Deinstitutionalisation (or deinstitutionalization ) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability . In the 1950's and 1960's, it led to the closure of many psychiatric hospitals, as patients were increasingly cared for at home, in halfway houses , group homes , and clinics, in regular hospitals, or not at all.
138-580: Harrisburg State Hospital , formerly known from 1851 to 1937 as Pennsylvania State Lunatic Hospital , in Harrisburg, Pennsylvania , was Pennsylvania's first public facility to house the mentally ill and disabled . Its campus is located on Cameron St. and Arsenal Blvd, and operated as a mental hospital until 2006. The Harrisburg State Hospital was created as the Pennsylvania State Lunatic Hospital and Union Asylum for
276-401: A "psychiatric community". Julie Racino argues that having a closed social circle like this can limit opportunities for mentally ill people to integrate with the wider society, such as personal assistance services. Criticism of deinstitutionalisation takes on a number of forms. Some, like E. Fuller Torrey , defend the use of psychiatric institutions and conclude that deinstitutionalisation was
414-480: A 1998 study of the effects of deinstitutionalisation in the United Kingdom, Means and Smith argue that the program had some successes, such as increasing the participation of volunteers in mental healthcare, but that it was underfunded and let down by a lack of coordination between the health service and social services. Thomas Szasz , a longtime opponent of involuntary psychiatric treatment, argued that
552-475: A barrier along the eastern edge of the city: passable only by bridge. Three large and ornately embellished passenger depots were built by as many rail lines. Pennsylvania Railroad was the largest rail line in Harrisburg. It built huge repair facilities and two large roundhouses in the 1860s and 1870s to handle its enormous freight and passenger traffic and to maintain its colossal infrastructure. Its rails ran
690-580: A community-based psychiatric system. The Italian system served as a model of effective service and paved the way for deinstitutionalisation of mental patients. Since the late 1960s, the Italian physician Giorgio Antonucci questioned the basis itself of psychiatry. After working with Edelweiss Cotti in 1968 at the Centro di Relazioni Umane in Cividale del Friuli – an open ward created as an alternative to
828-420: A height of 255 feet (78 m). The six largest ethnic groups in the city are: African American (52.4%), German (15.0%), Irish (6.5%), Italian (3.3%), English (2.4%), and Dutch (1.0%). While the metropolitan area is approximately 15% German-American , 11.4% are Irish-American and 9.6% English-American . Harrisburg has one of the largest Pennsylvania Dutch communities in the nation, and also has
966-521: A higher proportion of the patients than of the others in the neighborhoods reported symptoms of substance abuse. Findings on violence committed by those with mental disorders in the community have been inconsistent and related to numerous factors; a higher rate of more serious offences such as homicide have sometimes been found but, despite high-profile homicide cases, the evidence suggests this has not been increased by deinstitutionalisation. The aggression and violence that does occur, in either direction,
1104-611: A leading Italian psychiatrist who inspired and was the architect of the psychiatric reform in Italy , also defined mental hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents, and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism. Other critics went further and campaigned against all involuntary psychiatric treatment. In 1970, Goffman worked with Thomas Szasz and George Alexander to found
1242-483: A major role in the local economy throughout the latter part of the 19th century. The city was the center of enormous railroad traffic and its steel industry supported large furnaces, rolling mills, and machine shops. The Pennsylvania Steel Company plant, which opened in nearby Steelton in 1866, was the first in the country; later operated by Bethlehem Steel . Its first large scale iron foundries were put into operation shortly after 1850. As industries nationwide entered
1380-442: A mental healthcare system, a phenomenon known as "reinstitutionalisation" or " transinstitutionalisation ". The argument is that community services can leave the mentally ill in a state of social isolation (even if it is not physical isolation), frequently meeting other service users but having little contact with the rest of the public community. Fakhoury and Priebe said that instead of " community psychiatry ", reforms established
1518-563: A move in the wrong direction entirely. Torrey has opposed deinstitutionalisation in principle, arguing that people with mental illness will be resistant to medical help due to the nature of their conditions. These views have made him a controversial figure in psychiatry. He believes that reducing psychiatrists' powers to use involuntary commitment led to many patients losing out on treatment, and that many who would have previously lived in institutions are now homeless or in prison. Another form of critique argues that while deinstitutionalization
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#17327724187171656-521: A never-realized museum celebrating the American West . During the nearly 30-year tenure of former Mayor Stephen Reed from 1981 to 2009, city officials ignored legal restraints on the use of bond proceeds, as Reed spent the money pursuing interests including collecting Civil War and Wild West memorabilia – some of which was found in Reed's home after his arrest on corruption charges. Infrastructure
1794-407: A new receiver, William B. Lynch , was appointed. The City Council opposed the new receiver's plans for tax increases and advocated a stay of the creditor lawsuits with a bankruptcy filing, while Mayor Thompson continued to oppose bankruptcy. State legislators crafted a moratorium to prevent Harrisburg from declaring bankruptcy, and after the moratorium expired, the law stripped the city government of
1932-459: A person with access to amenities would be a happier person . In December 1900, a reformer named Mira Lloyd Dock , who had recently encountered well-ordered urban centers on an international trip to Europe, gave a lecture on "The City Beautiful" to Harrisburg's Board of Trade. Other prominent citizens of the city such as J. Horace McFarland and Vance McCormick advocated urban improvements which were influenced by European urban planning design and
2070-422: A phase of great expansion and technological improvement, so did industries – and in particular the steel industry – in Harrisburg. This can be attributed to a combination of factors that were typical of what existed in other successful industrial cities: rapid rail expansion; nearby markets for goods; and nearby sources for raw product. With Harrisburg poised for growth in steel production, Steelton became
2208-425: A programme of institutionalisation into extermination. More than 5,000 children were killed in the network of institutions for children with disabilities, followed by more than 200,000 disabled adults. The medical and administrative teams who developed the first mass extermination programme were transferred – together with their killing technology – to set up and manage the death camps of Treblinka and Sobibor during
2346-418: A prominent bluff, accessed by bridges across a wide swath of train tracks. It was developed in the late 19th century and offered affluent Harrisburg residents the opportunity to live in the suburbs only a few hundred yards from their jobs in the city. As the city expanded, it incorporated Allison Hill in its boundaries. In 1886, a single horse trolley line was established from the city to Allison Hill. Easy access
