The Mentally Ill: Practice of Hospitalization

Subject: Psychiatry
Pages: 6
Words: 1705
Reading time:
7 min
Study level: Bachelor


The process of hospitalizing mentally ill patients has undergone several remarkable changes. The patients no longer spend years in mental health facilities and receive customized psychiatric treatment. Deinstitutionalization of mental health institutions to community-based facilities is a major hospitalization change. The procedure of transitioning to community mental health institutions faces several challenges. There are positive effects associated with this deinstitutionalization process. Proposed changes need to be implemented in form of developing mental health policies to ensure further improvement of hospitalization. Through thematic analysis, this paper is a discussion of various changes in the process of hospitalization for mentally challenged people. The discussion furthers the research findings by providing insight into other related legal and trending concepts. The practice of hospitalization for the mentally ill encourages the deinstitutionalization of mental health facilities.

Comparison of the Topic

Changed Duration of Hospitalization and Treatment Process

Compared to the past, the current practice of hospitalization for the mentally challenged is different. Several decades earlier, mental illness was given little concern that it is now. Mentally ill patients were institutionalized for longer periods and given little to no treatment (Lamb & Weinberger, 2019). The primary purpose of hospitalizing them was to prevent self-harm or harming others. The medication administered sought to control psychopathic symptoms which barely improved their mental health status. Today, through rehabilitation centers and rehabilitative medication, patients can return to independent living sooner.

Deinstitutionalization of Mental Health Institutions

The process of deinstitutionalizing hospitalization adopts the use of community-based facilities instead of mental institutions. In the past, mentally challenged patients, voluntarily, involuntarily, or through emergencies were admitted to mental health hospitals (Hudson, 2019). These institutions have environmental settings that conform to the psychiatric behaviors of the patients. Mental health experts decided that such environments were inhumane and restrictive thus raising the need for deinstitutionalization (Mayer et al., 2021). Rehabilitation centers, whether private or public provide a healthy and explosive environment that positively alters the behaviors of the patients. On top of the easily adaptive conditions, more recovery medication is provided in these centers. Psychological therapies especially cognitive behavioral therapy is practiced in community-based facilities (Mayer et al., 2021). The combination of all these methods of treatment alongside a normal environment quickens the process of recovery.

Conforming With Emerging Mental Health Trends

Unlike how mental health institutions followed similar protocols in the treatment of various patients, rehabilitation centers’ treatment methods conform to emerging mental health trends. Before deinstitutionalization, which happened in the early 1920s, mental health institutions were mainly public hospitals (Marquant & Torres-Gonzalez, 2018). The major change in the hospitalization process ensured that private entities could admit mentally ill patients to their centers. The rehabilitative institutions not only treat psychotic diseases but trending mental health issues such as stress, depression, and anxiety (Marquant & Torres-Gonzalez, 2018). The institutions are teaching the importance of stable mental health status to their patients. Mental health facilities are governed by laws that seek to protect mentally ill patients from unnecessary coercion.

Research Findings

Factors that Led to Deinstitutionalization

In the 19th century, mental health became a serious problem that saw an increase in the number and size of mental illness institutions. The war of these times stopped funding the mental facilities hence leading to poor living conditions (Gawron, 2019). Mental health experts conceived the idea of community institutions as an alternative to mental hospitals. The community-level hospitals were expected to provide services at cheaper costs, including housing and supervision. The communities would better integrate the patients with their society members. When President John F. Kennedy passed the Community Mental Health Centers Act in 1963, deinstitutionalization increased (Gawron, 2019). Although the law supports the development of private organizations for the treatment of mental illness, public institutions are highly preferred.

