Lessons Learned from Deinstitutionalisation in the US

Deinstitutionalisation is at an advanced stage in the US, both in duration, and in reduction in state hospital beds. The new generation of chronically and severely mentally ill persons has posed the greatest problems. They no longer receive life-long hospital admission and thus permanent asylum from...

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Bibliographic Details
Published in:British journal of psychiatry 1993-05, Vol.162 (5), p.587-592
Main Author: Lamb, H. Richard
Format: Article
Language:English
Subjects:
Advanced stage
Attitude to Health
Beds
Community health care
Community Mental Health Services - organization & administration
Community Mental Health Services - standards
Deinstitutionalization
Drug abuse
Freedoms
Homeless people
Hospitalization
Humans
Lecture
Length of Stay
Medical treatment
Mental disorders
Mental Disorders - rehabilitation
Patient Admission
Patients
Quality of Health Care
Resistance
Substance abuse
United States
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Summary:Deinstitutionalisation is at an advanced stage in the US, both in duration, and in reduction in state hospital beds. The new generation of chronically and severely mentally ill persons has posed the greatest problems. They no longer receive life-long hospital admission and thus permanent asylum from the demands of the world. Resistance to treatment and substance abuse are problems. Early proponents of deinstitutionalisation believed it would be cheaper, better, and give the mentally ill their freedom. In reality, good community care does not cost less. While a number of community programmes in the US have been impressive, they have served only a small proportion of the total population of severely mentally ill persons. More freedom has been of benefit for many, but has proved difficult for some patients. Some patients have been deinstitutionalised who cannot be effectively treated in the community. The homeless mentally ill epitomise all these problems.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.162.5.587