In the 1990s, the Ministry of health, in accordance with several experiences of psychiatric reform in the Western world, but especially with the law 180/1978, of Italy (6), and the recommendations of the Pan American Health Organization (PAHO) in the letter of Caracas (1990) (7), defined a new mental health policy, which had been started with PAD (Programa de Apoio e Desospitalizacao, or Program of Support and Deinstitutionalization
Department of Health and Human Services, has published "Deinstitutionalization
: Unfinished business" which encourages the closure and displacement of individuals with profound disabilities from homes of four or more residents, without regard for individual choice and need and contrary to Olmstead.
We thus inferred that late adopters are motivated to implement deinstitutionalization
for technical efficiency reasons rather than social legitimacy reasons.
Both articles note that many individuals with disabilities did not really experience deinstitutionalization
. Rather, they left the state asylums only to find themselves in other institutions: nursing homes, board-and-care or "adult homes," even jails and prisons.
She wrote many book reviews, and studied and wrote on topics including Salem witchcraft, wives of medical and academic doctors, deinstitutionalization
, Smith College alumnae, Three Mile Island, and Love Canal.
A mental health professional and advocate, Torrey attributes the lack of care to deinstitutionalization
and the legal and political recognition that institutionalizing someone involuntarily violates their civil rights.
With the development of the Americans with Disabilities Act (ADA) of 1990 and the move toward deinstitutionalization
, there has been an increased awareness of the health needs of persons with disabilities.
Nasrallah's editorial about the tragic consequences of deinstitutionalization
("Bring back the asylums?" From the Editor, CURRENT PSYCHIATRY, March 2008, p.
The movement of deinstitutionalization
was (and is still in process) designed to gradually shift perception of mental defects and how professionals and the general public treat and label person with disabilities.
A key feature of mental health reform has been the deinstitutionalization
of people with serious forms of mental illness from large psychiatric hospitals to various kinds of facilities, including more home-like tertiary care facilities and other forms of supported housing in the community.
Also, as a result of deinstitutionalization
, retrenchments in social service budgets and professional antipathy towards the use of residential care, residential services are no longer widely used.