You're right. I shouldn't have implied that it was all Reagan's fault. As you noted there was a social movement to deinstitutionalize as horrors like Willowbrook made in into the public consciousness. I was unaware of states legislating it, be but it was my understanding that when Reagan effectively repealed Carter's Mental Health Services Act, it was the nail in the coffin that ended widespread, longterm mental healthcare.
The Reagan/Thatcher governments of the 80's are definitely implicated though.
Yes, institutionalisation needed to change - SWIM was heavily involved in the asylum closures and replacements of. It was always recognised there would be a core of patients who would need long-term care and the original models called for small, integrated community homes. The idea was that asylum savings, lands etc. would pay for them but even in the UK this didn't work as demolishing the existing structures is dangerous and expensive (the dreadful state of them was another thing governments chose to ignore.) That's why a lot are still standing; the land value is negligible and the costs outweigh the benefit, so the buildings are just lurking there, falling apart.
It took a long time to create community homes that were both homely and met medical and safety needs, every one had to be individually designed, land bought, NIMBYism fought. And the last patients out of the asylums were the most vulnerable, yet they were released even as the community support teams were being disbanded and before a fraction of these alternatives were built. They had nowhere to go, and if you go into many of the old asylums you can find banks of notes, meaning they didn't even have the most basic requirement for continuing care. Social care teams were dialled back at the same time, so not only nowhere to go but no-one to help them navigate meant they fell straight through the cracks. A fair few of them traipse through short-term wards which are not designed for long-term care and are then blocked to those they were intended for, jail and the streets and, apart from those, the saddest place of all - many old asylums have a clique of the dispossessed living in the ruins or the grounds.
It's ironic that this is the core of the "targeted." They're the furthest from targeted; the powers that be do not give a single solitary fuck about them. Yes, the old institutions were done; even the colony ones were impersonal, inefficient and broken down and don't deserve the somewhat romanticised image some now have. But the nothing that replaced them was entirely down to the economic and social outlook of the 80's governments.
End of :autism:
