Deinstitutionalization Versus Transinstitutionalization

  • Thomas MarquantEmail author
  • Francisco Torres-Gonzalez


For up to 40 years, European countries have turned towards deinstitutionalization to improve quality of life of psychiatric patients, reintegration into society and mounting costs of the exploitation of psychiatric hospitals. Increasingly, though, the use of deinstitutionalization has often been linked to an increase of patients towards forensic care, whether it concerns forensic hospitals or prison, which would be an unwanted and worrisome side effect of deinstitutionalization. In the current chapter, we will go into the main literature on the topic of transinstitutionalization. Especially, the Austrian situation is of interest, as it has been well documented and described. We found the link between deinstitutionalization and transinstitutionalization to be complex, and deinstitutionalization is only one of the several factors that can induce transinstitutionalization. Community-based care, a population shift, a critical number of beds, a zeitgeist and changes in civil commitment legislation are all just as important when it comes to the emergence of transinstitutionalization. Next to this, we added funding and education as possible elements that might be of importance as well. We concluded that transinstitutionalization is a real threat for specific patients when deinstitutionalization occurs but in a complex and multifactored way.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Justice Department Belgium, Faculty of Medicine, Collaborative Antwerp Psychiatric Research Institute (CAPRI)Antwerp UniversityAntwerpBelgium
  2. 2.Faculty of MedicineUniversity of GranadaGranadaSpain

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