Out of the Hospital, onto the Streets: The Overselling of Benevolence

Abstract

system no less so. When the deaths are reported by the media, there is a collective clucking of tongues, some remedial action, and then business as usual. These homeless people are one consequence of what has come to be known as deinstitutionalization, the release of several hundred thousand patients from public mental hospitals in the last twenty years. Deinstitutionalization is generally considered to have been caused by the deplorable conditions in a number of the hospitals, advances in drug therapy, court decisions, new (or newly accepted) theories of mental illness that helped form an ideology for noninstitutional care, and the unusual commonality of purpose (if not motives) of those whose values and objectives are not often compatible-politicians advocating "economy in government," civil libertarians under the banner of "patient's rights," and mental health professionals dedicated to "care in the community." The effects of deinstitutionalization have