ABSTRACT
Deinstitutionalization, as a social policy, has had a complex and confusing history. We will try to unravel much of the complexity and decipher a good deal of the mystification surrounding this policy in order to develop a clear and coherent framework for creating and sustaining a positive and systematic practice in the area of mental health after-care. We take it for granted that a coherent theory of practice must be a conscious correlate of a larger theory that addresses the social world in which that practice will occur. It is this belief that gives rise to our organizing rationale for this book. As you can see from the Table of Contents, the first section of the book is theoretical-our effort to explain the social world of working in mental health after-care. Initially, we provide a brief analysis of deinstitutionalization as a social policy, looking carefully at who it was intended to serve and who in fact has benefited from its existence. Along the way, we will identify several essential contradictions within the policy and its political economic context that have functioned as determinants of the policy throughout its history. Next there is an effort to create what we call a ‘problemdefinition’ level of theory: how are we to look at the reality of former patients’ lives? How we perceive that reality will ultimately inform our intervention into it (Kuhn, 1962), and therein lies our effort at articulating our theory of practice, the purpose of Chapter 2. The first section concludes with a chapter on social action strategy, the larger design for implementing our advocacy/empowerment approach to practice.
