Social Issues Surrounding De-institutionalisation
In the past, people diagnosed as mentally ill often resided in mental institutions.
During the 1960's there was a general questioning of the traditional practices of society, including the way individuals were admitted to psychiatric institutions and how they were treated there.
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The institutions had been designed initially to provide long term care for individuals with incurable and chronic behavioural/psychiatric conditions. The advent of neuroleptics meant that these conditions could be controlled, and therefore there was a reduced requirement for the facilities. |
Sociologists such as Irving Goffman and others managed to get themselves falsely admitted to the institutions in order to view the workings from the inside and then published papers in relation to the treatments and practices they had experienced and witnessed.
Institutions it seemed were dangerous places that operated outside the existing legal and ethical system whilst costing huge amounts of money to maintain. See 'One Flew Over the Cuckoo's Nest' as an indication of the workings of a mental health institution up to the 60's.
The closure of institutions moved the patients from situations of twenty four hour care in the company of a large number of other individuals to a situation of living independently without resident staff. The institutions were extremely structured facilities where the patients' time was organised for them. As a contrast the 'deinstitutionalised' clients became free to organise their own time.
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Unfortunately, long term clients with many years of experience in institutions had a limited range of skills and experience to prepare them for life outside. Whilst some settled into the community within supported accommodation programs with support workers there are some people for whom deinstituionalisation has not been successful. Many have taken a place amongst the long term homeless population. |
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Some reside in older shelters that are organised in a similar fashion to the institutions (that is, the individuals are woken by staff each morning at a set time, have their breakfast at a set time and are able to engage with the staff at any time during the day). Even more importantly, the clients are in the company of a large number of people with whom they can engage if they choose. The other people in the shelter are less likely to judge them or make reference to their odd behaviour.
The vulnerability of this group leaves them open to exploitation at the hands of more 'skillful' individuals. For example, their money and possessions can be stolen from them as they sleep within dormitory style accommodation.
The community response to individuals with mental illness varies from a position of fear to paternalism. Fear that the mentally ill will kill and maim people indiscriminately is common (a fear that is not supported by any research). Paternalism assumes that the individuals should be protected and isolated in communities of 'similar' people. These attitudes are born out of ignorance that is slowly being reduced through the activities of SANE and other groups.
In Australia, intensive support for people diagnosed with a mental illness is available. Case management practices, community mental health teams and a range of accommodation (supported residential facilities, public housing units, hostels and nursing homes) are accessible.
You may like to research the support services available in your local
area.
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