Institutionalization

Placing emotionally disturbed or psychotic people in a therapeutic facility.

Our views of mental institutions are often colored by media's portrayal of them, such as in the movies One Flew Over the Cuckoo's Nest and Girl, Interrupted. With an emphasis on care and treatment, the best institutions offer emotionally disturbed people a better chance at life. They can learn new skills, improve behavioral and psychological problems, and develop healthier self-esteem.

People with mild emotional or behavior problems often benefit from a short stay at an institution and benefit from a therapy protocol that minimizes the fact of institutionalization. However, severely disturbed people require a longer stay and a highly controlled environment.

Psychologists differ widely on the long-term effects of institutionalization. A shortage of research funds means that little solid evidence exists to support one side or the other. Although many improvements have been made in the quality of mental institutions, some civil-rights and patients'-rights groups claim that incidences of neglect or below-standard care still exist. Of particular concern is the lack of proper staff training. Detractors of institutions also point out that patients are often sedated without given any other form of treatment. They assert that institutions do more harm than good.

Some concerns have also been raised regarding the institutionalization of children. In 1990, the American Public Welfare Association estimated that 65,000 children were living in group homes, residential treatment centers, or psychiatric hospitals. Institutionalization for emotionally disturbed children and adolescents is usually not meant to provide long-term treatment. The average stay ranges from several months to two years.

During the 1980s, the federal government began a program of "deinstitutionalizing" the mentally ill. Some returned to their families. Others found themselves in hospitals or community health centers. Today, it is not uncommon to see emotionally disturbed or psychotic people living on the streets, along with other homeless people. Local communities have been reluctant to provide alternatives to mental institutions, refusing to allow mental health clinics, half-way houses, or group homes to be established in their neighborhoods.