Current Psychiatry Reports

, Volume 14, Issue 3, pp 259–269

Deinstitutionalization? Where Have All the People Gone?

  • Lisa Davis
  • Anthony Fulginiti
  • Liat Kriegel
  • John S. Brekke
SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS (SJ SIEGEL, SECTION EDITOR)

DOI: 10.1007/s11920-012-0271-1

Cite this article as:
Davis, L., Fulginiti, A., Kriegel, L. et al. Curr Psychiatry Rep (2012) 14: 259. doi:10.1007/s11920-012-0271-1

Abstract

Although there is broad consensus that the state psychiatric hospital population drastically declined over the past five decades, the destination and well-being of people with serious mental illness (SMI) have been in greater doubt. In this article, we examine the aftermath of the deinstitutionalization movement. We begin with a brief historical overview of the move away from state hospitals, followed by an examination of where people with SMI currently reside and receive treatment. Next, we review recent trends reflecting access to treatment and level of community integration among this population. Evidence suggests the current decentralized mental health care system has generally benefited middle-class individuals with less severe disorders; those with serious and persistent mental illness, with the greatest need, often fare the worst. We conclude with several questions warranting further attention, including how deinstitutionalization can be defined and how barriers to community integration may be addressed.

Keywords

DeinstitutionalizationSerious mental illnessIncarcerationMental health servicesMental health spendingCommunity integrationHomelessNursing homesInstitutionalInstitutionalization

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Lisa Davis
    • 1
  • Anthony Fulginiti
    • 1
  • Liat Kriegel
    • 1
  • John S. Brekke
    • 1
  1. 1.American Academy of Social Work and Social Welfare School of Social Work University of Southern CaliforniaLos AngelesUSA