2484-574: A series of skirmishes surrounding the city, such as the Skirmish of Sporting Hill in Camp Hill , just 2 miles (3 km) west of Harrisburg. The Second Corp were ultimately unsuccessful in both overcoming the local Union defenses and crossing the rain bloated Susquehanna into Harrisburg itself, and were forced to retreat southward to regroup with Lee's main Confederate force. This attempt marked
2622-490: A service-oriented base, with industries such as health care and convention centers playing a big role. Harrisburg's greatest problem was a shrinking city population after 1950. This loss in population followed a national trend and was a delayed result of the decline of Harrisburg's steel industry. This decline began almost imperceptibly in the late 1880s, but did not become evident until the early 20th century. After being held in place for about 5 years by WWII armament production,
2760-458: A small downtown area within walking distance, these were the sights and smells that most Steelton residents saw every day. The rail yard was another area of Harrisburg that saw rapid and thorough change during the years of industrialization. This was a wide expanse of about two dozen railroad tracks that grew from the single track of the early 1850s. By the late 19th century, this area was the width of about two city blocks and formed what amounted to
2898-479: A state-appointed receiver took charge of the city's finances. Governor Tom Corbett appointed bond attorney David Unkovic as the city's receiver, but Unkovic resigned after only four months. Unkovic blamed disdain for legal restraints on contracts and debt for creating Harrisburg's intractable financial problem and said the corrupt influence of creditors and political cronies prevented fixing it. As creditors began to file lawsuits to seize and sell off city assets,
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#17327724187173036-531: A town on his father's land, which he named Harrisburg. In the spring of 1785, the town was formally surveyed by William Maclay , who was a son-in-law of John Harris, Sr. In 1791, Harrisburg became incorporated, and in October 1812 it was named the Pennsylvania state capital, which it has remained ever since. The assembling here of the highly sectional Harrisburg Convention in 1827 (signaling what may have been
3174-486: A two-hour drive of the metro areas of Baltimore , Washington , Philadelphia and three-hour drive of New York and Pittsburgh . According to the United States Census Bureau , the city has a total area of 11.4 square miles (30 km ), of which 8.1 square miles (21 km ) is land and 3.3 square miles (8.5 km ) (29.11%) is water. Bodies of water include Paxton Creek , which empties into
3312-513: A variable, four-season climate lying at the beginning of the transition between the humid subtropical and humid continental zones ( Köppen Cfa and Dfa , respectively). The city limits fall within the Cfa Humid subtropical climate classification, while the suburban areas and rural surroundings fall just into the Dfa Humid continental climate classification. The hottest month of the year
3450-535: Is 107 °F (42 °C) on July 3, 1966. Summer thunderstorms also occur relatively frequently. Autumn is a pleasant season, when the humidity and temperatures fall to more comfortable values. The hardiness zone is 7a/7b. Winter in Harrisburg is mild to cool: January, the coolest month, remains above freezing, as it experiences a daily mean temperature of 32.6 °F (0.3 °C). A major snowstorm can also occasionally occur, and some winters snowfall totals can exceed 40 inches (102 cm), while in other winters,
3588-444: Is July, with a daily mean temperature of 77.5 °F (25.3 °C). Summer is usually hot and humid and occasional heat waves can occur. The city averages around 32 days per year with 90 °F (32 °C)+ highs, although temperatures reaching 100 °F (38 °C) are rare. Seven months average above 50 °F (10 °C) and three months average above 22 °C (72 °F). The hottest temperature ever recorded in Harrisburg
3726-572: Is a common perception by the public and media that people with mental disorders are more likely to be dangerous and violent if released into the community. However, a large 1998 study in Archives of General Psychiatry suggested that discharged psychiatric patients without substance abuse symptoms are no more likely to commit violence than others without substance abuse symptoms in their neighborhoods, which were usually economically deprived and high in substance abuse and crime. The study also reported that
3864-469: Is formed by the west shore of the Susquehanna River , which runs within the city boundaries and serves as the boundary between Dauphin and Cumberland counties. Harrisburg is divided into numerous neighborhoods and districts. Like many of Pennsylvania's cities and boroughs that are at build-out stage, there are several townships outside of Harrisburg city limits that, although autonomous, use
4002-815: Is home to the Pennsylvania State Capitol . Completed in 1906, the central dome rises to a height of 272 feet (83 m) and was modeled on that of St. Peter's Basilica in Vatican City , Rome. The building was designed by Joseph Miller Huston and is adorned with sculpture, including Love and Labor, the Unbroken Law and The Burden of Life, the Broken Law by sculptor George Grey Barnard ; murals by Violet Oakley and Edwin Austin Abbey ; tile floor by Henry Mercer , which tells
4140-731: Is situated on the east bank of the Susquehanna River and is located 83 miles (134 km) southwest of Allentown and 107 miles (172 km) northwest of Philadelphia . Harrisburg played a role in American history during the Westward Migration , the American Civil War , and the Industrial Revolution . During part of the 19th century, the building of the Pennsylvania Canal and later
4278-534: Is south of Harrisburg, suffered a partial meltdown. Although the meltdown was contained and radiation leakages were minimal, there were still worries that an evacuation would be necessary. Governor Dick Thornburgh , on the advice of Nuclear Regulatory Commission Chairman Joseph Hendrie , advised the evacuation "of pregnant women and pre-school age children ... within a five-mile radius of the Three Mile Island facility." Within days, 140,000 people had left
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4416-637: Is the capital city of the U.S. commonwealth of Pennsylvania and the seat of Dauphin County . With a population of 50,099 as of 2020 , Harrisburg is the ninth-most populous city in Pennsylvania. It is the larger principal city of the Harrisburg–Carlisle metropolitan statistical area , also known as the Susquehanna Valley , which had a population of 591,712 in 2020 and is the fourth-most populous metro area in Pennsylvania. Harrisburg
4554-676: Is the metropolitan center for some 400 communities. Its economy and more than 45,000 businesses are diversified with a large representation of service-related industries, especially health-care and a growing technological and biotechnology industry to accompany the dominant government field inherent to being the state's capital. National and international firms with major operations include Ahold Delhaize , ArcelorMittal Steel , HP Inc. , IBM , Hershey Foods , Harsco Corporation , Ollie's Bargain Outlet , Rite Aid Corporation , Tyco Electronics , and Volvo Construction Equipment . The largest employers,
4692-401: Is ultimately fueling the growth of its suburbs , although the decline – which was very rapid in the 1960s and 1970s – has slowed considerably since the 1980s. Unlike Western and Southern states , Pennsylvania maintains a complex system of municipalities and has very little legislation on either the annexation/expansion of cities or the consolidating of municipal entities. Harrisburg
4830-484: Is usually within family settings rather than between strangers. The argument that deinstitutionalization has led to increases in homelessness can also be viewed a misconception with some suggesting a correlative rather than causative relationship between the two. It has been argued that in United States, loss of low-income housing and disability benefits are the core causes of homelessness historically and placing
