| Abstract |
The controversial concept of deinstitutionalization means reducing the population of state institutions by either placing the mentally ill in community facilities, allowing them to live on their own in community residences, or permitting them to live by themselves in the community. The Mental Health Procedures Act which became law in 1976 furthers deinstitutionalization. It provides a mechanism for institutional treatment of acute episodic incidents, where necessary, but severely limits society's tendency to hold on to its patients. During the past seven years, Pennsylvania has reduced its mental hospital population by 47 percent. However, this trend is opposed by employees of mental hospitals for reasons of self-interest, as well as by involuntary protectionists who believe psychiatric decisions are medical decisions to be made by physicians without intervention by third parties or the courts. The new federal legislation stresses the view that continued mental treatment should be on a voluntary outpatient basis whenever possible. According to its provisions, it will become increasingly difficult to keep a person institutionalized for a prolonged period. Preliminary results from Philadelphia indicate that the new act is being implemented successfully. Because of this legislation, deinstitutionalization may for the first time integrate admission, commitment, and discharge processes in a meaningful way, instead of seeming to merely dump mental patients on the community. Footnotes are provided. Included is a figure illustrating client flow in the involuntary system between September 1976 and February 1977. |
