Introduction: Legacies of Deinstitutionalization through the Lens of Medical Sociology

Throughout the 1960s and 1970s, a revolution in mental health policy and practice known as deinstitutionalization occurred in Europe and the United States. This movement was catalyzed in large part by criticisms of psychiatric institutions leveled by sociologist Irving Goffman and others, and resulted in the release of hundreds of thousands of people with severe mental illness from long-term care facilities into the community. It is widely acknowledged that these reforms held great promise, but have had numerous unintended negative consequences for people with mental illness and their families. Having been chronically underfunded, deinstitutionalization has strained the resources and reach of community-based mental health treatment systems, spilling into other institutions such as criminal justice and social welfare. This has led to renewed debates in the United States, the United Kingdom, and elsewhere about problems in public mental health systems, and to calls for rebuilding some functional aspects of the inpatient system that were successfully dismantled by deinstitutionalization reforms.