NCJ Number
90108
Journal
Journal of Orthomolecular Psychiatry Volume: 10 Issue: 3 Dated: (1981) Pages: 193-201
Date Published
1981
Length
9 pages
Annotation
Deinstitutionalization had several unintended consequences that are not in the interests of former mental hospital patients or of society, principally the transfer of mentally ill offenders to penal institutions and aggregation of the mentally ill in marginal urban enclaves with no provisions for care or treatment.
Abstract
Soaring costs of institutional care combined with court decisions regarding living conditions and patients' rights have resulted in massive reductions of State hospital populations. However, local governments do not have the resources to assume responsibility for the deinstitutionalized mentally ill, and the Federal Government has been unwilling to take on such programs. Many former mental patients have simply disappeared, while others are in board and care facilities or halfway houses in deteriorating urban areas. Moreover, the courts have largely removed the power of psychiatry to institutionalize people who violate social norms but ignored services for this population. Cases where juries have convicted obviously psychotic individuals of major crimes reflect a disenchantment with psychiatry and rejection of the traditional distinction between the insane and criminal defendant. Recent court decisions expanding the rights of the mentally ill and statutes setting narrow criteria for involuntary hospitalization have led to courts increasing their use of judicial orders to require State hospitals to accept patients and the transfer of mentally ill offenders to general prison populations. With current judicial safeguards, locked psychiatric facilities continue to play an essential role for the mentally disturbed who cannot be housed in less secure facilities. Finally, governments should revise existing reimbursement plans to match appropriateness of treatment. No references are given.