Beyond Deinstitutionalization

Abstract

DEINSTITUTIONALIZATION of chronically mentally ill patients from large state mental hospitals has been a major movement in psychiatry for the past 30 years. The state-hospital population decreased1 from 559,000 in 1955 to approximately 138,000 in 1980. During this time the number of admissions to public institutions and the percentage of admissions that were readmissions increased, and the average length of stay became shorter.2 , 3 Deinstitutionalization (or dehospitalization) has been assisted by the advent of neuroleptic medications, concern for the civil rights of institutionalized patients, and a political ideology supporting a less restrictive setting. Economic incentives for care outside the hospital are . . .