4968-758: The Harrisburg–Carlisle metropolitan statistical area and serves as the seat of government for Dauphin County and the Commonwealth of Pennsylvania . There are over a dozen large neighborhoods and historic districts within the city. Harrisburg's architecture spans over 200 years of evolving construction and design and thus contains a breadth of various architectural styles. Six Municipal Historic Districts, multiple National Historic Districts, and Architectural Conservation Overlay Districts have in turn have been established to preserve and guide any new development of areas with respect to their character. Harrisburg
5106-692: The American Association for the Abolition of Involuntary Mental Hospitalisation (AAAIMH), who proposed abolishing all involuntary psychiatric intervention, particularly involuntary commitment , against individuals. The association provided legal help to psychiatric patients and published a journal, The Abolitionist , until it was dissolved in 1980. The prevailing public arguments, time of onset, and pace of reforms varied by country. Leon Eisenberg lists three key factors that led to deinstitutionalisation gaining support. The first factor
5244-664: The Community Mental Health Act , one of the most important laws that led to deinstitutionalization. The movement continued to gain momentum during the Civil Rights Movement . The 1965 amendments to Social Security shifted about 50% of the mental health care costs from states to the federal government, motivating state governments to promote deinstitutionalization. The 1970s saw the founding of several advocacy groups, including Liberation of Mental Patients, Project Release, Insane Liberation Front, and
5382-745: The Harrisburg Senators of the Eastern League , the Harrisburg Heat indoor soccer club, and Penn FC of the United Soccer League began operations in the city during his tenure as mayor. While praised for the vast number of economic improvements, Reed has also been criticized for population loss and mounting debt. For example, during a budget crisis the city was forced to sell $ 8 million worth of Western and American-Indian artifacts collected by Mayor Reed for
5520-582: The Mental Health Act 1959 , which removed the distinction between psychiatric hospitals and other types of hospitals. Enoch Powell , the Minister of Health in the early 1960s, criticized psychiatric institutions in his 1961 "Water Tower" speech and called for most of the care to be transferred to general hospitals and the community. The campaigns of Barbara Robb and several scandals involving mistreatment at asylums (notably Ely Hospital ) furthered
5658-528: The National Alliance on Mental Illness (NAMI) . The lawsuits these activist groups filed led to some key court rulings in the 1970s that increased the rights of patients. In 1973, a federal district court ruled in Souder v. Brennan that whenever patients in mental health institutions performed activity that conferred an economic benefit to an institution, they had to be considered employees and paid
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5796-571: The National Mental Health Act of 1946 , which created the National Institute of Mental Health (NIMH) . NIMH was pivotal in funding research for the developing mental health field. President John F. Kennedy had a special interest in the issue of mental health because his sister, Rosemary , had incurred brain damage after being lobotomised at the age of 23. His administration sponsored the successful passage of
5934-610: The Pennsylvania Railroad allowed Harrisburg to develop into one of the most industrialized cities in the Northeastern United States . In the mid- to late 20th century, the city's economic fortunes fluctuated with its major industries consisting of government, heavy manufacturing , agriculture , and food services. These economic fluctuations contributed to Harrisburg experiencing a decline of nearly half its population between 1950 and 2000. However,
6072-779: The Potomac to the Upper Susquehanna intersecting there. The first European contact with Native Americans in Pennsylvania was made by Englishman Captain John Smith , who journeyed from Virginia up the Susquehanna River in 1608 and visited with the Susquehanna tribe. In 1719, John Harris, Sr. , an English trader, settled here and 14 years later secured grants of 800 acres (3.2 km ) in this vicinity. In 1785, John Harris, Jr. made plans to lay out
6210-588: The Susquehanna River at Harrisburg, as well as Wildwood Lake and Italian Lake parks. In land area Harrisburg (proper) is also the third smallest of the United States capital cities . Directly to the north of Harrisburg is the Blue Mountain ridge of the Appalachian Mountains . The Cumberland Valley lies directly to the west of Harrisburg and the Susquehanna River, stretching into northern Maryland . The fertile Lebanon Valley lies to
6348-654: The Three Mile Island accident on March 28, 1979, in nearby Middletown . Harrisburg's site along the Susquehanna River is thought to have been inhabited by Native Americans as early as 3000 BC. Known to the Native Americans as "Peixtin", or " Paxtang ", the area was an important resting place and crossroads for Native American traders with trails leading from the Delaware to the Ohio rivers and from
6486-724: The United States Court of Appeals for the First Circuit ruled in favour of the Mental Patient's Liberation Front in Rogers v. Okin , establishing the right of a patient to refuse treatment. Later reforms included the Mental Health Parity Act , which required health insurers to give mental health patients equal coverage. Other factors included scandals. A 1972 television broadcast exposed
6624-545: The World's Columbian Exposition . Warren Manning was hired to help bring about these changes. Specifically, their efforts greatly enlarged the Harrisburg park system, creating Riverfront Park, Reservoir Park, the Italian Lake and Wildwood Park. In addition, schemes were undertaken for new water filtration, burial of electric wires, the paving of roads, and the creation of a modern sanitary sewer system. The efforts to improve
6762-514: The federal and state governments, provide stability to the economy. The region's extensive transportation infrastructure has allowed it to become a prominent center for trade, warehousing, and distribution. According to the Region Economic Development Corporation, the top employers in the region are: Deinstitutionalization Deinstitutionalisation works in two ways. The first focuses on reducing
6900-534: The 1950s and targeted people with mental illness. The second wave began roughly 15 years later and focused on individuals who had been diagnosed with a developmental disability. Loren Mosher argues that deinstitutionalisation fully began in the 1970s and was due to financial incentives like SSI and Social Security Disability, rather than after the earlier introduction of psychiatric drugs. The most important factors that led to deinstitutionalisation were changing public attitudes to mental health and mental hospitals,
7038-409: The 1970s to 1990s. A number of grievances were heard, including: poor reasons for admissions; unsanitary and overcrowded conditions; lack of communication to patients and family members; physical violence and sexual misconduct and abuse; inadequate mechanisms for dealing with complaints; pressures and difficulties for staff, within an authoritarian hierarchy based on containment; fear and humiliation in
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#17327724187177176-431: The 21st century, "budget realignments", and the new subterfuge of community data reporting. Community services that developed include supportive housing with full or partial supervision and specialised teams (such as assertive community treatment and early intervention teams ). Costs have been reported as generally equivalent to inpatient hospitalisation, even lower in some cases (depending on how well or poorly funded
