ABSTRACT
Across the United States, many states and communities have faced problems—real or perceived—associated with deinstitutionalization. "Deinstitutionalization" refers to the process by which the primary treatment responsibility for the mentally disabled is transferred from mental health hospitals to service providers in community-based settings. Deinstitutionalization first became popular in the United States in the late 1960s, when mental health care professionals reached a working consensus that care could occur most effectively and efficiently within the context of normal home and community ties. Deinstitutionalization became statewide policy in Virginia as early as 1968, when the state's general assembly authorized local governments to establish "community service boards," locally based agencies that delivered mental health services to clients discharged from state mental health facilities. The department's central office also played an important role in the community mental health system that served deinstitutionalized clients: ensuring that core services were available to those who needed them by planning, developing, and coordinating policies and programs for communities.
