Privatization and protective services for the elderly: Some observations on the economics of the aging process

Abstract

Various analysts of both social control and social welfare policies and practices have identified a major shift in the management of groups such as the mentally ill, the mentally retarded and the mentally infirm elderly in advanced capitalist countries (Emerson, 1981; Lerman, 1982; Scull, 1977, 1981; Warren 1981). Until relatively recently, reliance upon state-operated and financed institutions and services used to lie at the very heart of social control and welfare policies. However, since the early 196Os, the trend has been towards deinstitutionalization and the reprivatization of alternative care and treatment facilities (Lerman, 1982; Scull, 1977, 1981). This general development has been referred to as the “privatization and profitization of social control” (Spitzer & Scull, 1977), and, in the specific context of mental health systems, the ‘recommodification’ of the mental health patient (Scull, 1981). There is a growing interest in the way in which a private sector, social welfare and social control marketplace is being created and how, following a variety of financial initiatives on the part of the state, the incentive to engage in social welfare and social control entrepreneurship has been developed. The goal of this article is to identify and delineate another feature of this general trend. The focus of inquiry will be turned upon one specific group,of persons, who have been affected by the policies of deinstitutionalization and privatization: namely, the mentally infirm elderly. While a policy of reprivatization is unfolding in relation to care and treatment facilities, the reverse trend seems to be forming in relation to the provision of the guardianship and trusteeship (or “conservatorship”) services, which are an important adjunct to the policy of deinstitutionalization. Scull has contended that one notable consequence of deinstitutionalization has been “a much greater involvement of the private sector in spheres