7314-456: The Board of Public Charities was created to inspect all public and voluntary charitable institutions in the Commonwealth and to report to the legislature with recommendations concerning their operation. For four decades this unpaid Board and its small staff had no authority to correct the conditions it found within state institutions. Nonetheless, by persuasion and publicity they were able to improve
7452-540: The Harrisburg State Hospital, relegating its Board of Trustees to specific advisory duties. This act also provided for the appointment of a Commissioner of Mental Health in the Department of Public Welfare who assumed overall responsibility for Pennsylvania's mental health program. Like other institutions, Harrisburg State Hospital's patient population began to fall in the late 20th century. This
7590-500: The Health (Mental Services) Act 1981 was passed in order to prevent the wrongful hospitalisation of individuals. In the 1990s, there was still about 25,000 patients in the asylums. In 2009, the government committed to closing two psychiatric hospitals every year; in 2008, there were still 1,485 patients housed in "inappropriate conditions". Today, Ireland's hospitalisation rate to a position of equality with other comparable countries. In
7728-465: The Holocaust. The Nazi crimes against people with mental illness and disabilities in institutions was one of the catalysts for moving away from an institutionalised approach to mental health and disability in the second half of the 20th century. The advent of chlorpromazine and other antipsychotic drugs in the 1950s and 1960s played an important role in permitting deinstitutionalisation, but it
7866-539: The Insane in 1845 to provide care for mentally ill persons throughout the Commonwealth of Pennsylvania . The hospital was the result of the successful lobbying efforts of 19th century social reformer, Dorothea Dix . A nine-member board of trustees was empowered to appoint a superintendent, purchase land, and construct facilities near Harrisburg. This board of trustees received no compensation for their work. In 1848,
8004-603: The Japanese Ministry of Health introduced revised guidelines that placed more restrictions against the use of restraints. Uganda has one psychiatric hospital. There are only 40 psychiatrists in Uganda. The World Health Organization estimates that 90% of mentally ill people in the country never get treatment. New Zealand established a reconciliation initiative in 2005 to address the ongoing compensation payouts to ex-patients of state-run mental institutions in
8142-620: The Susquehanna River to access food and supplies before heading north towards Canada. During the American Civil War , Harrisburg was a significant training center for the Union Army , with tens of thousands of troops passing through Camp Curtin . It was also a major rail center for the Union and a vital link between the Atlantic coast and the Midwest, with several railroads running through
8280-834: The abuse and neglect of 5,000 patients at the Willowbrook State School in Staten Island , New York. The Rosenhan's experiment in 1973 caused several psychiatric hospitals to fail to notice fake patients who showed no symptoms once they were institutionalized. The pitfalls of institutionalization were dramatized in an award-winning 1975 film, One Flew Over the Cuckoo's Nest . In 1955, for every 100,000 US citizens there were 340 psychiatric hospital beds. In 2005 that number had diminished to 17 per 100,000. In several South American countries, such as in Argentina,
8418-509: The appraised worth of the campus was $ 2 Million. As of 2019, the campus cost $ 5 Million annually to maintain, and is up for sale to developers. The hospital was listed on the National Register of Historic Places in 1986. Italics indicates facilities no longer in operation as state psychiatric hospitals. Harrisburg, Pennsylvania Harrisburg ( / ˈ h æ r ɪ s ˌ b ɜːr ɡ / , Pennsylvania Dutch : Harrisbarrig)
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#17327724187178556-766: The area. Stephen R. Reed was elected mayor in 1981 and served until 2009, making him the city's longest-serving mayor. In an effort to end the city's long period of economic troubles, he initiated several projects to attract new business and tourism to the city. Several museums and hotels such as Whitaker Center for Science and the Arts , the National Civil War Museum and the Hilton Harrisburg and Towers were built during his term, along with many office buildings and residential structures. Several minor league professional sports franchises, including
8694-469: The authority to file for bankruptcy and conferred it on the state receiver. After two years of negotiations, in August 2013 Receiver Lynch revealed his comprehensive voluntary plan for resolving Harrisburg's fiscal problems. The complex plan called for creditors to write down or postpone some debt. To pay the remainder, Harrisburg sold the troubled incinerator, leased its parking garages for 40 years, and
8832-525: The birth of lobbying on a national scale) led to the passage of the high protective-tariff bill of 1828. In 1839, William Henry Harrison and John Tyler were nominated for president and vice president of the United States at the first national convention of the Whig Party of the United States, which was held in Harrisburg. Before Harrisburg gained its first industries, it was a scenic, pastoral town: compact and surrounded by farmland. In 1822,
8970-403: The blame on deinstitutionalization is an oversimplification which does not take into account the other policy changes which occurred during the same time. Some mental health academics and campaigners have argued that deinstitutionalisation was well-intentioned for trying to make patients less dependent on psychiatric care, but in practice patients were still left being dependent on the support of
9108-517: The book details Goffman's theory of the " total institution " (principally in the example he gives, as the title of the book indicates, mental institutions) and the process by which it takes efforts to maintain predictable and regular behavior on the part of both "guard" and "captor", suggesting that many of the features of such institutions serve the ritual function of ensuring that both classes of people know their function and social role , in other words of " institutionalizing " them. Franco Basaglia ,
9246-537: The campaign. The Ely Hospital scandal led to an inquiry led by Brian Abel-Smith and a 1971 white paper that recommended further reform. The policy of deinstitutionalisation came to be known as Care in the Community at the time it was taken up by the government of Margaret Thatcher . Large-scale closures of the old asylums began in the 1980s. By 2015, none remained. The United States has experienced two main waves of deinstitutionalisation. The first wave began in
9384-490: The capitol. They were mostly one story. No factories were present but there were blacksmith shops and other businesses. The ownership of land concentrated in the hands of a small number of wealthy families: five people held one-third of private land in 1850. During the first part of the 19th century, Harrisburg was a notable stopping place along the Underground Railroad , as persons escaping slavery utilized
9522-518: The city also paralleled the construction of an expanded monumental Capitol complex in 1906 which led, in turn, to the displacement of the Old Eighth Ward, one of the most ethnically and racially diverse communities in Harrisburg. The decades between 1920 and 1970 were characterized by industrial decline and population shift from the city to the suburbs. Like most other cities which faced a loss of their industrial base, Harrisburg shifted to
