Exodus: 40 Years of Deinstitutionalization and the Failed Promise of Community-Based Care

Ted Frankel

Abstract


The increasing number of Canadians with mental illness who are left uncared for and roaming the streets represents a huge failing that is not being seriously addressed in our society. Initially thought to be humane and progressive, "deinstitutionalization" has resulted in a very different reality for thousands of people with mental illness who have been released into the community. Many of those liberated from mental institutions and asylums have made an uneasy transition to life on the "outside", sometimes with tragic consequences.

The question for consumers of mental health services now is not whether the current system is failing but rather what is the best route to programs and entitlements that are routinely granted to other disadvantaged groups, such as people with physical disabilities. Claims grounded in Charter section 15 jurisprudence that mentally ill populations are underserved by existing aftercare programs are one possibility, although Canadian courts have shown a marked reluctance to interfere in the realm of policy-making. In the end only a restructuring of priorities - political, social and attitudinal can fully address the needs of some of our least understood and empowered citizens, as the experience o f one Canadian jurisdiction, Nova Scotia, demonstrates so well.


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