Deinstitutionalization: a new scenario

Area of Science:

• Public Health
• Health Services Research
• Mental Health Policy

Background:

• Large, warehouse-like state mental health facilities are widely considered inadequate.
• There is a consensus among the public, courts, and administrators regarding the inadequacy of current state facilities.
• The deinstitutionalization of mental health services remains a complex and unresolved issue.

Purpose of the Study:

• To explore the challenges and considerations for effective mental health delivery systems.
• To highlight the need for strategic planning in the transition from state facilities.
• To identify key stakeholders and their roles in successful deinstitutionalization.

Main Methods:

• Analysis of the current state of mental health populations in state facilities.
• Review of the agreement among public, courts, and administrators on facility inadequacy.
• Examination of the requirements for successful community-based mental health service implementation.

Main Results:

• Mental health populations in state facilities have decreased by over 50% since 1955.
• Successful implementation of mental health delivery systems necessitates careful, state-specific planning.
• Administrator training is crucial for effective collaboration with the public and courts.

Conclusions:

• Deinstitutionalization requires a thoughtful, community-tailored approach to mental health service delivery.
• Investing in administrator training can enhance the provision of appropriate mental health services.
• The future of mental health care depends on adaptable and well-planned systems, moving beyond outdated large-scale facilities.