Deinstitutionalization

Dan A. Lewis

Deinstitutionalization—the movement of mentally disabled people from mental institutions into a community- or family-based environment—is a concept that transformed in a generation from a solution to a problem. Introduced in the early 1960s as a way to reduce societal reliance on state institutions, the policy itself became a problem by the early 1980s. Increases in homelessness, poor community services for the mentally ill, the placement of the chronically mentally ill in nursing homes, the increase in the mentally ill in jails and prisons, and a general increase of incivility in large cities were all seen as consequences of deinstitutionalization. For many, the reform caused more problems than it solved. The United States, by the mid-20th century, had become a country reliant on “total institutions” to control and treat deviance and dependency. State mental hospitals counted more than a half million patients and had long waiting lists in most states. Institutions ...

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