Transinstitutionalization

While looking at treatment models in other states, I ran across this unfamiliar word. But it represents a sentiment and belief that I have had for a while. First of all, transinstitutionalization is the movement of people from traditional institutional hospitals to other institutional settings. So nursing homes and prisons have become the new institutional settings and thereby allowing people to continue to push an agenda that says that society has moved away from institutionalizing the mentally ill.

In fact, I saw Disability Rights Wisconsin tweet out a story about a Milwaukee institutional hospital shutting down their long-term care departments. In one way, it is good to be able to celebrate that people are able to move into the fold of society. In another way I think it’s tragic to see a disability rights organization flash this at their followers and clients. What happens when you leave an institution? Is a nursing home or group home not just a community-based institution?

Yes, there has been much progress in keeping people in the community; however I continue to run across people who get trapped in nursing homes because of the level of care they require. The general public continues to believe that we are progressing in not only our attitudes of mental illness but also in our treatment. Institutionalization is a trigger for me because I was almost sent to Central Wisconsin Center when I was little. A nurse tried to force my mom to sign papers to have me committed because of my complex medical needs. I now have a Masters in Social Work and an APSW license. My parents also had to fight relentlessly to prevent the school system from putting me into special education.

I have experience working with youth with autism and behavioral issues that would get them released from other programs or even temporarily institutionalized in a hospital. But then, here is my issue with crisis intervention and people not understanding how less severe or invasive it is to use a physical hold on someone rather than putting them in straps inside a hospital. Which one seems less traumatic for the client or the family? Which one could the state or county use in trying to push their agenda that says that they don’t institutionalize people anymore? Are hospital wards, nursing homes, and prisons not institutions in their eyes?
We must do more, we must hire more qualified staff, and we must remain client-focused.
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