Abstract
Deinstitutionalization of services for persons with chronic mental disorders is but one manifestation of a social reform momentum that for a number of postwar years prevailed in the United States. Closely related to such notions as “normalization” (Wolfensberger 1970) and “mainstreaming” (Anonymous 1977; Omang 1979; Silverman 1979), deinstitutionalization for the chronically mentally ill has counterparts in an increased emphasis on community-based services for the developmentally disabled, the physically disabled and juvenile and adult criminal offenders.
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References
Anonymous. Mainstreaming. Currents 2, 9–14 (1977).
Anonymous. Prisoners seen needing better mental treatment. Washington Post, August 15, 1979.
Anonymous. An imperfect reform. Raleigh (N.C.) News and Observer, September 24, 1980.
Ashbaugh, J. W., and Bradley, V. J. Linking deinstitutionalization of patients with hospital phase-down: The difference between success and failure. Hospital and Community Psychiatry 30: 105–110 (1979).
Bachrach, L. L. Deinstitutionalization: An Analytical Review and Sociological Perspective. Rockville, Md.: National Institute of Mental Health, 1976.
Bachrach, L. L. Planning mental health services for chronic patients. Hospital and Community Psychiatry 30: 387–393 (1979).
Bachrach, L. L. Is the least restrictive environment always the best? Sociological and semantic implications. Hospital and Community Psychiatry 31: 97–102 (1980a).
Bachrach, L. L. Overview: Model programs for chronic mental patients. American Journal of Psychiatry 137: 1023–1031 (1980b).
Bachrach, L. L. Continuity of care for chronic mental patients: A conceptual analysis. American Journal of Psychiatry 138: 1449–1456 (1981).
Bachrach, L. L. Assessment of outcomes in community support systems: Results, problems and limitations. Schizophrenia Bulletin 8: 39–61 (1982).
Bachrach, L. L., and Lamb, H. R. Conceptual issues in the evaluation of deinstitutionalization, in Innovative Approaches to Mental Health Evaluation, W. Tash and G. Stahler, eds. New York: Academic Press 139–161 (1982).
Bassuk, E. L., and Gerson, S. Deinstitutionalization and mental health services. Scientific American 238: 46–53 (1978).
Bassuk, E. L., and Gerson, S. Chronic crisis patients: A discrete clinical group. American Journal of Psychiatry 137: 1513–1517 (1980).
Bean, J. F., Makowiecki, M. M., and Yessian, M. R. A Service Delivery Assessment on Community Mental Health Centers: Executive Report. Rockville, Md.: National Institute of Mental Health, 1979.
Bradley, V. J. Policy termination in mental health: The hidden agenda. Policy Sciences 7: 215–224 (1976).
Bradley, V. J. Deinstitutionalization of Developmentally Disabled Persons: A Conceptual Analysis and Guide. Baltimore: University Park Press, 1978.
Budson, R. D. Sheltered housing for the mentally ill: An overview. McLean Hospital Journal 4: 140–157 (1979).
Cannon, L., and Kotkin, J. Crisis grows in California mental hospitals. Washington Post, April 16, 1979.
Carpenter, M. D. Residential placement for the chronic psychiatric patient: A review and evaluation of the literature. Schizophrenia Bulletin 4: 384–397 (1978).
Christensen, R. Many states reviewing deinstitutionalization. Raleigh (N.C.) News and Observer, September 21, 1980.
Colen, B. D. Some outpatients come “home” to St. Elizabeths for Christmas holiday. Washington Post, December 30, 1977.
Cramer, P. K. Report on the current state of deinstitutionalization: Period of retrenchment. Commentaries on Human Service Issues (May 1978), Health and Welfare Council, Inc., Philadelphia.
Division of Biometry and Epidemiology. Data sheet on state and county mental hospital patients. National Institute of Mental Health, Rockville, Md. (1979, photocopied).
Division of Biometry and Epidemiology. Unpublished data. National Institute of Mental Health, Rockville, Md.
Dorwart, R. A. Deinstitutionalization: Who is left behind? Hospital and Community Psychiatry 31: 336–338 (1980).
Goldman, H. H., Gattozzi, A. A., and Taube, C. Defining and counting the chronically mentally ill. Hospital and Community Psychiatry 32: 21–27 (1981).
Governor’s Task Force. Report on Mental Health. Raleigh, N.C. (September 1980, Draft report).
Gruber, L. N., Brown, A., and Mazorol, C. Ex-patient visitors to the hospital psychiatric unit. Hospital and Community Psychiatry 29: 731–734 (1978).
