Introduction
Deinstitutionalization of the mentally ill involves the replacement of isolated psychiatric hospitals where patients stay for a long time before they are integrated back to the community. Deinstitutionalization has two most important aspects: reduction of the number of individuals in mental institutions by releasing them and reduction of both admission and re-admission rates in such facilities. The intention is to ensure that the number of patients retained in such facilities for long term stay is minimized as much as possible (Valentine & DeAngelo, 2016). Deinstitutionalization is a good community practice because it prevents isolation of a particular group of people simply because their mental condition is different from others.
Even so, it is considerably important to appreciate that this practice comes along with various challenges. This emanates from the fact that it is difficult for psychiatric patients with serious mental illnesses to learn to live in a community setting. The psychiatric hospitals with a primary intra vires role of restraining and treating severe and persistent global illnesses are rare. Ethical dimensions and social responsibility have, however, compelled most governments to amend national policies to accommodate the mentally ill in the community. This capstone research project seeks to provide a comprehensive discussion of deinstitutionalization and its effects on individuals, society and community health services.
Background
The research project will involve various research surveys with different sample sizes that shall be dependent on the moderate number of the selected location. The researcher intends to use a population of individuals in the American society with different age ranges, formal literacy, and educational background. This shall be done to ensure that there is a wide range of opinions and views. The main target population shall include psychiatric students, experienced psychiatric officers, officers in the government and members of the general public. Even so, as much as the general public shall be involved, a relatively equal level of education and fair illiteracy level shall be a major consideration before individuals are invited as respondents (Weiss, 2016). In searching for appropriate respondents, the researcher also intends to consider the age of the respondents with a major focus on the middle ages.
One of the major issues facing the population is deinstitutionalization of the mentally ill. It is challenging for members of the population to interact comfortably with the mentally ill both in the community and in the society at large. Over the years, both the state and the federal government have reduced their commitment to mental illness, and the number of hospitals that are specifically meant to handle mental problems has significantly reduced. Further, the available hospitals have continuously avoided patient admission and re-admission. Only severe cases are admitted for long term stay in these health facilities. This has resulted to an estimated 4.5 million Americans (1 in every 108 Americans) suffering from severe brain disordered and mental illnesses with no treatment hence incarceration, homelessness, and violence. This kind of incarceration is totally unjust and unfair as the individuals go against the law unintentionally due to their wanting mental conditions. The figure below provides a statistical summary of the prevailing situation as far as deinstitutionalization of the mentally ill is concerned.
Figure 1: Comparison of American Government Expenditure on Mental Illnesses
Source: The Washington Post
It is unarguable that a large number of mentally ill patients discharge and absorbed into the communities cause a considerable financial burden to members of such communities. For those who fear that the mentally ill may cause them harm, they increase their investment in security. For philanthropists and well-wishers, they allocate more funds into helping and for the families where such patients emanate from, more resources to cater for their well-being are allocated. Further, state funding increases it’s spending on such issues. Deinstitutionalization is, therefore, a significant economic influencer. In late 1960, the American Society found it morally right to deinstitutionalize the mentally ill in an attempt to ensure that they are not isolated, but they are given an opportunity to interact with other members of the society. The majority of the individuals found it ethical to do so especially based on the notion that ethics demand respect for everyone irrespective of their protected characteristics (Kreig, 2016).
The society mainly perpetuates deinstitutionalization through the government which is an institution for the people by the people. As pointed out earlier, in the 1960s, Americans portrayed major concern for their mentally ill colleagues and found it wise to move them from highly isolated state institutions to the less isolated and interactive communities. Through their representatives, policies were passed that required the state, rather than the federal, government to man the mentally ill in their communities. Further, the number of people admitted and re-admitted in such institutions was significantly reduced as this was the people’s interest. The society at large is, therefore, the main contributor. Few individuals, especially top government officials, also form major contributors in perpetuating deinstitutionalization.
