[The deinstitutionalization process in the United States (Part 1).].

Area of Science:

• Public Health
• Sociology
• Health Policy

Context:

• Analysis of the socio-economic-political factors contributing to the closure of 78.5% of state psychiatric beds in the U.S. over the past three decades.
• Examination of the U.S. government's legislative and fiscal strategies implemented for deinstitutionalization.
• Overview of the influence of legal battles, initiated by psychiatric patients and their advocates, on the deinstitutionalization policy.

Purpose:

• To analyze the multifaceted conditions leading to the significant reduction in American asylum bed capacity.
• To elucidate the governmental mechanisms and legal precedents shaping mental healthcare policy shifts.
• To understand the interplay between policy, legislation, and patient advocacy in deinstitutionalization.

Summary:

• The study identifies key socio-economic-political drivers behind the closure of 78.5% of U.S. asylum beds in the last 30 years.
• It details how legislative and fiscal measures were employed by the U.S. government to enact its deinstitutionalization policy.
• The analysis highlights the crucial role of court battles, led by psychiatric patients and supporters, in advancing this policy.

Impact:

• Provides critical insights into the historical trajectory of mental healthcare in the United States.
• Informs contemporary policy discussions regarding institutionalization versus community-based care.
• Underscores the impact of patient advocacy and legal action on public health policy reform.