9660-489: The city and spanning the Susquehanna River. As a result of this importance, it was a target of General Robert E. Lee 's Army of Northern Virginia during its two invasions. The first time during the 1862 Maryland Campaign , when Lee planned to capture the city after taking Harpers Ferry, West Virginia , but was prevented from doing so by the Battle of Antietam and his subsequent retreat back into Virginia. The second attempt
9798-436: The city was $ 26,920, and the median income for a family was $ 29,556. Males had a median income of $ 90,670 versus $ 24,405 for females. The per capita income for the city was $ 15,787. About 23.4% of families and 24.6% of the population were below the poverty line , including 34.9% of those under age 13 and 16.6% of those age 65 or over. The very first census taken in the United States occurred in 1790. At that time Harrisburg
9936-501: The community alternatives are). Although deinstitutionalisation has been positive for the majority of patients, it also has shortcomings. Walid Fakhoury and Stefan Priebe suggest that modern day society now faces a new problem of "reinstitutionalisation". and many critics argue that the policy left patients homeless or in prison . Leon Eisenberg has argued that deinstitutionalisation was generally positive for patients, while noting that some were left homeless or without care. There
10074-420: The discovery of psychiatric drugs in the mid-20th century, which could manage psychotic episodes and reduced the need for patients to be confined and restrained. Another major impetus was a series of socio-political movements that campaigned for patient freedom. Lastly, there were financial imperatives, with many governments also viewing it as a way to save costs. The movement to reduce institutionalisation
10212-443: The east. Harrisburg is the northern fringe of the historic Pennsylvania Dutch Country . The city is the county seat of Dauphin County . The adjacent counties are Northumberland County to the north; Schuylkill County to the northeast; Lebanon County to the east; Lancaster County to the south; and York County to the southwest; Cumberland County to the west; and Perry County to the northwest. Harrisburg's western boundary
10350-618: The era of costly hospitalized psychiatry. In most countries (except some countries that are either in extreme poverty or are hindered from importing psychiatric drugs by their customs regulations), more than 10% of the population are now on some form of psychiatric medicine. This increases to more than 15% in some countries such as the United Kingdom . A 2012 study by Kales, Pierce and Greenblatt argued that these medicines were being overprescribed. Moves to community living and services have led to various concerns and fears, from both
10488-748: The extermination of people with disabilities. The 1920 essay, “Permitting the Destruction of Life Unworthy of Life” is seen by many as a blueprint for the Nazis’ future crimes against humanity. In 1939, the Nazi regime began ‘Aktion T4’. Through this programme, psychiatric institutions for children and adults with disabilities were transformed into killing centres. The government compelled midwives to report all babies born with disabilities, then coerced parents to place their children in institutions. Visits were discouraged or forbidden. Then medical personnel transformed
10626-725: The fields of "intellectual disabilities" (e.g., amicus curae, Arc-US to the US Supreme Court; US state consent decrees). Community organizing and development regarding the fields of mental health, traumatic brain injury, aging (nursing facilities) and children's institutions/private residential schools represent other forms of diversion and "community re-entry". Paul Carling's book, Return to the Community: Building Support Systems for People with Psychiatric Disabilities describes mental health planning and services in that regard, including for addressing
10764-452: The form of commitment from the mental hospital to other forms of coercion, questions the basis of psychiatry, affirming that mental hospitals are the essence of psychiatry and rejecting any possible reform of psychiatry, that must be eliminated. In the United Kingdom, the trend towards deinstitutionalisation began in the 1950s. At the time, 0.4% of the population of England were housed in asylums. The government of Harold Macmillan sponsored
10902-428: The gradual dismantlement of psychiatric hospitals, which required an effective community mental health service. The object of community care was to reverse the long-accepted practice of isolating the mentally ill in large institutions and to promote their integration in a socially stimulating environment, while avoiding subjecting them to excessive social pressures. The work of Giorgio Antonucci , instead of changing
11040-535: The health and personal effects of "long term institutionalization". and the psychiatric field continued to research whether "hospitals" (e.g., forced involuntary care in a state institution; voluntary, private admissions) or community living was better. US states have made substantial investments in the community, and similar to Canada, shifted some but not all institutional funds to the community sectors as deinstitutionalization. For example, NYS Education, Health and Social Services Laws identify mental health personnel in
11178-625: The highest psychiatric hospitalisation rate of any Western country. The Lunatic (Asylums) Act, 1875, the Criminal Lunatics Act, 1838 and the Private Lunatic Asylums Act of 1842 created a network of large "district asylums". The Mental Treatment Act, 1945 caused some modernisation but by 1958 the Republic of Ireland still had the highest psychiatric hospitalisation rate in the world. In the 1950s and '60s there
11316-549: The ideal location for this type of industry. It was a wide swath of flat land located south of the city, with rail and canal access running its entire 4 mile length. There was plenty of room for houses and its own downtown section. Steelton was a company town, opened in 1866 by the Pennsylvania Steel Company. Highly innovative in its steel making process, it became the first mill in the United States to make steel railroad rails by contract. In its heyday Steelton
11454-430: The impressive brick capitol was completed for $ 200,000 (~$ 5.78 million in 2023). Harrisburg's strategic location gave it an advantage over many other towns; it was settled as a trading post in 1719 at a location important to westward expansion, past the Blue Mountain range . The Susquehanna River flowed generally west to east at this location, providing a route for boat traffic from the east. The head of navigation
11592-507: The individuals themselves and other members of the community. Over a quarter of individuals accessing community mental health services in a US inner-city area are victims of at least one violent crime per year, a proportion eleven times higher than the inner-city average. The elevated victim rate holds for every category of crime, including rape/sexual assault, other violent assaults, and personal and property theft. Victimisation rates are similar to those with developmental disabilities. There
11730-419: The introduction of psychiatric drugs and individual states' desires to reduce costs from mental hospitals. The federal government offered financial incentives to the states to achieve this goal. Stroman pinpoints World War II as the point when attitudes began to change. In 1946, Life magazine published one of the first exposés of the shortcomings of mental illness treatment. Also in 1946, Congress passed
11868-612: The largest indoor agriculture exposition in the United States, was first held in 1917 and has been held every January since then. The present location of the Show is the Pennsylvania Farm Show Complex & Expo Center , located at the corner of Maclay and Cameron streets. On March 28, 1979, the Three Mile Island nuclear plant, along the Susquehanna River located in Londonderry Township which
