Institutionalization, Deinstitutionalization, and the Penrose Hypothesis

Abstract

Psychiatry began to emerge as a medical specialty and science after the French revolution with the transinstitutionalization of mentally ill from imprisonment to psychiatric hospitals. Psychiatric hospitals grew in size, many of them housing thousands of people by the end of the nineteenth century. The twentieth century was characterized by psychiatric reforms shifting services from institutions to outpatient care settings and removing large numbers of psychiatric beds. In the year 1939, the British psychiatrist Penrose pointed to a possible inverse relationship between psychiatric bed numbers and prison population rates. Prison populations were on the rise throughout the twentieth century in most countries. By the end of the twentieth century, worries about a transinstitutionalization of people from psychiatric institutions to penal justice institutions came up again. In the beginning of the twenty-first century, the Penrose hypothesis was in the focus of scientific interest again. Studies from Western Europe and South America point to a significant inverse relationship of psychiatric bed numbers and prison population rates in longitudinal data.