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From a recent journey in the U.S.A. we bring any news about deinstitutionalization. This current is not knew as soon as it must in France and connoted of ideological conceptions, which are very distant from the real practices.

The Quarterway House was founded in December 1978 to deinstitutionalize and provide rehabilitation services to a small group of long-term, seriously ill inpatients of the Massachusetts Mental Health Center. The purposes of the residential program are to provide a less institutional therapeutic environment and to develop a psychosocial treatment program that might enable some patients to move toward more independent settings in the community. In a randomized experimental study, with center inpatients as the control group, the effectiveness of the program was assessed by multiple outcome measures before the program began and at one year. Although neither group moved rapidly to more independent community living, Quarterway House patients showed improvement in general functioning and socialization-survival skills and decreased medication and seclusion. They did not show a decline in psychotic symptoms, obstreperousness, or antisocial behavior. Over-all, the findings suggest the program may prove useful for the long-term rehabilitation of severely ill patients.

The author describes the characteristic environment and afterwork leisure hours of a mentally handicapped woman residing in a hostel for mentally handicapped adults. Such hostels are described and presented as one of the possibilities of accommodating such individuals. These hostels are described as small-scale projects close to the original district in which the patients had grown up, the ultimate aim being the social integration of the inmates. The hostels in question were erected as homesteads for mentally handicapped adults who are mainly engaged in working in a sheltered workshop. The working principles are described, followed by an outline of the development of homesteads in the Federal Republic, listing the available capacities and future requirements. In addition, legal pointers are also given, besides a description of aspects of financing and constructional problems and of the tasks of residents and staff. From the description of a few essential structural and conceptional problems in this field, the article arrives at important demands to be made in future to both government and society. The article then points out the possibilities of continuing to set up suitable hostels for mentally handicapped adults in spite of strained financial budgets of the state and of the local communities. In the author's opinion, chances are offered by improving the cooperation between building societies and communities to ensure adequate housing in accordance with regional requirements.

Deinstitutionalization began with some noble sentiments: to treat and care for the mentally ill in settings that were closer to their homes, families, and neighborhoods; to treat people in more therapeutic and less restrictive settings; and to provide the array of services and settings in the community rather than in far distant institutions. However, few of these intentions have been realized. It is up to us to point out the discrimination, the inequity, indeed the insanity of our current practices and non-system.

The planning and development of community-based facilities for the mentally ill have been hindered by many factors, one of which is the lack of an acceptable methodology for determining the housing needs of this population. This paper describes a consumer-oriented needs assessment strategy that provides a basis for planning residential facilities for the mentally ill. Survey results provided detailed descriptions of the population in need of residential programs, the types of facilities needed, the total volume of need for each, and the distribution of need. Implications for program planning are discussed as well as the advantages and disadvantages in utilizing this approach for establishing a basis for residential facilities planning for the mentally ill.

The presence of large numbers of former mental patients in the community has forced municipal governments to become aware of the deinstitutionalization process. Many, such as in Asbury Park, New Jersey, have voiced strong criticism of the process and have resisted the influx of patients. In 1979 the city was selected by the state mental health authority to work with the Urban Health Institute, a nonprofit health care consulting firm, in a project designed to encourage local planning and resource development for deinstitutionalized mental patients. The authors describe how the project, using traditional community organizing techniques, worked to reduce conflict and to create an atmosphere in which positive local planning for these patients became possible.