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.
Article
Deinstitutionalization
Steven P. Segal
Article
Deinstitutionalization in Macro Practice
Steven P. Segal
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 trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding 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 and 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. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.
Article
Elder Abuse
Eloise Rathbone-McCuan
Elder abuse is now recognized internationally as a social problem among the aging population. Intentional abuse, neglect, and exploitation among caregivers to frail and isolated elderly create serious risks across diverse formal and informal care settings. This field has expanded continuously since the early 1970s. Accurate prevalence and incidence rates have not been determined. There is a national system of elder victim protection operating within each state. The social work profession is legally mandated to report situations where an elderly person is suspected to be at risk of abuse. Social workers are involved in all aspects of elder abuse prevention and intervention services.
