The politics of normalization

The concept of normalization is an influential paradigm in mental health. However, little attention has been paid to how the psychiatrically disabled fare in the competition for generic services. Four psychiatric aftercare areas were examined: income maintenance, housing, vocational-educational, social-recreational. Results indicate that generic services do not successfully support the chronic patient in three of the four areas examined. Only in the field of vocational-educational support have generic agencies made a serious effort, and even here the most seriously disabled patients still rely on specialized services. The authors suggest that the theory of normalization is constructed on fundamentally erroneous assumptions and discuss alternative rather than normative programs for the long-term mentally ill.