12006-573: The late 19th century, but reached the height of its influence between the two world wars. One stated aim was to improve the health of the nation by ‘breeding out defects’, isolating people with disabilities and ensuring they could not procreate. Charles Darwin's son lobbied the British government to arrest people deemed as ‘unfit’, then segregate them in colonies or sterilise them. At the same time, in Germany medics and lawyers joined forces to argue for
12144-517: The late 19th century. The original capacity of the building was 250 patients, but was later expanded with the removal of dining rooms and the addition of the North and South Branch Buildings. Patients from all parts of the state would be accepted at the hospital, at the expense of the counties that they belonged; or, if able they would pay for themselves at a cost of $ 2.50 per week. This cost included board and medical attention. A 130-acre (53 ha) farm
12282-415: The length of Harrisburg, along its eastern border. It had a succession of three passenger depots, each built on the site of the predecessor, and each of high style architecture, including a train shed to protect passengers from inclement weather. At its peak in 1904, it made 100 passenger stops per day. It extended west to Pittsburgh , across the entire state, and east to Philadelphia , serving Steelton along
12420-464: The main street for the moderately wealthy. State Street, leading from the Capitol directly toward Allison Hill, was planned to provide a grand view of the Capitol dome for those approaching the city from Allison Hill. This trend towards outlying residential areas began slowly in the late 19th century and was largely confined to the trolley line, but the growing prevalence of automobile ownership quickened
12558-457: The male and female sides of the campus mirrored each other until the addition of new buildings in the 1930s. In 1921, the name of the hospital was changed to the Harrisburg State Hospital. Also that year, the Board of Public Charities was abolished and the Department of Public Welfare was created to administer all state hospitals. With the completion of the new "Cottage Plan" buildings, the hospital had grown considerably larger. Its patient capacity
12696-509: The minimum wage required by the Fair Labor Standards Act of 1938 . Following this ruling, institutional peonage was outlawed. In the 1975 ruling O'Connor v. Donaldson , the U.S. Supreme Court restricted the rights of states to incarcerate someone who was not violent. This was followed up with the 1978 ruling Addington v. Texas , further restricting states from confining anyone involuntarily for mental illness. In 1975,
12834-613: The misuse of seclusion ; over-use and abuse of ECT , psychiatric medications, and other treatments as punishments, including group therapy , with continued adverse effects ; lack of support on discharge; interrupted lives and lost potential; and continued stigma, prejudice, and emotional distress and trauma. There were some references to instances of helpful aspects or kindnesses despite the system. Participants were offered counselling to help them deal with their experiences, along with advice on their rights, including access to records and legal redress. The Republic of Ireland formerly had
12972-720: The name Harrisburg for postal and name-place designation. They include the townships of: Lower Paxton , Middle Paxton , Susquehanna , Swatara and West Hanover in Dauphin County. The borough of Penbrook , located just east of Reservoir Park , was previously known as East Harrisburg. Penbrook, along with the borough of Paxtang , also located just outside the city limits, maintain Harrisburg ZIP codes as well. The United States Postal Service designates 26 ZIP Codes for Harrisburg, including 13 for official use by federal and state government agencies. Harrisburg has
13110-551: The name of the future hospital was changed to the Pennsylvania State Lunatic Hospital when $ 50,000 was appropriated to begin construction. In 1851, construction of the Main Building designed by John Haviland was completed, which was initially the only building for the hospital, housing the administration, staff, and patients. It was designed following the Kirkbride Plan , which was a very popular building style during
13248-453: The nation's ninth-largest Swedish-American communities in the nation. There were 20,561 households, out of which 28.5% had children under the age of 13 living with them, 23.4% were married couples living together, 24.4% had a female householder with no husband present, and 46.9% were non-families. 39.3% of all households were made up of individuals, and 10.4% had someone living alone who was 65 years of age or older. The average household size
13386-590: The northernmost advance of the Confederate Army during the Civil War. On July 3, 1863, the artillery barrage that marked the beginning of Pickett's Charge of the Battle of Gettysburg was heard from Harrisburg, almost 40 miles away. Harrisburg's importance in the latter half of the 19th century was in the steel industry. It was an important railroad center as well. Steel and iron became dominant industries. Steel and other industries continued to play
13524-404: The patients' re-integration into the community. Unlike most developed countries, Japan has not followed a program of deinstitutionalisation. The number of hospital beds has risen steadily over the last few decades. Physical restraints are used far more often. In 2014, more than 10,000 people were restrained–the highest ever recorded, and more than double the number a decade earlier. In 2018,
13662-524: The population peaked shortly after the war, but then took a long-overdue dive as people fled from the city. Hastening the white flight to the suburbs were the cheap and available houses being built away from the crime and deteriorating situation of the city. The reduction in city population coincided with the rise in population of the Metropolitan Statistical Area. The trend continued until the 1990s. The Pennsylvania Farm Show ,
13800-408: The population size of mental institutions by releasing patients, shortening stays, and reducing both admissions and readmission rates. The second focuses on reforming psychiatric care to reduce (or avoid encouraging) feelings of dependency, hopelessness and other behaviors that make it hard for patients to adjust to a life outside of care. The modern deinstitutionalisation movement was made possible by
13938-457: The prison-like asylums of old, these were designed to be comfortable places where patients could live and be treated, in keeping with the movement towards " moral treatment ". In spite of these ideals, they became overstretched, non-therapeutic, isolated in location, and neglectful of patients. By the beginning of the 20th century, increasing admissions had resulted in serious overcrowding, causing many problems for psychiatric institutions. Funding
14076-465: The psychiatric hospital – from 1973 to 1996 Antonucci worked on the dismantling of the psychiatric hospitals Osservanza and Luigi Lolli of Imola and the liberation – and restitution to life – of the people there secluded. In 1978, the Basaglia Law had started Italian psychiatric reform that resulted in the end of the Italian state mental hospital system in 1998. The reform was focused on
14214-481: The public and patients. Up until 1955, certain administrative responsibilities, such as the selection of the hospital Superintendent and the enactment of rules and regulations governing the hospital were vested in the Board of Trustees of the Harrisburg State Hospital. In 1955 an amendment to the Administrative Code authorized the Department of Public Welfare to assume administrative responsibilities for