As pointed out earlier, deinstitutionalization, however, has personal, and ethical implications on the society. One of the main personal impacts of the phenomena is the danger of half treated or fully neglected patients. When the mentally ill are integrated with the society, the event that they fail to take complete medication procedures increases. As pointed out earlier, 4.5 million American who are severely mentally ill are not under any special treatment. This would not have been the condition if the patients had not been deinstitutionalized (Sickel, 2016). In isolated state institutions, mental illness officials take care and follow up the behavior of the mentally ill patients and ensure that everything is in order. Further, deinstitutionalization results to more people with mental illnesses in jails and prisons rather than state hospitals. Such individuals end up there as a result of incarceration. This is unethical because mentally ill individuals should not be jailed or imprisoned because the laws they do not break the laws intentionally but as a result of their mental conditions. The best place such individuals should be is in psychiatric institutions.
Based on the functionality theory perspective, when a societal order is attained, the community is able to remain relatively stable. The theory further states that when various societal functions work in harmony, it is possible to achieve stability. Further, as evidenced by the functional theory, the roles of societal functions differ from one another. Therefore, since each societal function has a distinct role, it is vital that each stakeholder executes his specified role to ensure that there is a common good for the society. Similarly, based on the prepositions of Emile, people are integrated into the community based on their specific roles. The perception that the mentally ill individuals have a little or no role to play in society is misguided. From this assumption, challenges emanate hence increased incarceration of the mentally ill. From the research survey conducted, thirty-eight of the fifty. From the research survey conducted, thirty-eight of the fifty participants suggested that those who are mentally ill can be fully dependent and make no contribution while the rest purported that they have minor roles to play. These results have been summarized in the chart below:
Figure 2: Population’s Opinion on the Function of the Mentally Ill
Source: Author
Karl Marx’s preposition suggests that the role played by coercion and power is significant in bringing societal order. Further, the preposition implies that the society competes for economic resources. According to Karl Marx, it is hard to achieve consensus in the society if there is no harmony between the culture and government institutions. The reason behind Karl Marx’s argument is that those with more resources tend to exercise power over others and this leads to lack of societal order among the community. Therefore, those who have more resources can oppress those who have nothing by ensuring that the get the best integration in society. For instance, they provide the best medical care to their keens and best education for their children while ignoring those who are less fortunate. Such instances leads to lack of societal order (O’Brien, 2016). As, deinstitutionalization of the mentally was, to some extent, not as a result of the public interest but as a result of those in power. Individuals who had power over the rest in the 1960s and 1970s influenced the others such that a considerable portion was convinced and came into a consensus that deinstitutionalization is the best way to handle the mentally ill. Even today, persons in power continue to deinstitutionalize these institutions in spite of the public outcry for the need to isolate them. From the research survey, 34 respondents found it wise to isolate the mentally ill while 16 were of the opinion that deinstitutionalization is more beneficial than isolation. The figure below summarizes the results of the survey:
Figure 3: Population’s Opinion on Whether or Not to Deinstitutionalize
Source: Author
Research Plan
The researcher intends to adopt an analytical approach where facts or information that is already available shall be used to make a critical evaluation of the research topic. Further, the research topic is an already existing problem in the society, and it is, therefore, necessary for the researcher to adopt an applied research approach where the main aim should be finding a solution to the research problem. Deinstitutionalization is related to various theories including those of sociological perspectives, and it is, for this reason, important for the researcher to adopt a conceptual research approach as well rather than an empirical one.
Among the main data assessment tools that the researcher intends to utilize include primary data that will involve the acquisition of new data using data acquisition techniques such interviews and questionnaires. While using questionnaires, the researcher intends to use both open and close-ended question with close-ended questions dominating over the open-ended questions as they are more convenient in opinion assessment. Moreover, secondary data shall as well be utilized. This is data that had been collected for other research purposes, but still proves to be useful for this research topic. Most of this data are mainly presented in various forms including tabulation, case graphs, charts, and reports (Salisbury et al., 2016). Desk research shall be utilized in an attempt to collect secondary data that is mainly contained in staff reports, past reference materials, and public cooperation journals amongst others. To test the reliability and validity of data collection instruments, the researcher intends to lobby for peer review. After drafting the questionnaire, the researcher will give several to the peers to assess whether or not they meet the expected standards.
