What Is Deinstitutionalization?

The lack of mental health services available to the mentally-ill and the deinstitutionalization of mental health hospitals have created a public health concern. These issues along with a failed continuum of care plans and a lack of community mental health services have been major contributing factors to homelessness. In addition, the strict guidelines for psychiatric hospitalization are critical when analyzing homelessness. In many cases, only the critically ill are meeting clinical criteria for hospitalization, leaving those who have significant mental health problems to fend for themselves. The link between homelessness and mental health is acknowledged but requires reform.

In an effort to transform the public mental health system, in 1963, President Kennedy proposed the Community Mental Health Act. It was the first among several federal initiatives to create a community mental health care system. Once the act was ratified, there was an intense deterioration in institutionalization, otherwise known as “deinstitutionalization”, and by 1980 there was a 75% declined of the inpatient population at many public psychiatric hospitals. In 2000, there was less than 10% of the public institutionalized just fifty years earlier. In 2009, there was even a more dramatic shift among children and adolescence whereby there was a 98% decline in

Mental illness affects many people throughout the United States each year. It is classified by some as any psychiatric disorder that is the cause of untypical behavior. Many years ago, those who were classified as mental ill were locked up in mental institutions and basically forgotten about. Medical professionals housed the mentally ill in different corridors of the hospital. Sometimes, they stayed in isolation and were in some type of restraints. When it appeared to be getting out of control, deinstitutionalization became a topic among government officials. Deinstitutionalization started out to be a government policy that became a long-term trend to lessen the burden on professionals in mental treatment facilities. Its intent was to have

In the video, “The New Asylums”, it demonstrated how deinstitutionalization has left thousands of mentally ill patients in the hands of the prison system. As the mental health hospitals closed down, the police department and prison system has become responsible for the mentally ill people that are on the streets. There was a firm point made about the release of mentally ill patients- “When hundreds of thousands of mentally ill are released, they do not magically become healthy. They went to the streets, became homeless, and turned to a system that cannot say no.” The video also stated that today, there are nearly 500,000 mentally ill people being held in jails and prisons throughout the country. Furthermore, there was no safety net for those

With states closing many of its mental facilities in the communities, there were a lot of people in need of outpatient care who fell through the cracks of the system and ended up in prison. Prison is where many of them died from inadequate treatment. Prisons were suddenly receiving inmates with the following types of mental illnesses: Schizophrenia, bipolar, and deep depressions. These prisons just did not provide these inmates with any medication during their incarceration. Because the community based health services is lacking, and patients aren’t receiving sufficient outpatient care, it makes the effectiveness of deinstitutionalization a serious problem. Without the availability of 24/7 psychiatric services that are well structured, I believe that deinstitutionalization is what is accounting for the increase of the mentally ill inmates in the correctional facility.

Deinstitutionalization further exacerbated the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill, and this situation continues up to the present.

In addition to the historical aspect, confusion about mental health is another reason leading to the perception of the mentally ill. The Surgeon General's Report on Mental Health, (1999), dispels any confusion by making detailed analogies and information. Mental health and mental illness are not opposites; they are like two points on a continuum. The value of mental health is

Homelessness as a result of deinstitutionalization in the US increased dramatically, tripling in 182 cities over the court of the 1980s (Bagenstos, 2012). In addition, mental health and substance abuse is a major problem in across the country because of homelessness. According to the Substance Abuse and Mental Health Services Administration,20 to 25% of the homeless population in the United States suffers from some form of severe mental illness (DMHAS, 2014). Consequently, mental illnesses disrupt people’s ability to carry out key aspects of daily life, such as self-care and household responsibilities. As a result of these factors and the stresses of living with a mental disorder, people with mentally illnesses are much more likely to become homeless than the general population (Karger, & Stoesz, 2014). Even if homeless individuals with mental illnesses are provided with housing, they are unlikely to achieve residential stability and remain off the streets unless they have access to continued treatment and services. In Connecticut there are a number of housing options that are in place like supportive housing. Research has shown that supported housing is effective for people with mental illnesses (DMHAS, 2014). Unfortunately, in Connecticut, lack of funding is a significant barrier to the successful implementation of supported housing programs. Because of homelessness people cycle between street corner, jail cell and hospital beds, in addition the homeless who are

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

People with mental illnesses are at greater risk of homelessness. This is particularly true for people with serious mental illnesses, particularly those that might impact their reality testing, such as schizophrenia, bipolar disorder, or major depression (National Coalition for the Homeless, 2009). California, like other areas of the country, sees a relationship between mental illness and homelessness. In fact, mental illness may be one of the most significant risk factors for homelessness. Of people with serious mental illness seen by California's public mental health system, approximately 15% of them experienced at least one bout of homelessness in a one-year period (Folsom et al., 2005). Furthermore, "According to the Substance Abuse and Mental

The release of institutionalized individuals from institutional care (as in a psychiatric hospital) to care in the community. Deinstitutionalization is a long term pattern wherein less individuals live as patients in mental facilities and less psychological well-being treatments are delivered in public facilities. This trend is directly due to the process of closing public hospitals and the ensuing transfers of patients to community-based mental health services in the late twentieth century. It represents the dissipation of patients over a wider variety of health care settings and geographic areas.

Jails have been described as “de facto mental hospitals” because they have filled the void created when state psychiatric hospitals began closing in the early 1960s through a process known as deinstitutionalization. Supporters of deinstitutionalization thought the process would help individuals suffering from a mental illness live more self-reliantly while being treated by community mental health programs. However, the federal government did not provide the necessary funding to meet the mounting demand for these programs, leaving numerous untreated. Individuals with serious mental illnesses are often poor or homeless and are likely to have substance abuse problems. Therefore, when they are left untreated, they are more likely to commit minor crimes that have been the focus of law enforcement in recent years (H. Richard Lamb and Linda Weinberger).

The homeless- found on city park benches, street corners, and subway grates. Where did all of these people come from? One third, to one half of the homeless suffer from a mental illness. A lot is said about the homeless-mentally ill, but what their plight says about us may be more significant. We still have not found a place for those who are both poor and insane. Once there was a place for them; the asylum fulfilled the basic needs of thousands for decades, but now these institutions lay empty and in ruin. Has the hope to heal the mentally ill also been abandoned? Is there once again a need for the asylum? The disbandment of the asylum was the first step in ending segregation for those

Lyndsey, I completely agree with what you are saying about the courts expectations being unrealistic. I think deinstitutionalization was the cause of so many mentally ill being incarcerated. There are so many homeless mentally ill still on the streets without treatment. It is no wonder they are arrested for committing crimes. At least once they are arrested, they receive room and board. It might not necessarily be safe, but it might be warm. I wonder if sometimes that is why they go back jail. Jail is a familiar place and sadly the only place they can turn to for help. Funding could be used to create more diversion programs for the mentally ill who have committed crimes. Diversion programs could include the use of group homes or other