Deinstitutionalization: Impacts and Challenges

Deinstitutionalization is a complex process that involves transitioning mentally or physically handicapped individuals from institutional settings, primarily focused on treatment, into their respective communities while providing necessary services under the supervision of healthcare professionals. While deinstitutionalization has yielded positive outcomes for both patients and society, it has also presented various challenges and drawbacks. In this essay, we will delve into the multifaceted nature of deinstitutionalization, its historical context, and the implications it holds for society.

The Deinstitutionalization Process

The deinstitutionalization process is not a simple or singular event; rather, it encompasses a series of steps and procedures that impact the entire community.

It began to gain traction in the late 1950s and early 1960s when institutions became financially responsible for their committed patients and sought ways to transfer this financial burden to the federal government through patient discharge.

While some argue that deinstitutionalization primarily arose due to the inadequate treatment provided within these facilities, it was also motivated by concerns about patients' civil rights.

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This shift towards deinstitutionalization aimed to establish more stringent standards for civil commitment and introduce practical safeguards, including the right to receive treatment in the least restrictive environment possible (Watnik, 2001).

However, the implementation of deinstitutionalization has varied across states, and New York, for instance, faced challenges in its approach. Prior to 1994, New York was the only state with specific limitations prohibiting outpatient commitment. Recognizing the need for change, in 1994, the Bellevue Pilot Program was established to facilitate the deinstitutionalization process.

In 1999, New York Governor George Pataki enacted Kendra's Law in response to rising concerns about mentally unstable individuals causing harm to others.

This law permits certain individuals, such as family members, to petition the court for an order mandating outpatient treatment for individuals meeting specific criteria. Kendra's Law aims to track mentally ill individuals upon their discharge from mental or correctional facilities, assisting them in finding suitable outpatient programs tailored to their needs (Watnik, 2001).

Community-Based Programs and Challenges

New York, like many states, has introduced disbursement programs designed to address ongoing social issues such as homelessness, crime, and the spread of communicable diseases. These programs encompass a range of services provided in community settings, including mental health centers, outpatient clinics, partial care organizations, assertive community treatment, consumer-run programs, and services offered by state hospitals off hospital grounds. The success and effectiveness of these programs are evaluated based on both residential and nonresidential services.

Kendra's Law, in conjunction with these community-based programs, serves as a means of ongoing support and assistance for the mentally ill community. It aims to help individuals manage their illnesses and stay out of trouble (Watnik, 2001).

Challenges and Future Directions

While deinstitutionalization has brought about significant changes in the treatment of mentally ill individuals, it is not without its challenges. One area that warrants attention is the need for stricter laws and regulations aimed at encouraging mentally unstable individuals to remain in outpatient treatment, even when they believe they do not require it.

Moreover, society must establish additional programs focused on helping these individuals regain their financial, emotional, and physical stability. Too often, individuals prematurely discontinue treatment, potentially resulting in harm to themselves or others. Implementing safeguards and comprehensive support systems can contribute to the safety of our communities.

Conclusion

In conclusion, deinstitutionalization is a multifaceted process that seeks to transition mentally or physically handicapped individuals from institutional settings into their communities while ensuring necessary support and supervision. While its implementation has varied across states and posed challenges, initiatives such as Kendra's Law and community-based programs have played a crucial role in providing ongoing assistance and support to mentally ill individuals.

Addressing the challenges associated with deinstitutionalization requires the development of stricter regulations to encourage treatment adherence and the establishment of comprehensive support programs. By doing so, we can strive to create safer and more supportive communities for everyone, including those with mental health needs.