Deinstitutionalization Process

The practice of deinstitutionalizing mental health facilities entails down-sizing institution capacities and at times closing them. The highly populated mental hospitals send their patients to their local rehabilitation centers and keep a few patients or close down (Bilir, 2018). In the 18th century, mental institutions were homes for the needy and homeless population in society. According to Bilir (2018), sifting care from psychiatric hospitals to community mental health facilities means deselecting the needy and homeless people for support. In rehabilitation centers, services are offered in terms of voluntary, involuntary, and emergency admission. People who voluntarily request to be admitted to these facilities have less serious mental issues. Legal regulation states that they have the right to quit the treatment process whenever they want. Involuntary admission is often subjected to mentally ill patients who refuse to be hospitalized (Lamb & Weinberger, 2019). Emergency admission entails taking mentally ill patients during their severe episodic moments or patients developing mental illnesses (Schenkel et al., 2022). From these different categories, only family-bound mentally ill patients will be admitted to the health facilities. Therefore, the needy and the homeless receive no mental care or support.

Criminalization of People with Serious Mental Illnesses

One of the serious problems in the legal system is the criminalization of people with severe mental sicknesses. Initially, mental health patients with serious conditions would receive care and support from state hospitals (Schenkel et al., 2022). Today, the state hospitals release these patients and place them in community-based centers. The treatment at this level is effective for many patients but a few poses recovery challenges. Some of those that differ with the treatment methods express dangerous behaviors that lead them to incarceration. According to Lamb and Weinberger (2019), the public community-level institutions lack sufficient treatment interventions such as adequate inpatients beds thus significantly contributing to the imprisonment of mentally sick patients. Local mental health facilities receive a higher number of patients than they can facilitate. Many patients are left without proper care thus worsening their mental health statuses.

Further Effects of Deinstitutionalization

Localizing mental illness care and support has both positive and negative effects. Community facilities host a small number of mentally challenges patients to offer customized care. According to Lima et al. (2022), the use of psychiatric treatment alongside psychological therapy improves patients’ health and social achievement. Community-based institutions that are less congested offer spaces to socialize as the patients receive care (Mayer et al., 2021). The patients, through social interactions, attain emotional well-being. Other benefits include faster recovery, limited relapses enabled by a calmer environment, and adequate care (Marquant & Torres-Gonzalez, 2018). However, some facilities still need to improve their treatment process. Other than patients congestion, community-based mental health institutions face challenges such as unequal distribution of national funding and lack of professional training. Hudson (2019) proposes policy development to solve common deinstitutionalization issues. The mental health policy would cover problems such as improvement of community-based funding, proper training of psychiatric caregivers, and decongestion of public facilities. Such a policy would ensure minimal negative effects resulting from the current hospitalization of mentally ill patients

Legal Regulation and Emerging Trends

The United States legal system has taken further steps to protect its citizens by responding to mental health trends. Recently, law enforcers found that sex offenders needed hospitalization in mental health institutions. According to Pelletier et al. (2021), sex offenders often have mental disorders that need treatment before releasing them from prison. Therefore, the law requires the offenders to be hospitalized in their community facilities to treat the disorders. With the emerging need for equal treatment in various factors, mental health activists expect equal treatment of patients in hospitalizing institutions (Pelletier et al., 2021). The US law enactors are vigilant of mental health institutions exploiting admitted patients. Some people are unnecessarily admitted to these facilities especially when the intentions are restraining children, denying services, or keeping people out of work (Santillanes et al., 2020). The legal system warns against such practices and does not hesitate to arrest such offenders. With the increase in community mental health facilities, more crime is expected to rise. Henceforth, the implementation of protective law needs to be practiced in the future.


The Need for Bridge Gap of Care

The exiting gap in care and support for mentally ill patients in state-level hospitals created a need for deinstitutionalization. Although many other factors led to the hospitalization change, conforming to the trends, was a major drive. Mental health has become such a valuable concept in today’s world. The hospitalization of mental patients is today inclusive of less serious issues. In highly developed countries, mental illness is highly funded as the treatment of cancer and other terminal diseases. Community mental hospitals provide extensive mental care and support thus promoting better outcomes. The facilities provide improved treatment processes including medication and therapy sessions.

