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.

This is a collection of mental health resources for Mad, Bad and Sad. It consists of databases, websites and books to aid in researching the question: "How would you improve mental health services for children with a specific mental disorder in Philadelphia?" Also included are basic information evaluation resources.

Philadelphia Department of Human Services school based program, a collaboration with the school system.

Child and Adolescent Mental Health page from the Substance Abuse and Mental Health Services Administration. (SAMHSA)

It is the mission of the UPenn Collaborative to lead the field in the development of the core concepts and practical technologies of community integration and to advance the centrality of community integration in the future development of policies and supports for people with serious psychiatric disabilities.

The Mental Health Association of Southeastern Pennsylvania (MHASP) is a nonprofit citizen's organization that develops, supports and promotes innovative education and advocacy programs. MHASP serves adults, children and family members through our programs and advocacy efforts.

Basic introduction to psychiatric disorders, modeled after the DSM-IV. Within each section is a series of chapters that briefly describe an overview, time of onset, clinical features, course, complications, etiology, differential diagnosis, and treatment of a given disorder.

The DSM-IV-TR is a Text Revision of the 1994 publication. There were very few revisions. This page explains what the TR is.

The OSS provides comprehensive special education, behavioral health, school health, and prevention/intervention programs which are aligned with the educational and organizational goals as outlined in the District's Strategic Plan.

Database of online social services available for Philadelphia residents.

This Web site is a resource for individuals, families and agencies concerned with behavioral health and mental retardation services. It provides information about behavioral health and mental retardation services, laws, and related news, as well as communication tools and other features.

DBH/MRS is comprised of the Office of Mental Health (OMH), the Coordinating Office for Drug and Alcohol Abuse Programs (CODAAP), Mental Retardation Services (MRS), and Community Behavioral Health (CBH).

Nice organizational chart of the city services under BHS.

"The report from CDC's National Center for Health Statistics is based on six years of data from the National Health Interview Survey. The main finding is that immigrants reported significantly better physical and mental health, such as lower rates of obesity and high blood pressure, than their U.S.-born counterparts despite having limited access to health care and little or no health insurance."