HUMAN SERVICES RECIPIENTS

Human Services Recipients

Human Services Recipients

Introduction

The policy of the deinstitutionalization of psychiatric services is probably the most controversial that has been implemented in the field of mental health during the past century. Debate about the deinstitutionalization of psychiatric services is rooted in whether the motive was therapeutic or political/financial. Arguably, the crucial issue is whether it results in improved mental health of the community.

Concept of Deinstitutionalization

The ideas, on which the policy of deinstitutionalization, are based, include the following: There are savings that could be achieved by closing beds and mental hospitals. These savings can be invested to better effect by developing mental health services that would treat patients in their communities and allow them to stay at home rather than becoming institutionalized. Three principal assertions form the basis for this policy: (1) psychiatric hospitals are expensive and serve fewer patients than can be served in community based services; (2) people are more likely to access services that are located in a location that is close to where they live; and (3) reducing admissions and length of stay in long term psychiatric hospitals allow patients to make maximum use of their current social supports and/or reduce their level of readjustment upon discharge. The latter is sometimes referred to as avoiding the iatrogenic effects of hospitalization, on the one hand, and leveraging the social supports that patients already have, which, at least, involves not contributing to the erosion of these social supports (Davidson et al. 2001; Lamb and Bachrach 2001; Leff et al. 1996). According to Health and Welfare the benefits of psychiatric services are optimized when the treatment and rehabilitation occur in a familiar community and on an “as needed” basis.

Impact of Deinstitutionalization on Human Service

The impact of deinstitutionalization within the local community has been lower medical ...