The research data provided and the conclusions made after the research shall be of great importance to various parties. One of these parties is the government in developing its policies. The government, using its legislative power, may consider amending the law relating to deinstitutionalization. In that case, a comprehensive research relating to the same subject must be conducted to prove whether or not to amend the specific policy. At that point, the conclusions made after the completion of this research study would prove to be useful secondary data sources.
Also, the conclusions made and the results of this research project shall be an essential point of reference to various organizations, especially when the issue of deinstitutionalization is a matter of concern, or there is a heated debate relating to the same. Since the research shall contain comprehensive research discussions and research results, the debaters may decide to use it as an important point of reference to support their propositions or even why they oppose certain motions (Bagenstos, 2016). This is made possible by the fact that the research shall be reliable due to its high quality and a firm basis on facts as opposed to mere fictions.
Moreover, the research data, presentations, and conclusions that shall be provided by this statistical research project may prove to be important in certain litigations. An individual or an organization may file a case against another. If the case is related to deinstitutionalization, such individuals or the court itself may rely on the details of this research study to familiarize themselves with the conclusions made and their basis. Also, the individuals in court rely on the data provided without focusing on the conclusion in an attempt to make related conclusions from the same data.
Morality and ethics organizations and agencies may also be interested in the findings of this statistical research study. This is because the perceptions of the people relating to the less privileged in the society is a major determiner of the people’s ethics, morality and the extent to which they are ready and willing to stomach social responsibility. Where the people are not willing to intermingle with the less privileged, their morality is reduced, and they have a little sense of social responsibility. As such, this statistical research project is of great importance to agencies and organizations that deal with such analysis.
Finally, the findings and conclusions made in this research project can be used for future improvement in various areas. This includes future improvement in policies relating to deinstitutionalization, improvement in societal morals and ethics as well as future improvement on how individuals in the society handle the mentally ill and the less privileged in the society at large (Kung, 2016).
Conclusion
References
Bagenstos, S. (2016). The Past and Future of Deinstitutionalization Litigation (1st Ed.). Cardozo Law Review.
Kreig, R. (2016). An Interdisciplinary Look at the Deinstitutionalization of the Mentally Ill. The Social Science Journal, 38, 367-380.
Kung, W. (2016). Cultural and Practical Barriers to Seeking Mental Health Treatment for Chinese Americans (1st Ed.). University of Southern California.
Martin, G., Costello, H., & Leese, M. (2016). An exploratory study of assertive community treatment for people with intellectual disability and psychiatric disorders: conceptual, clinical, and service issues. Journal of Intellectual Disability Research, 49.
O'Brien, A. (2016). Closing Asylums for the Mentally Ill. Social Consequences, Health Sociology Review. International Journal of Mental Health Nursing, 14(3), 220-221.
Salisbury, T., Killaspy, H., & King, M. (2016). An international comparison of the deinstitutionalization of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit) (1st Ed.).
Sickel, A., Seacat, J., & Nabors, N. (2016). Mental health stigma update: A review of consequences (1st Ed.). Minneapolis, USA: Walden University.
Simpson, G., & Price, V. (2016). From inclusion to exclusion: some unintended consequences of Valuing People (1st Ed.). Stafford Street, Wolver Hampton WV1 1SB, UK. University of Wolver Hampton.
Valentine, A., & DeAngelo, D. (2016). Translating Disparities Research to Policy: A Qualitative Study of State Mental Health Policymakers’ Perceptions of Mental Health Care Disparities Report Cards (1st Ed.). Massachusetts: Cambridge Health Alliance.
Weiss, S. (2016). Filling the Gap (1st Ed.). Massachusetts: Cambridge Health Alliance.
