I just wanted to give my perspective on deinstitutionalization.

In the mid-80s, about a decade later than time The Away Place was describing, I volunteered in a homeless shelter in Raleigh, NC.  We fed the clients every night (soup and some protein) and then gave them donuts that were donated by Dunkin Donuts for breakfast (we knew it was awful nutrition but we didn’t have any money to get something better.  Many clients took extra donuts for their lunch.

It was clear to me, and the Shelter staff confirmed it, that many of the clients suffered from various degrees of mental illness or retardation.  I don’t know the percent but it was at least half.

The permanent staff of the Shelter said that these people were on the street because the state had closed many mental hospitals and the deinstitutionalized people ended up on the street.  It wasn’t clear to me exactly how they had gotten there, whether they had no other place to go, or whether they had been at some group home and just didn’t fit in there.

Anyway, from this experience, I developed a negative attitude toward deinstitutionalization.  I knew the hospitals were underfunded and often provided poor care (I had volunteered at a mental hospital in New Jersey when I was in college), but I reasoned that they must have been better than living on the street where the clients were subject to violence and suffered in extreme weather.  I also found out that the clients with the most severe problems often ended up in jail.

The Away Place gave me a new perspective.  I learned that group homes could work for certain patients although they were underfunded and worked largely because of the incredible dedication of the staff.  So reading this book, and talking to the author Ruth Tiger, has rounded out my understanding of deinstitutionalization.  I still believe that care of the mentally challenged is woefully insufficient in the USA, but it is good to know that there are those fortunate enough to find an “Away Place” that works for them.

Listed below are three articles on deinstitutionalization.  The first is a peer reviewed scholarly article the other one is from Wikipedia.  They give an up to date accounting of the effects, positive and negative, of deinstitutionalization.


Some Perspectives on Deinstitutionalization



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