Halpern, J., Binner, P. R., Mohr, C. B., and Sackett, K. L. The Illusion of Deinstitutionalization. Denver, Col.: Denver Research Institute, 1978.
Hanseil, N. Services for schizophrenics: A lifelong approach to treatment. Hospital and Community Psychiatry 29: 105–109 (1978).
Hayakawa, S. I. Language in Thought and Action, 3rd ed. New York: Harcourt, Brace, Jovanovich, 1972.
Hersch, C. Social history, mental health, and community control. American Psychologist 27: 749–754 (1972).
Holder, H. D. Accountability and Productivity in a System of Services for Chronic Patients. Presented at the 29th Institute on Hospital and Community Psychiatry, San Francisco (October 1977).
Johnson, P. J. Community Support Systems for the Mentally Ill: A Study of the General Public, Mental Health Workers, and Board Members in Leon County, Florida, 1979–1980. Ph.D. Dissertation, Florida State University School of Social Work (June 1980).
Kennedy, J. F. Message from the President of the United States to the 88th Congress. Document No. 58. Washington (February 5, 1963).
Kihss, P. City jails seek to prevent suicides. New York Times, October 23, 1980.
Kotkin, J. Governor Brown is sued over confinement of mental patients. Washington Post, February 14, 1979.
Kramer, B. A., and Rubinson, E. A study of former mental patients who returned to visit the ward on which they were hospitalized. Psychiatry 41: 302–307 (1978).
Lamb, H. R. The board and care home wanderers. Archives of General Psychiatry 37: 135–137 (1980).
Lamb, H. R., and Goertzel, V. The long-term patient in the era of community treatment. Archives of General Psychiatry 34: 679–682 (1977).
Langsley, D. G. The Community Mental Health Center: Does It Treat Patients? Presented at the 32nd Institute on Hospital and Community Psychiatry, Boston (September 1980).
Link, B., and Milcarek, B. Selection factors in the dispensation of therapy: The Matthew effect in the allocation of mental health resources. Journal of Health and Social Behavior 21: 279–290 (1980).
Mansfield, S. The neon havens of last resort. Washington Post, September 29, 1980.
Marmor, J. The relationship between systems theory and community psychiatry. Hospital and Community Psychiatry 26: 807–811 (1975).
Miller, J. G. Beware the “experts” on mental health. Washington Star, September 18,1977.
Minkoff, K. A map of chronic mental patients, in The Chronic Mental Patient, J. A. Talbott, ed., 11–37. Washington: American Psychiatric Association, 1978.
Miser, H. J. Operations research and systems analysis. Science 209: 139–146 (1980).
Modlin, H. C. The Mentally Ill Inmate. Presented at the Annual Meeting of the American Psychiatric Association, Chicago (May 1979).
Moos, R., and Igra, A. Determinants of the social environments of sheltered care settings. Journal of Health and Social Behavior 21: 88–98 (1980).
Moran, A. E. Psychiatric bed needs: Quantifying the impact of alternative services. Journal of Medical Systems 4: 9–26 (1980).
Neill, J. R. The difficult patient: Identification and response. Journal of Clinical Psychiatry 40: 209–212 (1979).
Nunes, D. Little care available for mentally ill in D.C. jail. Washington Post, June 12, 1980.
Omang, J. Entry of handicapped children into schools brings problems. Washington Post, January 14, 1979.
Panzetta, A. F. The concept of community. Archives of General Psychiatry 25: 291–297 (1971).
Peele, R., and Keisling, R. Commitment to Freedom. Presented at Meetings of American Academy of Psychiatry and the Law, Chicago (September 1980).
Peele, R., and Palmer, R. R. Patient rights and patient chronicity. Journal of Psychiatry and Law: 59–71 (Spring 1980).
Pepper, B., Edmonds, J., Goldberg, W., and Grabel, H. 1,000 “Chronics” in Community Mental Health Center Treatment: Theory and Practice. Presented at the Annual Meeting of the American Psychiatric Association, San Francisco (May 1980).
President’s Commission on Mental Health. Report to the President from the President’s Commission on Mental Health, Vol. 1. U.S. Government Printing Office, Washington (1978).
Rich, S. Figures show end of era in social-program growth. Washington Post, February 14, 1979.
Robbins, E., Stern, M., Robbins, L., and Margolin, L. Unwelcome patients: Where can they find asylum? Hospital and Community Psychiatry 29: 44–46 (1978).
