Mechanic, D. & Rochefort, D. A. (1990). Deinstitutionalization: An appraisal of reform. Annual Review of Sociology. 16, 301-327.

In 1963, President Kennedy introduced the Community Mental Health Centers Act. It was met with great enthusiasm by professionals and the public, and surpassed its goals of deinstitutionalization of mental health care by leaps and bounds. Little did Kennedy know that his piece of legislation would have significant negative effects on the mentally ill community. In their article “Deinstitutionalization: An Appraisal of Reform,” Mechanic and Rochefort examine these effects and their possible causes.
As Mechanic and Rochefort state, deinstitutionalization initially achieved what few public policy initiatives have—rousing support and unexpected success. As time went on, however, it became clear that the measure was, in fact a failure. Because of the incomplete and inadequate performance of supportive services that were intended to accompany the release of patients from inpatient facilities, many severely and persistently mentally ill patients did not receive the essential care that they needed. This led to a growing number of mentally ill homeless, who, having been released from their inpatient hospitals, had no sufficiently supportive community-based system to turn to. The undersupply of community mental health centers was due in part to significant financial cuts in social programs. These cuts particularly affected those who were both young and severely mentally ill.
One Flew Over the Cuckoo's Nest presents to the audience an example of the negative facets of institutional mental health care. This article is interesting because it argues the opposite side of the matter. It presents deinstitutionalization as a well-intentioned but misguided alternative to inpatient facilities. Even if conditions in a mental hospital are not ideal, some patients may require such a system in order to function. The movie seems to argue that the institutional mental health care system crushes individuality and human expression, and portrays such atrocities as ECT and lobotomies as characteristic of such a system. However, in order to truly appreciate the issue, one must also be exposed to the other side of the coin—the argument that the rigidly controlled hospital system is the only system in which the most severely ill can thrive, and that giving free reign to those who cannot live independently is disastrous and counterproductive.