The process of deinstitutionalization: an international overview

Abstract

The process of deinstitutionalization has led to the closing or downsizing of former asylums and to the development of community-based mental health care models in many countries, most notably in Western Europe, North America and Australia/New Zealand. The quality of the resulting community mental care systems varies substantially across countries worldwide, depending on various factors such as financial resources and social acceptance of deinstitutionalization. Confinement of those with dangerous behaviours, the right of mentally ill people as members of the community, their successful integration in the community and access to employment and housing are some of the challenges facing countries with advanced deinstitutionalization. In others, the process of de-hospitalization is still under way. Future research may utilize international comparisons to analyse deinstitutionalization processes from a sociological and historical perspective and focus on evaluating new forms of institutionalized care in the community, in particular, models of supported housing.