This chapter reflects on periods of mass institutionalisation, deinstitutionalisation and the remaining legacies of these periods for those thought to be impacted by mental “illness”. In the aftermath of institutional closures associated with deinstitutionalisation, those described as mentally “ill” are often “over-represented” in interactions with police, often managed in a range of institutions, including prisons and the criminal legal system. In this context, this chapter calls for closer conversation between abolitionist and anti-carceral activists, psychiatric survivors and scholars within Mad Studies in seeking an end to carceral approaches to managing mental distress, whether through policing, prisons and coercive “care” within the mental health system.