COMPREHENSIVE APPROACHES TO DEINSTITUTIONALIZATION INCLUDE STATE AGENCY, REGIONAL, INSTITUTIONAL, COMMUNITY, AND INDIVIDUAL INITIATIVES. MOST LARGE RESIDENTIAL FACILITIES ARE STATE-OPERATED PROGRAMS. DEINSTITUTIONALIZATION IN CONNECTICUT IS CHARACTERIZED BY STRONG PLANNING AT THE STATE LEVEL, WITH THE STATE MENTAL RETARDATION AGENCY ASSUMING A MAJOR LEADERSHIP ROLE. REGIONAL MENTAL RETARDATION INSTITUTIONS, AS PARTNERS WITH THE STATE AGENCY, HAVE MOBILIZED CITIZEN SUPPORT AND DEVELOPED COMMUNITY ALTERNATIVES TO ACHIEVE DEINSTITUTIONALIZATION GOALS. PRIMARY OBJECTIVES OF THE CHILD ADVOCACY CENTER IN DURHAM, N.C., ARE TO HELP RESIDENTIAL INSTITUTIONS DEVELOP INSTITUTIONAL RENEWAL PROCEDURES, TO DEVISE PROCEDURES FOR THE DEPOPULATION OF INSTITUTIONS, AND TO DEVELOP MEASURES FOR PREVENTING THE FLOW OF PERSONS INTO INSTITUTIONS. THE STATE DEPARTMENT OF MENTAL HEALTH IS DIVIDED INTO FOUR REGIONS, WITH AN ALCOHOLIC REHABILITATION CENTER, A PSYCHIATRIC HOSPITAL, AND A MENTAL RETARDATION CENTER SERVING EACH REGION. BECAUSE THE PROVISION OF SERVICES TO MENTALLY RETARDED CITIZENS IS PRIMARILY THROUGH THE STATE'S REGIONAL MENTAL RETARDATION INSTITUTIONS, NORTH CAROLINA IS CHARACTERIZED AS EMBRACING AN INSTITUTIONAL PHILOSOPHY. REGIONAL INITIATIVES IN THE STATES OF WASHINGTON, NEW YORK, AND NEBRASKA, THE CANADIAN PROVINCE OF SASKATCHEWAN, AND COMMUNITY OR LOCAL INITIATIVES IN NEW YORK AND WISCONSIN ARE CITED. VARIOUS INSTITUTIONAL AND INDIVIDUAL INITIATIVES ARE NOTED ALSO. THE ROLE OF SPECIFIC PROJECTS IN THE DEINSTITUTIONALIZATION MOVEMENT IS CONSIDERED IN RELATION TO THE USE OF CROSS-MODALITY TEAMS TO ASSIST IN DEINSTITUTIONALIZATION ACTIVITIES, PUBLIC AWARENESS PROGRAMMING, AND VOUCHER SYSTEM EXPERIMENTS. ATTENTION IS GIVEN TO COURT INTERVENTION IN CASES INVOLVING THE VIOLATION OF HUMAN RIGHTS, CITIZEN AROUSAL, AND PROGRAM STANDARDS AND MONITORING PROCEDURES REGARDING DEINSTITUTIONALIZATION. REFERENCES ARE INCLUDED.