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PubMed1979

Deinstitutionalization in context.

Unlike other policy developments, which are regular and cumulative or even circular, reforms in mental health have been characterized by a peak-trough movement. Public responses continue to be very different from professional responses to achieving the practical limits of mental health. Ironically, the lack of machinery to integrate special services into a broad national program has mobilized more creative energy in the United States than has been the case in Britain.

Community Mental Health Services↗
PubMed1989

[Who is left in the institutions? Some problems in connection with the process of deinstitutionalization].

The medical and psychiatric diagnoses of 168 clients aged 16 to 65 years in a Norwegian institution for the mentally retarded were registered together with medication, level of functioning, and types of problem behavior. Most of these clients (64.9%) were profoundly or deeply retarded, and only 6.5% were independent of continuous supervision or help. Medical diagnoses were found in 87.5%, psychiatric diagnoses in 89.1% (DSM-III, axis I). Daily use of medication was found in 81.0% of the clients, and 48.9% used psychotropic drugs on a daily schedule. 58.3% of the clients had exhibited violent behavior during the last year, defined as assaults on persons, self-mutilation or destructiveness. The article discusses the implications of these observations for primary health care, which is expected to supply the necessary service to these clients after 1991.

Adolescent↗