The Need for Implementing Proposed Changes

Research findings highlight several challenges of deinstitutionalization at the community level. The lack of sufficient and basic care materials makes it hard to deliver patient-centered care. With pressing concerns about mental health status amongst young people in the 21st century, more changes will need implementation. In the future, there will be more mentally ill patients admitted to community facilities. The increase in number will be resulting from the toughening cost of living and upcoming health conditions. Government mental hospitals will require more funding and the advancement of employees’ skills. The legal system has updated its related regulations to protect mentally ill patients. The criminalization of mentally ill patients is done within boundaries and with lots of considerations.


The shift of care and support for the mentally ill from long periods of hospitalization to short community-based treatment processes is a positive practice. At a community level, the treatment process is expansive and effective for both the less ill and patients with serious mental illness. The process of deinstitutionalization started in the 19th century continues to receive advancement in terms of treatment methods. Community mental institutions connect patients with a familiar environment thus attaining mental and social health. However, this type of hospitalization is faced with several challenges including defunding, lack of adequate treatment interventions, and improper employee training. Interceptive government focus should be set on resolving these issues. Trending mental health issues such as increasing levels of stress and the number of depressed people in the US are likely to change the factors of hospitalization and legal regulation. Further research should be done to investigate future changes in hospitalization in deinstitutionalized systems.


Bilir, M. K. (2018). Deinstitutionalization in mental health policy: From institutional-based to community-based mental healthcare services. Hacettepe Sağlık İdaresi Dergisi, 21(3), 563-576. Web.

Gawron, C. R. (2019). Funding mental healthcare in the wake of deinstitutionalization: how the United States and the United Kingdom diverged in mental health policy after deinstitutionalization, and what we can learn from their differing approaches to funding mental healthcare. Notre Dame J. Int’l Comp. 9 (14), 1-113. Web.

Hudson, C. G. (2019). Deinstitutionalization of mental hospitals and rates of psychiatric disability: An international study. Health & Place, 56, 70-79. Web.

Lamb, H. R., & Weinberger, L. E. (2020). Deinstitutionalization and other factors in the criminalization of persons with serious mental illness and how it is being addressed. CNS Spectrums, 25(2), 173-180. Web.

Lima, H. D. P., Silva, D. B. D., Aratani, N., Arruda, G. O. D., Lopes, S. G. R., Palhano, P. S. D., & Brasil, E. G. M. (2022). Advances and challenges of the Back Home Program as a deinstitutionalization strategy: An integrative review. Ciencia & Saude Coletiva, 27, 89-100. Web.

Marquant, T., & Torres-Gonzalez, F. (2018). Deinstitutionalization versus transinstitutionalization. Forensic psychiatry and psychology in Europe, 293-304. Web.

Mayer, R. C. F., Alves, M. R., Yamauti, S. M., Silva, M. T., & Lopes, L. C. (2021). Quality of life and functioning of people with mental disorders who underwent deinstitutionalization using assisted living facilities: A cross-sectional study. Frontiers in Psychology, 12, 1693. Web.

Pelletier, J. H., Rakkar, J., Au, A. K., Fuhrman, D., Clark, R. S., & Horvat, C. M. (2021). Trends in US pediatric hospital admissions in 2020 compared with the decade before the COVID-19 pandemic. JAMA, 4(2), 203-227. Web.

Santillanes, G., Axeen, S., Lam, C. N., & Menchine, M. (2020). National trends in mental health-related emergency department visits by children and adults, 2009–2015. The American Journal of Emergency Medicine, 38(12), 2536-2544. Web.

Schenkel, J. M., Silva, G. W. D. S., Amorin, A. K. D. M. A., Miranda, F. A. N. D., Carvalho, J. B. L. D., Ribeiro, S. E. A., & Silva, M. M. (2022). Mental health, art, and deinstitutionalization: An aesthetic-poetic-theatrical account of the city’s occupation. Ciencia & Saude Coletiva, 27, 39-48. Web.