Suchergebnisse

A growing number of concerned citizens in the United States are becoming aware of some of the negative characteristics associated with large public institutions for disabled children and adults. As an alternative to institutional placement, this article discusses deinstitutionalization as a process for normalizing the environments of disabled persons through their removal from public institutions and the provision of comprehensive community services at the local level. The ten major objectives of deinstitutionalization are discussed in detail, and several examples of decentralized programs are presented.

The Croatian government is undertaking a five-year plan to move people with intellectual and physical disabilities from confinement in two long-stay institutions, to supported housing within their communities.This paper examines a 17-year investment by the Mental Health Initiative of the Open Society Public Health Program to make these reforms possible. It reviews the development of civil society engagement, past organizational failures, changes in international law and political pressure, the roots of government partnership, and future challenges and opportunities.

AbstractWe are now beginning to realize that treating the most severely impaired of our mentally ill citizens involves the thoughtful conceptualization of complex public policy problems.

AbstractThe need for systems‐oriented planning strategies is being increasingly recognized and a sophisticated body of literature on the essentials of comprehensive deinstitutionalization planning is beginning to emerge.

Deinstitutionalization refers here to the erosion or discontinuity of an institution alized organizational activity or practice. This paper identifies a set of organiza tional and environmental factors that are hypothesized to determine the likelihood that institutionalized organizational behaviours will be vulnerable to erosion or rejection over time. Contrary to the emphasis in institutional theory on the cultural persistence and endurance of institutionalized organizational behaviours, it is suggested that, under a variety of conditions, these behaviours will be highly susceptible to dissipation, rejection or replacement.

Examines deinstitutionalization in the 20th century not as a single, consistent public policy, but as a result of unrelated, successively worsening developments in the mental health field. After 1945, inpatient mental hospitals were not as socially & medically endorsed because of such factors as the efficacy of outpatient treatments demonstrated by the experiences of WWII & journalistic exposes that showed the Depression's impact on mental hospitals. The introduction of Medicaid, which transferred the care of the elderly from mental hospitals to nursing homes, & Social Security Disability Insurance, which provided an income to those who were disabled & incapable of holding a job, also had significant effects on deinstitutionalization, since both shifted financial responsibility from state to federal governments & resulted in inpatients being discharged from mental hospitals. The effects of deinstitutionalization on the subgroup of young mentally ill adults with high rates of alcoholism & substance abuse, which led to high rates of homelessness, are also analyzed. Successful examples & suggestions for improving services for the chronically mentally ill are discussed. C. Haywood

Before America began creating a federally based welfare state in the 1930s, most publicly funded responses to social problems had an institutional bias. The ways in which the welfare programs initiated 50 years ago have helped to influence institutional trends, and are likely to continue doing so in the future, constitute the major focus of this analysis. Four special problem groups are assessed from a historical perspective: (1) the dependent aged and the movement from local almshouses and state insane asylums to nursing homes; (2) the mentally ill and the movement from state hospitals to a variety of local medical and nonmedical residences; (3) the developmentally disabled—formerly the mentally retarded—and the movement from state schools to private community residential facilities; and (4) the dependent/neglected and delinquent youth and the movement away from orphan asylums and training schools to group homes, treatment centers, adolescent psychiatric units, halfway houses, and outdoor camps. Recent trends and projections, as well as present and future policy issues, are assessed.

Before the US began creating a federally based welfare state in the 1930s, most publicly funded responses to social problems had an institutional basis. The ways in which welfare programs initiated fifty years ago have influenced institutional trends, & are likely to continue to do so, are examined using previous survey research. Four special problem groups are assessed from a historical perspective: (1) the dependent aged & the movement from local almshouses & state insane asylums to nursing homes; (2) the mentally ill & the movement from state hospitals to a variety of local medical & nonmedical residences; (3) the developmentally disabled -- formerly the mentally retarded -- & the movement from state schools to private community residential facilities; & (4) the dependent/neglected & delinquent youth & the movement away from orphan asylums & training schools to group homes, treatment centers, adolescent psychiatric units, halfway houses, & outdoor camps. Recent trends & projections, as well as present & future policy issues, are assessed. 4 Tables. HA