According to Bazelon and Kyoyanagi, over a million and a half individuals are on Medicaid in various nursing homes, and over half of all the nursing home costs are taken care of by Medicaid. Since the late 1950s, there has been a transition from state and local psychiatric institutions to nursing homes as the main caregivers to people with mental health problems. In the early days, deinstitutionalization focused on the transfer of individuals from public mental hospitals to other alternatives that were to be established in the local communities.
Torrey goes ahead to define deinstitutionalization has been varying from state to state. It is not accurate to go ahead and subtract the 1994 number of patients from that of 1955. This, he goes on to explain, is due to the shift in state populations that have taken place over time. It is evident that there has been a decline in the populations, for instance, California and Florida, among others. These populations have been taken into account in the Appendix table. It clearly illustrates the population changes over time and based on the 1994 number of patients hospitalized subtracted from the number of people expected to be hospitalized in the same year.
Deinstitutionalization has, however, not had the best results, especially in the early years after its introduction. There was an influx of mentally ill patients everywhere. Most of them ended up in the streets due to the homeless situation as the state closed down the public mental hospitals. Some of these mentally ill people have ended up in prisons and jails over and over again, which is very unfair.