Mental Health Care Reappraisal

Report Outline
Crisis in Community Care
Locating the Outcast Ill
Fighting for Human Rights
Special Focus

Crisis in Community Care

Shuffling and Dumping of Disturbed People

The removal of mentally ill people from large institutions and their placement into community situations is not a new story, but it remains, even after a quarter-century of steady deinstitutionalization, a deeply troubling story. Just about everybody involved in the process describes the results as unsatisfactory, or worse.

What was justified as an effort to provide disturbed people with more humane treatment in less restrictive settings has left thousands of patients adrift, barely able or unable to cope, and for thousands more it has meant re-institutionalization in in-appropriate facilities. The comprehensive system of community care facilities that was supposed to take the place of central institutions is only half-built, and now, at a time when federal programs are being cut, professionals in the mental health field are beginning to wonder whether deinstitutionalization was a mistake.

Since the late 1960s, yearly spending on community care facilities has increased enormously. By 1978, the latest year for which figures have been officially compiled, spending was above $1 billion and more than two million patients were receiving help in such facilities annually. The number of patients in mental hospitals dropped to less than 150,000 from a peak of about 650,000 in the mid-1950s.