the number of uninstitutionalized persons who have severe mental illness, and are homeless. "Deinstitutionalization, once hailed as an ideal social reform, is now decried as a near disaster." - Rhoden. The films Exorcist (1973), One Flew over the Cuckoo's Nest (1975), Halloween (1978), and When a Stranger Calls (1979) helped weave a tapestry of distrust.
Some Perspectives on Deinstitutionalization - H. Richard Lamb, M.D. and Leona L. Bachrach, Ph.D. The authors discuss what can be learned from our experience with deinstitutionalization. The deinstitutionalization of mentally ill persons has three components: the release of these individuals from hospitals into the community, their diversion from hospital admission, and the development of alternative community services. Among the lessons learned from deinstitutionalization are that successful deinstitutionalization involves more than simply changing the locus of care.
Radical deinstitutionalization: Rousseau versus Freud - Mayerhoff, David. Abstract: Considers the policy of radical deinstitutionalization of the chronic, treatment-refractory mentally ill from the perspective of two theories concerning the nature of man and civilization. Two apparently opposing points of view are reviewed, that of J. J. Rousseau and that of S. Freud. Results & conclusions: An extrapolation from these points of view suggests that neither would espouse a categorical view of deinstitutionalization in the context of current societal conditions.
The Satellite System: A Model for Deinstitutionalization. - Boyan, Craig. Abstract: The paper presents the community-based satellite system as a residential and program model to effect deinstitutionalization of mentally retarded young adults in urban centers worldwide. The system is reported to consist of a large, central educational facility surrounded by a series of small houses and apartment units.
The Folklore of Deinstitutionalization: Popular Film and the Death of the Asylum, 1973–1979 - Troy Rondinone. The demise of America's state mental hospital system, or “deinstitutionalization,” has received much attention from sociologists and historians of medicine. Less understood is the manner in which the public experienced and came to terms with it. Using elements of folklore and horror studies, I will examine how popular films accommodated audiences to institutional decline and confirmed popular antistatist pessimism. By endorsing popular conceptions of institutional failure and presenting mythical narratives of individualist triumph, these films helped pave a path towards the conservative Reagan era to come.
Testing the limits of deinstitutionalization - RL Okin. From 1978 to 1993, under favorable administrative and political conditions and protected by a court-ordered consent decree, a comprehensive community-based mental health system was established in western Massachusetts that entirely replaced Northampton State Hospital.
Deinstitutionalization, another way: The Italian mental health reform - OTA DE LEONARDIS, FRANCO ROTELLI. The article describes the Italian experience of deinstitutionalization in psychiatry. Deinstitutionalization is no longer perceived as an aspect of the "welfare crisis", but rather as a significant pointer to new post-welfare social policies.
Deinstitutionalization and the homeless mentally ill. - Lamb
HR.
Abstract: Although
homelessness among the chronically mentally ill is closely linked with
deinstitutionalization, it is not the result of deinstitutionalization per se
but of the way deinstitutionalization has been carried out. It has
become clear after two decades of deinstitutionalization that what is needed is
a vast expansion of community housing and other services and a whole revamping
of the mental health system to meet the needs of the chronically mentally ill
for support and stability. In addition, mental health professionals must accept
the full extent of the dependency needs of many chronic patients.
Criminal Offending in Schizophrenia Over a 25-Year Period Marked by
Deinstitutionalization and Increasing Prevalence of Comorbid Substance Use Disorders -
Cameron Wallace, Ph.D., Paul E. Mullen, Philip Burgess, Ph.D. OBJECTIVE: This study examined the pattern of criminal convictions in persons with
schizophrenia over a 25-year period marked by both radical deinstitutionalization and
increasing rates of substance abuse problems among persons with schizophrenia in the
community.
Deinstitutionalization of psychiatric patients, a critical review of outcome
studies - P Braun, G Kochansky, R Shapiro, S Greenberg, JE Gudeman, S Johnson and MF Shore. The authors performed a critical review of experimental studies on the outcomes for
deinstitutionalization of psychiatric patients.
