Cover image for Out of bedlam : the truth about deinstitutionalization
Out of bedlam : the truth about deinstitutionalization
Johnson, Ann Braden, 1945-
Personal Author:
Publication Information:
[New York, N.Y.] : Basic Books, [1990]

Physical Description:
xxvi, 306 pages ; 25 cm
Reading Level:
1630 Lexile.
Format :


Call Number
Material Type
Home Location
Item Holds
RC439.5 .J64 1990 Adult Non-Fiction Central Closed Stacks

On Order



The author is a social worker who writes with experience, authority, and compassion about what really happened when thousands of mental patients were discharged from state hospitals--and what to do about it. Annotation copyrighted by Book News, Inc., Portland, OR

Reviews 2

Booklist Review

An intelligent and bitter expose of the failings of our mental health system, written by a mental health professional whose particular concern is for the chronically ill. Johnson places the recent deinstitutionalization of mental patients in historical context, revealing how state mental hospitals were shut down with little or no planning for the future. As a result, attempts to mainstream the mentally ill into the community have succeeded in fits and starts. The patients themselves have become the scapegoats for additional social problems, such as homelessness, violent crime, and overcrowded prisons. A fragmented mental health system with a severe rift between administrators and practitioners needs fixing. This book offers no magical solutions, but valuable, realistic recommendations are offered with the rights and needs of the patients in mind. Index. --Betsy Levins

Library Journal Review

A social worker for the chronically mentally ill (CMI) and now the mental health unit chief at Montefiore/Riker's Island, New York, the author here offers a clear, generally incisive, and provocative analysis of the rationale behind deinstitutionalization (mainstreaming mental patients into the community). She debunks several myths: that deinstitutionalization was planned; that it should cost less; and that medications like Thorazine are the cure-all. She also attacks the false assumptions that CMIs make up the bulk of the homeless, that they fill the prisons, and that we don't know what care they require. Lastly, she discusses the chasm between practitioners and bureaucrats, who turn ``messy, unscientific social problems into neat, tidy empirical surveys. . . .'' With statistics, case histories, and chapter notes all meant to shock, Johnson delivers a cogent and witty commentary supported by facts and a compassionate perspective.-- Janice Arenofsky, formerly with Arizona State Lib., Phoenix (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Table of Contents

Prefacep. xi
Acknowledgmentsp. xvii
Introduction News from the Front in the War against Mental Illnessp. xix
Chapter 1 The Historical Context for Deinstitutionalizationp. 5
Chapter 2 How No One Planned Deinstitutionalization: It Would Have Happened Anywayp. 24
Chapter 3 May the Sales Force Be with You: Psychotropic Medication, the New Magic Bulletp. 38
Chapter 4 What Happened to the Myth That Mental Illness Is a Myth?p. 53
Chapter 5 Treatment of Choice: Community Care (Whether It Exists or Not)p. 70
Chapter 6 How Deinstitutionalization Never Saved Us a Dimep. 87
Chapter 7 Where the Patients Really Wentp. 115
Chapter 8 Maybe It's Easier to Be Homeless If You're Crazyp. 134
Chapter 9 True or False? Deranged Criminals Are at Large and the Mentally III Are in Jailp. 158
Chapter 10 Backwards into History: Waiting for Moral Treatment to Be Rediscoveredp. 179
Chapter 11 The Mental Health Bureaucracy: Who's in Charge Here?p. 215
Chapter 12 The System in Action: Numbers, Not Peoplep. 235
Epilogue: A Twentieth-Century Ship of Foolsp. 254
Notesp. 260
Indexp. 297