Robins, E. Diagnosis and chronic mental illness. Psychiatric Quarterly 50: 166–177 (1978).
Rosenblatt, A., and Mayer, J. E. Patients who return: A consideration of some neglected influences. Journal of the Bronx State Hospital 2: 71–81 (1974).
Salzman, E. Examining California’s mental health. California Journal: 231–233 (July 1975).
Sargent, M. Deinstitutionalization and state mental hospitals: We can’t have both —historian. ADAMHA News, August 8, 1980.
Scherl, D. J., and Macht, L. B. Deinstitutionalization in the absence of consensus. Hospital and Community Psychiatry 30: 599–604 (1979).
Shore, M. F., and Shapiro, R. The effect of deinstitutionalization on the state hospital. Hospital and Community Psychiatry 30: 605–608 (1979).
Silverman, M. Beyond the mainstream: The special needs of the chronic child patient. American Journal of Orthopsychiatry 49: 62–68 (1979).
Simon, W. B. On reluctance to leave the public mental hospital. Psychiatry 28: 145–156 (1965).
Smith, C. A., and Smith, C. J. Learned helplessness and preparedness in discharged mental patients. Social Work Research and Abstracts 14: 21–27 (1978).
Smith, W. G., and Hart, D. W. Community mental health: A noble failure? Hospital and Community Psychiatry 26: 581–583 (1975).
Spiegel, D.E., and Keith-Spiegel, P. K. Why we came back: A study of patients readmitted to a mental hospital. Mental Hygiene 53: 433–437 (1969).
Steadman, H. J., and Ribner, S. A. The Mentally Ill in Local Jails: New Claims Versus Old Problems. New York State Department of Mental Hygiene, Bureau of Special Projects Research, Albany (May 1980).
Stelovich, S. From the hospital to the prison: A step forward in deinstitutionalization? Hospital and Community Psychiatry 30: 618–620 (1979).
Stern, R., and Minkoff, K. Paradoxes in programming for chronic patients in a community clinic. Hospital and Community Psychiatry 30: 613–617 (1979).
Stratas, N. E., and Boyd, C. The chronic patient: A systems approach in North Carolina, in Chronic Mental Patients: Treatment, Programs, Systems, J. A. Talbott, ed. New York: Human Sciences Press (1981).
Stratas, N. E., Bernhardt, D. B., and Elwell, R. N. The future of the state mental hospital: Developing a unified system of care. Hospital and Community Psychiatry 28: 598–600 (1977).
Sullivan, R. Hospital forced to oust patients with psychoses. New York Times, November 8, 1979a.
Sullivan, R. Hospitals will gain by cutting bed use. New York Times, December 31, 1979b.
Talbott, J. A. Toward a public policy on the chronic mentally ill patient. American Journal of Orthopsychiatry 50: 43–53 (1980).
Task Panel on Deinstitutionalization, Rehabilitation and Long-Term Care. Report. In President’s Commission on Mental Health, Report to the President from the President’s Commission on Mental Health, Vol. 2, 356–375. U.S. Government Printing Office, Washington (1978).
Teltsch, K. Young terminal patients to get a loving hospice. New York Times, April 10, 1980.
U.S. General Accounting Office. Returning the Mentally Disabled to the Community: Government Needs To Do More. U.S. Government Printing Office, Washington (1977).
U.S. Government Accounting Office. Prison Mental Health Can Be Improved by Better Management and More Effective Federal Aid. U.S. Government Printing Office, Washington (1979).
Whitmer, G. E. From hospitals to jails: The fate of California’s deinstitutionalized mentally ill. American Journal of Orthopsychiatry 50: 65–75 (1980).
Witkin, M. J. Provisional patient movement and selective administrative data, state and county medical hospitals, inpatient services by state: United States 1976. Mental Health Statistical Note No. 153 (August 1979).
Witkin, M. J. Trends in patient care episodes in mental health facilities, 1955–1977. Mental Health Statistical Note No. 154 (September 1980).
Wolfensberger, W. The principle of normalization and its implications to psychiatric services. American Journal of Psychiatry 127: 291–297 (1970).
Zusman, J., and Lamb, H. R. In defense of community mental health. American Journal of Psychiatry 134: 887–890 (1977).
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Bachrach, L.L. (1983). Concepts and Issues in Deinstitutionalization. In: Barofsky, I., Budson, R.D. (eds) The Chronic Psychiatric Patient in the Community. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-6308-8_1
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