The internal validity of many of the studies was compromised by shortcomings in design and
performance and generalizability limited by selection of patient populations. Satisfactory
deinstitutionalization appears to depend on the availability of appropriate programs for
care in the community.
Deinstitutionalization of Status Offenders: Individual Outcome and System
Effects - Irving A. Spergel, Frederic G. Reamer, James P. Lynch. In recent years there have been widespread attempts to remove juvenile status
offenders
from secure detention and correctional facilities. This article summarizes findings from the
evaluation of a statewide program, designed as part of a national deinstitutionalization
strategy, that provided alternatives to secure detention for status
offenders between the time of arrest and court appearance. Data are provided
concerning status offenders' careers and the ability of the deinstitutionalization
strategy to divert youths from the juvenile justice and social service systems.
Deinstitutionalization and the ‘long-term mentally ill’: a Swedish case
study - ERIK FORSBERG and BENGT STARRIN. We discuss deinstitutionalization and the question of how ‘long-term mentally
ill’ persons adjust to life outside institutions.
The Leros PIKPA Asylum Deinstitutionalization and Rehabilitation Project
A follow-up study on care staff fears and attitudes - John Tsiantis,
Stavroula P. Diareme, Gerasimos Kolaitis.
This is a three-year follow-up study on the results from the Deinstitutionalization
Project of the Leros PIKPA asylum regarding job-related fears of care staff of the
institution as well as their attitudes towards people with learning disabilities.
Race and the Impact of Juvenile Deinstitutionalization -
M. A. Bortner, Mary L. Sunderland, Russ Winn.
In a study of 32,000 referrals to juvenile court, the effects of a program to
deinstitutionalize status offenders on detention
decisions, intake screening, and final dispositions were examined. The data indicates a slight general trend toward less use of
secure detention, a greater use of informal hearings, and a lower rate of juveniles placed
on probation or in institutions.
Deinstitutionalization's
Throwaways: The Development of a Juvenile Prison in Massachusetts -
Ronald E. Vogel, Edward A. Thibault
With its deinstitutionalization of juvenile offenders in the early 1970s, the Department
of Youth Services in the state of Massachusetts developed the reputation of being
extremely progressive. In the midst of deinstitutionalization, a small
maximum-security prison was developed for juvenile offenders who could not be treated in
any of the community-based programs designed to replace the training schools.
Deinstitutionalization for Older Adults With Severe Mental Retardation: Results
From Australia - Louise Young and Adrian F. Ashman. University of
Queensland.
Abstract: A deinstitutionalization research project in which residents from the largest
institution in Queensland, Australia, were relocated after a government decision to close
the center was described.
Longitudinal Study of Deinstitutionalization and the Exercise of Choice -
Roger J. Stancliffe, and Brian H. Abery. In this longitudinal study day-to-day choices available to former institution residents with
severe/profound developmental disabilities (movers) were assessed before and after
deinstitutionalization and compared with peers who remained in the same institutions
(stayers). Effects of deinstitutionalization did not differ with level of disability. However, the absolute
level of choice available to both movers and stayers was very low.
Deinstitutionalization of Minors with Mental Retardation. Research & Resources on Special Education.
Abstract: The brief paper summarizes the final report of a federally funded project
titled, "Ramps Are Not Enough: The Movement of Children with Mental Retardation from
Institutional to Community-Based Care." The follow-up study of former residents
(N=178) of New Hampshire's Laconia State School included an examination of residential and
educational consequences of deinstitutionalization, four in-depth case studies, and an
effort to trace the chronological relationship between federal and state policy and
budgetary changes and the community living experiences of subjects.
New Forms of Social Control: The Myth of Deinstitutionalization. Carol A. B. Warren.
Rhoden, The Limits of Liberty:
Deinstitutionalization, Homelessness, and Libertarian Theory.