14352-495: The public sector virtually no patients remain in 19th-century mental hospitals; acute care is provided in general hospital units. Acute private care is still delivered in stand-alone psychiatric hospitals. The Central Mental Hospital in Dublin is used as a secure psychiatric hospital for criminal offenders, with room for 84 patients. Italy was the first country to begin the deinstitutionalisation of mental health care and to develop
14490-497: The quality of care in public institutions. A major objective was the removal of the insane from almshouses to the Pennsylvania State Lunatic Hospital and other state hospitals. A Committee on Lunacy was created within the Board of Public Charities in 1883 to oversee the operations of these mental institutions. The early 20th century was a time of extensive change for Harrisburg State Hospital. The Main Building had become outdated and
14628-490: The reforms never addressed the aspects of psychiatry that he objected to, particularly his belief that mental illnesses are not true illnesses but medicalized social and personal problems. In Hong Kong , a number of residential care services such as halfway houses , long-stay care homes, supported hostels are provided for the discharged patients. In addition, community support services such as rehabilitation day services and mental health care have been launched to facilitate
14766-459: The region is seen as financially stable in part due to the high concentration of state and federal government agencies. The Pennsylvania Farm Show , the largest indoor agriculture exposition in the U.S., was first held in Harrisburg in 1917 and has been held there every early to mid-January since. The city also hosts the annual Great American Outdoor Show , the largest of its kind in the world, among many other events . Harrisburg experienced
14904-573: The region may receive very little snowfall. Snow that does fall often melts away quickly. The largest snowfall on a single calendar day was 26.4 in (67 cm) on January 23, 2016 , recorded at Harrisburg International Airport in Middletown, while the snowiest month on record was February 2010, with 42.1 in (107 cm), recorded at the same location. Overall Harrisburg receives an average of 29.9 in (75.9 cm) of snow per winter. The coldest temperature ever recorded in Harrisburg
15042-614: The route. The anthracite coal mines in the Allegheny Mountains were reached by the Northern Central Railroad. The Lebanon Valley Railroad extended east to Philadelphia with spurs to New York City . Another rail line was the Philadelphia and Reading Railroad , which provided service to Philadelphia and other points east. Allison Hill , Harrisburg's first suburb, is located east of the city on
15180-472: The school system deficit, the school district's $ 437 million long-term debt, nor unfunded pension and healthcare obligations. Harrisburg was the first municipality ever in the history of the U.S. Securities and Exchange Commission to be charged with securities fraud, for misleading statements about its financial health. The city agreed to a plea bargain to settle the case. In October 2011, Harrisburg filed for Chapter 9 bankruptcy when four members of
15318-614: The seven-member City Council voted to file a bankruptcy petition in order to prevent the Pennsylvania State Government from taking over the city's finances. Bankruptcy Judge Mary France dismissed the petition on the grounds that the City Council majority had filed it over the objection of Mayor Linda Thompson , reasoning that the filing not only required the mayor's approval but had circumvented state laws concerning financially distressed cities. Instead,
15456-590: The state Commonwealth Court approved the plan, and became implemented. The city balanced its budget in the late 2010s, was expected to have a surplus of $ 1 million in 2019, and maintained a surplus in 2020 despite the COVID-19 pandemic . Harrisburg is located at 40°16′11″N 76°52′32″W / 40.26972°N 76.87556°W / 40.26972; -76.87556 (40.269789, -76.875613) in South Central Pennsylvania , within
15594-469: The state legislature selected the small town of Harrisburg to become the state capital in 1812. The grandeur of the Colonial Revival capitol dominated the quaint town. The streets were dirt, but orderly and platted in grid pattern. The Pennsylvania Canal was built in 1834 and coursed the length of the town. The residential houses were situated on only a few city blocks stretching southward from
15732-531: The state of New York, and the two term Obama Presidency in the US created a high-level Office of Social and Behavioral Services. The 20th century marked the growth in a class of deinstitutionalization and community researchers in the US and world, including a class of university women. These women follow university education on social control and the myths of deinstitutionalization, including common forms of transinstitutionalization such as transfers to prison systems in
15870-563: The story of the Pennsylvania. The state capitol is only the third-tallest building of Harrisburg. The five tallest buildings are 333 Market Street with a height of 341 feet (104 m), Pennsylvania Place with a height of 291 feet (89 m), the Pennsylvania State Capitol with a height of 272 feet (83 m), Presbyterian Apartments with a height of 259 feet (79 m) and the Fulton Bank Building with
16008-572: The trend and spread out the population in the 20th century. In the early 20th century, the city of Harrisburg was in need of change. Without proper sanitation, diseases such as typhoid began killing many citizens of Harrisburg. Seeing these necessary changes, several Harrisburg residents became involved in the City Beautiful movement . The project focused on providing better transportation, spaces for recreation, sanitation, landscaping, and parks for those living in cities, as research showed that
16146-544: The world (e.g., individual and family support services, groups homes, community and supportive living, foster care and personal care homes, community residences, community mental health offices, supported housing) that they are often "delinked" from the term deinstitutionalization. Common historical figures in deinstitutionalization in the US include Geraldo Rivera, Robert Williams, Burton Blatt, Gunnar Dybwad , Michael Kennedy, Frank Laski, Steven J. Taylor, Douglas P. Biklen , David Braddock, Robert Bogdan and K. C. Lakin. in
16284-540: Was 2,019, but at one time it held as many as 2,441 with 437 on parole. The hospital was self-sufficient, with its own farm, power plant, and stores; it became known as the "City on the Hill". During wartime there was a 50% shortage of attendants, at the lowest level of employment there were as few as one nurse to 166 patients. In June 1945, only 26 of the 92 authorized positions on the male side were filled. The manpower shortage resulted in widespread curtailment of services to both
16422-408: Was 2.32 and the average family size was 3.15. In the city, the population was spread out, with 28.2% under the age of 18, 9.2% from 13 to 24, 31.0% from 25 to 44, 20.8% from 45 to 64, and 10.9% who were 65 years of age or older. The median age was 33 years. For every 100 females, there were 88.7 males. For every 100 females age 13 and over, there were 84.8 males. The median income for a household in
16560-540: Was a move in the right direction and had laudable goals, many shortcomings in the execution stage have made it unsuccessful thus far. New community services developed as alternatives to institutionalization leave patients dependent still on the support of mental healthcare without clear evidence of providing adequate treatment and support. Multiple for-profit businesses, non-profit organizations and multiple levels of government involved have been criticized as being uncoordinated, underfunded and unable to meet complex needs. In
16698-428: Was a series of socio-political campaigns for the better treatment of patients. Some of these were spurred on by institutional abuse scandals in the 1960s and 1970s, such as Willowbrook State School in the United States and Ely Hospital in the United Kingdom. The second factor was new psychiatric medications made it more feasible to release people into the community and the third factor was financial imperatives. There
