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SERVICE-INTEGRATING MODEL FOR DEINSTITUTIONALIZATION

NCJ Number
51898
Journal
ADMINISTRATION IN MENTAL HEALTH Dated: (SPRING 1975) Pages: 35-45
Author(s)
W E DATEL; J G MURPHY
Date Published
1975
Length
11 pages
Annotation
THIS ARTICLE DISCUSSES AN INTEGRATION OF SERVICES MODEL FOR ORDERLY DEINSTITUTIONALIZATION IN VIRGINIA FEATURING A COALITION OF INSTITUTION AND COMMUNITY WORKERS TO ASSESS CLIENTS' NEEDS AND PRESCRIBE SERVICES.
Abstract
THE TARGET POPULATION CONSISTS OF 500 MENTALLY ILL AND 400 MENTALLY RETARDED PERSONS AND 70 JUVENILES, ALL FROM PLANNING DISTRICT 6 (RURAL AREA) OR PORTSMOUTH (URBAN AREA) AND HOUSED IN STATE INSTITUTIONS THAT ARE LARGELY OUTSIDE THE DEMONSTRATION AREAS. THE MODEL HAS FIVE SOCIOTECHNICAL COMPONENTS: (1) ASSESSMENT AND PRESCRIPTION TEAM, AN INTERDISCIPLINARY COALITION OF 10 TO 12 INSTITUTIONAL STAFF AND COMMUNITY SERVICE DELIVERERS; (2) BROKER ADVOCATE WHO ACTS FOR THE CLIENT IN ARRANGING AND MAINTAINING SERVICE DELIVERY; (3) AUTOMATED INFORMATION SYSTEM USED BY CASE MANAGERS AND PROGRAM ADMINISTRATORS; (4) QUALITY CONTROL TEAM, PROJECT STAFF WHO EVALUATE, DEVELOP, AND COORDINATE THE SYSTEM AND IDENTIFY PROBLEM ISSUES; AND (5) COMMITTEE OF COMMISSIONERS, THE GOVERNING BODY FOR THE MODEL'S OPERATION. THE MODEL ALSO INCLUDES PROGRAM ACTIVITIES NOT DIRECTLY RELATED TO THE CLIENT SUCH AS A MANAGEMENT INFORMATION SYSTEM, COST-BENEFIT ANALYSIS, COMMUNITY DEVELOPMENT, ESTABLISHMENT OF COMMUNICATION CHANNELS, LEGISLATIVE REFORM, AND RESOURCE DEVELOPMENT. A STRONG JUSTIFICATION FOR A DEINSTITUTIONALIZATION POLICY CAN BE BASED ON SIMPLE HUMANITARIANISM, CIVIL RIGHTS, COST CONSCIOUSNESS, OR THE STATE OF REHABILITATIVE ART. IT IS OBVIOUS, HOWEVER, THAT COMMUNITY PLACEMENT WITHOUT COMMUNITY SUPPORT IS AN UNFAIR TEST OF THE DEINSTITUTIONALIZATION CONCEPT. THE VIRGINIA MODEL ATTEMPTS TO OVERCOME SOME OF THE PROBLEMS ENCOUNTERED BY OTHER STATES IN THE DEINSTITUTIONALIZATION PROCESS SUCH AS IMPERMEABILITY OF STATE AND COMMUNITY ORGANIZATIONAL BOUNDARIES, LACK OF COMMUNITY SERVICES, HIGH RECIDIVISM RATES, INSUFFICIENT ACCOUNTABILITY AND PLANNING, AND LACK OF COMMUNICATION, COORDINATION, AND FOLLOWUP. SINCE THE MODEL BEGAN PROCESSING CLIENTS IN MAY 1973, 65 PERCENT OF 376 CLIENTS HAVE BEEN RECOMMENDED FOR COMMUNITY PLACEMENTS, 22 PERCENT HAVE BEEN PLACED, AND 4 HAVE RETURNED TO INSTITUTIONS. FIGURES ILLUSTRATE THE CLIENT-PROCESSING PROCEDURES, AND REFERENCES AND A BIBLIOGRAPHY ARE INCLUDED.