Deinstitutionalization of the Mentally Ill: Evidence for Transinstitutionalization from Psychiatric Hospitals to Penal Institutions1:

Abstract Since the deinstitutionalization movement, many researchers have suggested that psychiatric patients have moved from one type of institution to another—a process known as transinstitutionalization. This study sought to assess evidence that suggests the mentally ill from Pennsylvania psychiatric hospitals have been transinstitutionalized to penal institutions over the years 1978 to 2010. We gathered data from a number of state agencies and found a significant negative correlation between the incarceration rate and number of psychiatric hospital beds, even after taking into account via partial correlation the changes in population and economic indices such as unemployment and poverty rates in the state. Regression analysis indicated that 6.8% of the year-to-year variation in incarceration rate could be accounted for by the decrease in statewide psychiatric hospital beds after controlling for population and unemployment rate. These transinstitutionalization effects were estimated to cost the state $...

[1]  Robert John Zagar,et al.  Can Violent (Re)offense be Predicted? A Review of the Role of the Clinician and Use of Actuarial Tests in Light of New Data , 2009, Psychological reports.

[2]  Robert John Zagar,et al.  Accepted Legal Applications of Actuarial Testing and Delinquency Interventions: Examples of Savings in Real-Life Situations , 2009, Psychological Reports.

[3]  C. Peternelj-Taylor.  Criminalization of the mentally ill. , 2008, Journal of forensic nursing.

[4]  H. Whiteford,et al.  Prisons: mental health institutions of the 21st century? , 2006, The Medical journal of Australia.

[5]  J. Burnham.  A Clinical Alternative to the Public Health Approach to Mental Illness: a forgotten social experiment , 2006, Perspectives in biology and medicine.

[6]  S. Banks,et al.  Utilization of local jails and general hospitals by state psychiatric center patients , 2000, The Journal of Behavioral Health Services & Research.

[7]  B. Pescosolido,et al.  The closing of central state hospital: Long-term outcomes for persons with severe mental illness , 1999, The Journal of Behavioral Health Services & Research.

[8]  W. Wainwright,et al.  Transfers to a psychiatric emergency room: A fresh look at the dumping syndrome , 2005, Psychiatric Quarterly.

[9]  L. Lamberg.  Efforts grow to keep mentally ill out of jails. , 2004, JAMA.

[10]  M. Knapp,et al.  Twelve years on: Service use and costs for people with mental health problems who left psychiatric hospital , 2004 .

[11]  Margaret E. Severson.  The Impact of a State Hospital Closure on Local Jails: The Kansas Experience , 2000, Community Mental Health Journal.

[12]  W. Fisher,et al.  A continuum of services for the deinstitutionalized, chronically mentally ill elderly , 1991, Administration and Policy in Mental Health and Mental Health Services Research.

[13]  A. Estrada,et al.  Reversing the Criminalization of Mental Illness , 2003 .

[14]  C. Mowbray,et al.  Managed behavioral health care in the public sector: will it become the third shame of the States? , 2002, Psychiatric services.

[15]  H. Lamb,et al.  Outcome for psychiatric emergency patients seen by an outreach police-mental health team. , 1995, Psychiatric services.

[16]  G. Palermo,et al.  Jails versus Mental Hospitals: A Social Dilemma , 1991 .

[17]  H. Lamb,et al.  The mentally ill in an urban county jail. , 1982, Archives of general psychiatry.

[18]  H. Lamb,et al.  Legislating social control of the mentally ill in California. , 1981, The American journal of psychiatry.

[19]  H. Steadman,et al.  Explaining the increased arrest rate among mental patients: the changing clientele of state hospitals. , 1978, The American journal of psychiatry.