16836-422: Was a short distance northwest of the town, where the river flowed through the pass. Persons arriving from the east by boat had to exit at Harrisburg and prepare for an overland journey westward through the mountain pass. Harrisburg assumed importance as a provisioning stop at this point where westward bound pioneers transitioned from river travel to overland travel. It was partly because of its strategic location that
16974-399: Was a small, but substantial colonial town with a population of 875 residents. With the increase of the city's prominence as an industrial and transportation center, Harrisburg reached its peak population build up in 1950, topping out at nearly 90,000 residents. Since the 1950s, Harrisburg, along with other northeastern urban centers large and small, has experienced a declining population that
17112-489: Was a transition to outpatient facilities and care homes. The 1963 Irish Psychiatric Hospital Census noted the extremely high hospitalisation rate of unmarried people; six times the equivalent in England and Wales . In all, about 1% of the population was living in a psychiatric hospital. In 1963–1978, Irish psychiatric hospitalisation rates were 2 + 1 ⁄ 2 times that of England . Health Boards were set up in 1970 and
17250-527: Was an argument that community services would be cheaper. Mental health professionals, public officials, families, advocacy groups, public citizens, and unions held differing views on deinstitutionalisation. However, the 20th century marked the development of the first community services designed specifically to divert deinstitutionalization and to develop the first conversions from institutional, governmental systems to community majority systems (governmental-NGO-For Profit). These services are so common throughout
17388-488: Was an increase in prescriptions of psychiatric medication in the years following deinstitutionalization. Although most of these drugs had been discovered in the years before, deinstitutionalisation made it far cheaper to care for a mental health patient and increased the profitability of the drugs. Some researchers argue that this created economic incentives to increase the frequency of psychiatric diagnosis (and related diagnoses, such as ADHD in children) that did not happen in
17526-613: Was due to new medicines being developed and finally deinstitutionalization . The hospital was finally closed on January 27, 2006. Currently, the hospital sits on a 295-acre (119 ha) campus with stately buildings in a country setting, in Dauphin County , with a majority of its campus in Susquehanna Township . There are over fifty buildings still located on the campus. The former hospital facility now provides office and storage space for many state agencies. In 2017,
17664-554: Was home to more than 16,000 residents from 33 different ethnic groups. All were employed in the steel industry, or had employment in services that supported it. In the late 19th century, no less than five major steel mills and foundries were located in Steelton. Each contained a maze of buildings; conveyances for moving the products; large yards for laying down equipment; and facilities for loading their product on trains. Stacks from these factories constantly belched smoke. With housing and
17802-460: Was in need of replacement. Between the years 1893 and 1912, the hospital was rebuilt following the " Cottage Plan ", which became popular at the beginning of the 20th century. At its peak, the hospital consumed over 1,000 acres (400 ha) and included more than 70 buildings. Designed and constructed by Pennsylvania architects Addison Hutton and John A. Dempwolf , the campus and buildings were meant to represent an Italianate window. The buildings on
17940-596: Was later achieved via the State Street Bridge leading east from the Capitol complex and the Market Street Bridge leading from the city's prominent business district. Among the most desirable sections of Allison Hill at the time was Mount Pleasant, which was characterized by large Colonial Revival -style houses with yards for the very wealthy and smaller but still well-built row houses lining
18078-519: Was left unrepaired, and the heart of the city's financial woes was a trash-to-electricity plant, the Harrisburg incinerator , which was supposed to generate income but instead, because of increased borrowing, incurred a debt of $ 320 million. Missing audits and convoluted transactions, including swap agreements, make it difficult to state how much debt the city owes. Some estimates put total debt over $ 1.5 billion, which would mean that every resident would owe $ 30,285. These numbers do not reflect
18216-472: Was located adjacent to the hospital and provided work therapy for the patients and also enabled the hospital to be self-supporting, by growing its own food, and raising its own livestock. When the first patient was admitted on October 6, 1851, every poor district was charged a $ 2.00 weekly maintenance fee for the care of each indigent patient. The boarding charges for private patients were scheduled to vary between $ 3.00 and $ 10.00 based upon ability to pay. In 1869,
18354-617: Was made during the Gettysburg Campaign in 1863 and was more substantial. Under orders from Gen. Robert E. Lee directly, Confederate Lt. Gen. Richard S. Ewell 's Second Corps were tasked with capturing Harrisburg and disrupting the vital Union supply and rail lines. However, Ewell's forces were intercepted by the forces of the Department of the Susquehanna under the command of Union Maj. Gen. Darius N. Couch in
18492-454: Was met with wide acceptance in Western countries, though its effects have been the subject of many debates. Critics of the policy include defenders of the previous policies as well as those who believe the reforms did not go far enough to provide freedom to patients. The 19th century saw a large expansion in the number and size of asylums in Western industrialised countries. In contrast to
18630-529: Was not until social movements campaigned for reform in the 1960s that the movement gained momentum. A key text in the development of deinstitutionalisation was Asylums: Essays on the Social Situation of Mental Patients and Other Inmates , a 1961 book by sociologist Erving Goffman . The book is one of the first sociological examinations of the social situation of mental patients, the hospital. Based on his participant observation field work ,
18768-434: Was often cut, especially during periods of economic decline and wartime. Asylums became notorious for poor living conditions, lack of hygiene, overcrowding, ill-treatment, and abuse of patients ; many patients starved to death. The first community-based alternatives were suggested and tentatively implemented in the 1920s and 1930s, although asylum numbers continued to increase up to the 1950s. The eugenics movement started in
18906-437: Was to briefly go further into debt by issuing new bonds. Receiver Lynch had also called for setting up nonprofit investment corporations to oversee infrastructure improvement, repairing the city's crumbling roads and water and sewer lines, and pensions and economic development. These were intended to allow nonprofit fundraising and to reduce the likelihood of mismanagement by the city government. Harrisburg's City Council and
19044-501: Was −22 °F (−30 °C) on January 21, 1994 . Spring is also a pleasant time of year for outdoor activities. Precipitation is well-distributed and generous in most months, though July is clearly the wettest and February the driest. See or edit raw graph data . Downtown Harrisburg, which includes the Pennsylvania State Capitol Complex , is the central core business and financial center for
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