[20180626]IF10870_精神病机构化和非机构化.pdf

https:/crsreports.congress.gov Updated June 26, 2018Psychiatric Institutionalization and DeinstitutionalizationThe history of mental health care in the United States can be understood as a period of institutionalization followed by one of deinstitutionalization. Federal law, however, has not been fully aligned toward either institutional care or community-based (i.e., noninstitutional) care. Institutionalization The early U.S. health care system offered little treatment for mental illness. People with serious mental health conditions often ended up in prisons or shelters for the poor. Few privately or publicly funded asylums had been established by the mid-19th century, when state psychiatric hospitals began to grow in number and size. Institutional mental health care was viewed as a state responsibility and was not funded by the federal government. Community-based (i.e., noninstitutional) mental health care was mostly unavailable. Even as institutionalization was on the rise, the foundations for its decline were emerging in the form of perceived problems with institutional care and benefits of community-based care. Stories of poor living conditions in psychiatric hospitals raised