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date: 07 December 2022

Deinstitutionalizationlocked

Deinstitutionalizationlocked

  • Steven P. SegalSteven P. SegalSchool of Social Welfare, University of California, Berkeley

Summary

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as transinstitutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, while it has expanded admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase/model programs illustrating what can be done, yet it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness.

Deinstitutionalization policy has motivated political, economic, legal, and social change in the care and control of six populations—older adults, children, people with mental illness, people with developmental disabilities, people under correctional system supervision, and, more recently, individuals without a home. A truer implementation of deinstitutionalization’s initial aspirations requires reconsideration of these changes.

Subjects

  • Aging and Older Adults
  • Children and Adolescents
  • Criminal Justice
  • Disabilities
  • Health Care and Illness
  • Mental and Behavioral Health

Updated in this version

Content and references updated to reflect recent research.

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