Decarceration

...He details the ways in which the usual predators moved in to cash in on deinstitutionalization as the emphasis shifted away from small, family-run houses "towards larger, more heavily capitalized units...

...Last year, for example, a room ing house in Beverly, Massachusetts, burned down...

...According to the Globe, about 2,000 patients remain in seven state hospitals, with another 100,000 receiving outpatient services...

...The most important change Scull notes since 1977 is the enhanced "net of control" over "deviants" which has been flung wider and drawn more taut...

...I wonder about the clause ' 'if inadequately funded...

...others involve partial qualifications and retractions...

...Nonintervention, he argues, "dressed up as community treatment and promoted in the name of the very virtues once attributed to the asylum, can be advocated on the grounds of its advantages to the client...

...The timing is right for a revised and up-dated version of Andrew Scull's Decarceration...

...Violent and dangerous criminals may be released, given the push towards plea-bargaining and early probation, and many who are simply marginal find themselves tangled in a web of disciplinary procedures...

...May 16, 1981), I argued that in order for deinstitutionalization to work a whole range of locallybased, decently-funded social services was necessary...

...Scull took a more cautious view, showing the promise of cost savings behind many of the upbeat paeans to patient freedom...

...It is clear," I stated, "that current deinstitutionalization efforts, even the best, come nowhere close to this vision...

...Noting the "profound disjuncture" between "the myth and reality of 'community care,' " Scull tells a dismal tale...

...Larger units are "clear-cut business enterprises requiring substantial amounts of capital investment" and "are highly concerned with costs and profits...

...Some of the changes are important...

...It is better, therefore, to see the fiscal crisis of the state as one among several powerful structural forces pushing towards deinstitutionalization...

...The Boston Globt (July 6, 1984) reported that among 11,181 mental health department clients living in 3,436 sites throughout the state, 1,565 were living in 612 rooming houses...

...Rooming houses, if well-tended and safe, are preferable to large warehouses...

...This thesis, most powerfully advanced in the writings of Michel Foucault, alerts us to control in the name of care and greater freedom...

...Finally, neither institutional treatment nor community care offer panaceas but both, Scull warns, if inadequately funded, "provide ample opportunity for, and plenty of concrete examples of, squalor, neglect, abuse, and inhumanity...

...As well, a "medical explanation" — that the increase in sophisticated psychotropic drugs inexorably compelled out-patient care — is not universally valid...

...Scull, a sociologist at the University of Pennsylvania, published his work originally, in 1977...

...In an article in The Nation several years ago ("A Key to Unlock the Asylum...

...The questions are: what happened, why, and what is to be done...

...This seems to me not the case — not so long as we continue to construe the mentally ill and the criminal as "deviants," as the marginalized...

...Categorized as other by our language, we will always find ways to reduce those we fear or cannot understand to a sub-human status that guarantees their social and economic marginality just as our language legitimates and structures their "deviance" in the first place...

...It turns out that comparative data does not support this thesis as a uniform explanation...

...One might, in fact, make the case that deinstitutionalization was never seriously tried...

...The deinstitutionalized person, whether mentally ill or "criminal," rather than basking in a promised "freedom" and the more intimate relations of community care, often find themselves a group of atomized and debilitated "consumers" sent into a' 'hostile community and left to cope as best they can — in the virtual absence of state-supported aftercare or follow-up services...

...Looking back on eight years of experimentation with deinstitutionalization and in light of his earlier arguments, Scull engages in a lively reassessment of his work...

...Now, as Scull notes, "the situation has changed rather markedly...

...The smaller operations at least offered the possibility of providing low-income people with some additional money as "service providers'' even as they performed a genuine service...

...Now, four years later, pronouncements on deinstitutionalization need not be hedged nor couched about with "if s": everyone acknowledges the disaster...

...To be free means to be neglected...

...Ironically, some former psychiatric hospitals, re-opened as shelters, number among their regular homeless many former patients — or inmates — of the building when it was an asylum, not a shelter...

...As a radical sociologist, Scull should be sensitive to the ways in which language structures refer to "the deviant...

...At the time its advocates dominated the discussion in the United States...

...Drugs, Scull insists, played a secondary role, helping to persuade physicians of the feasibility of community treatment though drugs did not of themselves create the pressure for such treatment...

...Fourteen people were killed, eight of them Department of Mental Health clients and former patients in state mental hospitals...

...In a recent piece for In These Times (Jan 23-29, 1985), Joan Waish noted that an estimated 25 to 33 percent of homeless shelter-users in major cities ' 'have been psychiatrically hospitalized at least once...

...Jean Bethke Elshtaln DEINSTITUONAUZATION has failed: that is the currently reigning view, one pronounced by professional groups such as the American Psychiatric Association and journals of political opinion, including The New Republic and In These Times...

...But all too often they are firetraps, ill-heated, dirty, and cramped It is not unusual for upwards of one hundred people to be packed into strucCommonweal: 412 tares intended originally for half that number...

...Those who fall through the net completely wind up on the streets...

...But he now believes that his original arguments concerning the emergence of deinstitutionalization were too deterministic, locating the emphasis almost wholly in the fiscal crisis of welfare capitalism...

...So the lines between punishment and therapy get blurred, creating a maze of' 'supervised release schemes, halfway houses, community correctional centers, group homes, foster homes, pre-trial release centers, deferred sentencing agencies, and the like" — a baroque bureaucratic apparatus that disguises its controlling aspects or legitimates them in terms of' 'diagnoses and treatment rather than rules, responsibilities, and punishment...

...The proportions of the dilemma become clearer every day...

...This would include special education programs for developmentally disabled individuals, medical and dental care, vocational training, community-based group homes and residences, transportation allowances, adoption services for hard-to-place children, and so on...

...His "radical view" played a role in the then-raging debates on deinstitutionalization...

...Scull hints that adequate funding may be the, or a, solution...

...The plight of the homeless and occasional tragedies involving the marginal) enhoused, push the too-often invisible discards of our driven, achievementoriented culture to the forefront of our attention and, often fleetingly, our consciences...

...Reviewing his original explanatory framework in light of developments in ' 'the mental health sector over the past eight or nine years," Scull sees an "extension and intensification of the trends already visible in the mid-seventies, rather than any substantial modification or change of directions...

...At this time, Scull concludes, the state is "more likely to intrude into the emotions, thought, and behavior of the indivdual" than ever before, concerning itself with ' 'generalized behavioral problems rather than specific acts.'' We wind up with the worst of both worlds: a precipitous increase in our prison population and the number of violent offenders together with a proliferation of non-institutional forms of punishment/treatment...