Community Psychology

Community Psychology Deinstitutionalization refers to releasing a mentally handicapped person from an institution whose main purpose was to provide treatment into a community with the intent of providing services through the community under the supervision of health-care professionals. There have been some positive outcomes from deinstitutionalization trend for society but there have also have been a wide array of drawbacks limiting care provided to these individuals. Among other things, crime, violent crime, and homeless are among the major consequences of releasing some of these patients to the public.

Much of the trend began in the 1950s and the 1960s and the deinstitutionalization of institutional patients has been a trend that has impacted society on many levels and continues to this day. Deinstitutionalization There were a number of factors that were responsible for the reversal of the institutional framework that was built nationally to house the mentally damaged. After the Second World War, many of the state institutions had become crowded and the level of patient care and the living conditions had become marginal in many facilities.

There were also advances in medications that allowed a greater role of pharmaceuticals that allowed psychiatrist to treat some conditions with medication rather having to keep them in the institution on an inpatient basis. Furthermore, there were federal funds made available to provide healthcare for the mentally ill patients through federally administered programs which created a financial incentive for states to deinstitutionalize their mentally ill because of the expense associated with housing these populations. There were other factors that were also at play.

There was the emergence of a group of young, civil libertarian lawyers in the 1960s who decided that mental patients needed to be "liberated." They implemented a series of successful lawsuits, forcing states to discharge mental patients and making hospitalization exceedingly difficult (Torrey, Geller, Stanley, & Jaffe, N.d.). Furthermore, there was also a cultural shift in perspective that was largely influenced by popular media in the contemporary period.

One famous example, a book which later became a movie known as One Flew Over the Cuckoo's Nest, portrayed the patients receiving mental problems as a result of their stay at the institution; not necessarily by their own accord. Because of these factors, the decline in public psychiatric beds available for mentally ill patients decreased rapidly.

In 1955 there were 558,239 public (state and county) psychiatric beds available for mentally ill individuals and the population of the United States was 164.3 million which resulted in the availability of public psychiatric beds was thus 340 beds per 100,000 population; however, in 2005 there were 52,539 public (state and county) psychiatric beds available for mentally ill individuals and at this time the population of the United States was 269.4 million resulting in the availability of public psychiatric beds was thus 17 beds per 100,000 population (Torrey, Geller, Stanley, & Jaffe, N.d.).

The rate has continued to decrease as well and the number of beds per 100,000 patients in 2010 was slightly over 14% with a large variance in this rate among individual states. Consequences of Deinstitutionalization There were 340 public psychiatric beds per 100,000 people in the population in 1955 but only 17 such public psychiatric beds per 100,000 population in 2005. Currently there are roughly fourteen beds per the same numbers. One estimate concluded that the bear minimum number of beds for any population should be in the area of 50 per 100,000 people.

Therefore, it is likely that over two thirds of the seriously mentally ill people in the population will not receive the level of care that they need. This has vast implications for the rest of society. One result of this trend has been homelessness. These social costs are matched by fiscal costs.

In Los Angeles it was estimated that the cost of "arrests, incarcerations, emergency medical care and other crisis interventions" runs between $35,000 and $150,000 per person per year for individuals who are chronically homeless (Torrey, Geller, Stanley, & Jaffe, N.d.). Another consequence has been an increase in crime. A large portion of the mentally ill patients have found their way into prison. The three largest de facto psychiatric institutions in the United States are the Los Angeles County Jail, Chicago's Cook County Jail, and New York's Riker Island Jail.

The solutions to the problems associated with deinstitutionalization could be address by simply re-institutionalizing society to some degree; at least to the minimal standards as recommended by the experts.