meself, That is true to a large extent. Much more effective antipsychotic medications really made a big difference in the number of people with severe and persistent mental illness (SPMI)who did not require long-term hospitalization because of florid psychosis.

However, costs were what really drove changes in government policy. It was thought a lot of money could be saved by moving the mentally ill into the community. Hospitalization is expensive, most state psychiatric facilities are State funded--Medicaid will not pay for hospitalizatin in a State facility. And the mentally ill were turned out in droves with no thought to what their needs were to live in the community. And law makers still don't get that it costs as much or more than hospitalization to adequately serve people with SPMI in the community. The community services, housing, (both supervised and unsupervised), psychosocial rehab programs, mobile crisis services, ACTT services, and income maintenance programs are still grossly inadequate. The mentally ill are a disenfranchised population, they have no political clout, and no real hope of political power. While plenty of people in the USA arwe homeless who are not mentally ill, the dramatic rise in homelessness in the USA over the last 25 years correlates very strongly with the disinstitutionalization movement.

I was working in the public welfare system back then, in a rural area and was pretty oblivious to it. bobert, you know a lot more about the immediate aftermath of deinstitutionalization than do I. However, I moved over into public mental health after I went back to graduate school for my MSW, and have been working with SPMI populations, as well as other indigent populations in need of mental health and psychotherapy since the early 90's. It was bad then. It is much worse now, at least in North Carolina, where we have just started another cycle of 'Mental Health Reform' (Ha! to quote Bobert.)

Janie