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Updated: May 24, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Published on: February 16, 2011

What did we really expect from deinstitutionalization?

H R Lamb

    Hospital & Community Psychiatry
    |February 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Deinstitutionalization for long-term psychiatric patients requires realistic goals focused on dignity and comfort. Increased investment in community living arrangements and private sector involvement can improve care for the chronically mentally ill.

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    Area of Science:

    • Psychiatry
    • Public Health
    • Social Work

    Background:

    • Long-term psychiatric patients are a marginalized population facing challenges with deinstitutionalization.
    • Current programs often focus on higher-functioning individuals, neglecting the needs of the severely disabled.
    • Societal expectations of "mainstreaming" and "normalization" are frequently unrealistic for this group.

    Purpose of the Study:

    • To critically evaluate the effectiveness and realism of current deinstitutionalization strategies.
    • To propose a more achievable and humane approach to community care for severely disabled psychiatric patients.
    • To explore the role of the private sector in providing services for the chronically mentally ill.

    Main Methods:

    • Critical analysis of existing deinstitutionalization policies and programs.
    • Review of societal expectations versus patient capabilities.
    • Assessment of the potential for private sector involvement in community mental health services.

    Main Results:

    • Many proposed solutions for deinstitutionalization are simplistic and unrealistic.
    • Achieving dignity and comfort in community living is a more attainable goal than full "normalization."
    • The private sector, with appropriate incentives and oversight, can offer large-scale quality services.

    Conclusions:

    • Deinstitutionalization efforts must set realistic expectations, prioritizing dignity and comfort for long-term psychiatric patients.
    • Significant investment in community living arrangements is crucial for successful integration.
    • Engaging the private sector with proper support can enhance the provision of care for the chronically mentally ill.