The term “deinstitutionalization” refers to a practice of transferring individuals with mental illness institutionalized settings to community-based treatment. In the USA, this process began to be implemented actively in the middle of the 20th century with the introduction of antipsychotic medication. Deinstitutionalization is currently one of the most topical issues related to mental health management, because it is closely linked to a number of problems, such as high rates of homelessness and criminalization of mental illness.
One of the factors that caused deinstitutionalization was the Community Mental Health Act signed under the presidency of John F. Kennedy in 1963. Under the new law, the responsibility for the treatment of people with mental illness was moved from state institutions to community-based treatment (Lamb & Weinberger, 2019). Unfortunately, President Kennedy was assassinated a month after the Act was signed into law, and the government never provided funds for its full implementation. In addition, when Medicaid and Medicare programs were established in 1965, they did not cover people with mental illness. Two years later, president Reagan signed the Lanterman–Petris–Short Act, which banned the practice of institutionalizing people with mental disorders (Lamb & Weinberger, 2019). As a result of this measures, psychiatric facilities emptied by more than 50% in the following decades. Instead of being treated, mentally ill people were now transferred to jails and prisons.
This problem remains relevant today: the lack of federal funding and state responsibility for the treatment of people with mental disorders have led to a number of issues. These include high rates of homelessness in all American cities and the criminal justice system overloaded with cases of mentally ill people committing crimes. Unless the issue of deinstitutionalization is addressed in the nearest future, these problems are likely to become more serious and common.
Lamb, H. R., & Weinberger, L. E. (2019). Deinstitutionalization and other factors in the criminalization of persons with serious mental illness and how it is being addressed. CNS Spectrums, 25(2), 173–180. Web.