Deinstitutionalization

We are all well aware that the two systems within which I work are broken.  Mental health/Medicaid system as well as the child welfare system have definite deficits.  Through my process of working in them, I've wondered how they've gotten this way.  What happened to the lunatic asylums and the orphanages that used to house our mentally ill adults and despondent children?

From my internet research I don't find any clear law or act that got rid of those kinds of institutions all at once.  It was all pretty gradual, perhaps first initiated with the Social Security Act in 1935.  And in the 1950s psychotropics came out and greatly reduced the symptoms of mental illness.  In 1963 Kennedy was able to pass the Community Mental Health Centers Act.  He had a special concern with those with mental illness because his own sister had been lobotomized in her early twenties.  Also in the 1960s, the Federal Aid for Families with Dependent Children legislation provided funding and services for preserving biological families and preventing children from being placed in orphanages.  The premise of these two legislative measures was on track, provide services for individuals needing care within the community rather than locking them away in institutions.

Those of you educators out there know the common phrase, "least restrictive environment."  That was our hope with deinstitutionalization, provide environments that were less restrictive and envelop those with disabilities into the community at large.  But somehow, we've let individuals fall between the cracks and are not providing those environments for them.  There are people with mental illness not receiving the proper after-care services, floundering in the broken system.  There are children in the welfare system jumping from one home to another in our efforts to provide them a less restrictive home environment setting.  Though we may have gotten rid of a lot of the evil institutions, it doesn't mean that the people that were in them no longer exist.  They still need our help.

If interested, find out more about:
A legislator whose "reforms" he worked on worsened his son's life (excerpt of this article also published in Washington Post) by Paul Gionfriddo, author of blog entitled, Health Policy

the high concentration of people with mental illness in the Uptown area of Chicago, and

the rise and demise of the American orphanage