One segment of the American population that is of great concern for the human services and health services profession are those who are suffering from a form of mental illness. There are various forms of mental illness that range from schizophrenia, bipolar disorder, schizoid personality, acute psychosis, catatonic schizophrenic (Mental Illness and homelessness, 2009). These types of medical conditions were the basis and the catalyst for placing an individual in state regulated and state run mental hospitals during the 18th, 19th and early 20th centuries in the United States (Martin, 2011).
The institutionalization of mentally ill patients was a practice that originated from Europe, which in turn was brought to the colonial new world (Martin, 2011). However, during the 1950’s, with the advent of new drugs to treat psychiatric conditions, there was a rise in psychopharmacology, which correlated with the decrease in the importance of psychosurgery, which placed emphasis on medical lobotomies, which were the preferred mode of treatment for aggressive mentally ill patients that were housed in mental hospitals (Krieg, 2001). With the advent of new drugs such as haloperidol, fluoxetine, lithium, valproic acid, and methyldopa, the conditions that used to prevent psychiatric patients from operating in society were not the case. Incidentally, with the creation and use of this revolutionary anti-psychotic medication, more and more groups in society were calling for a change in how mental health was to be run. This led to the birth of the deinstitutionalization movement (Grob, 1995).
Deinstitutionalization is a long term trend when fewer people reside as patients in mental hospitals and fewer mental health treatments are delivered in public hospitals. Deinstitutionalization is due in part to the process of closing the publically operated mental hospitals, which facilitated the need to transport these patients to community based mental services; enabling wider geographic access (Martin, 2011). The movement grew great acclaim and was supported during the1960’s and 1970’s, illustrating the change in the structure, practice, experience and purpose of mental health hospitals from providing total care for mentally ill patients, to transferring these former responsibilities to local community facilities that were given federal aid ( Curtis, 2008).
One of the main driving factors to adopt deinstitutionalization was the consensus that the process might improve the quality of life for the mentally ill patients. There was a consensus that liberty was linked to increased quality of life to these mentally ill patients that were institutionalized at state run mental hospitals (Curtis, 2008). Quality of life is a term used to evaluate an individual’s general well-being in his setting in society. There are nine factors that determine quality of life and they include healthcare, family life, community life, material well-being, political stability, climate & geography, job security, political freedom and gender equality.
Some of the proponents of deinstitutionalization indicate that the process have secured the mentally ill have gained an increased measure of liberty. Richard Lamb, who was a proponent of the medical change stated, “There is often a tendency to underestimate the value & humanizing effects for former hospital patients of simply having their liberty to the extent that they can handle it and of being able to move freely in the community,†(Curtis, 2008). Another positive effect that deinstitutionalization created was that it allowed for mentally ill patients to live in community based rehabilitation facilities. While living in said facilities, these patients were able to care for themselves, attend school, and work a job and to maintain a sense of independence like any other American citizen (Curtis, 2008).
There are negative views concerning deinstitutionalization of the mentally ill. One of the views claims that the concept of deinstitutionalization has taken the mentally ill out of hospitals and placed them into prisons due to their inability to live within societal norms and misunderstanding of mental illness. A second view states that many homeless pave mental illness and have been forced out into the streets ( because of the deinstitutionalization program that was promulgated with the passing of the Aid to the Disabled Act, and the Mental Retardation Facilities & Community Mental Health Centers Construction Act (Netto, 2006). Many homeless shelters do not have the resources as well as the capacity to care for said homeless patients with mental illness. Another point is that there is a stigmatic association of mental illness and crime such as sexual activity, panhandling activity, drug proliferation as well as violence committed by schizophrenic homeless individuals (Curtis, 2008).
It is noted that the deinstitutionalization program have had positive and negative effects on the community as a whole and on the mentally ill person who was forced out of the mental health hospitals. In large urban cities like New York, Philadelphia, Chicago, Los Angeles, Atlanta, Houston etc, there is a considerable homeless population and a great many of these individuals have mental illness. Due to the limitations of the community services agencies, they are unable to assist all the mentally ill patients who were forced out of the state owned hospitals. The resources of these said communities are limited and as a result, these individuals who are forced to live in the streets are not given proper medical care, food, housing, and thus affects their quality of life. One can say that given the current situation, the deinstitutionalization process has actually exacerbated the homeless population in the United States and has influenced the negative stigma that homeless are mentally ill.
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Topic: Deinstitutionalization of the Mentally Ill (Read 790 times)