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Reexamination and reinterpretation of the process of deinstitutionalization of public mental hospital inpatients.

A comprehensive review of related research is presented and lessons learned for the sociology of mental health are identified.

The processes of both institutionalization and deinstitutionalization were motivated by belief in the influence of the social environment on the course of mental illness, but while in the early 19th century the social environment of the mental hospital was seen as therapeutic, later in the 20th century the now primarily custodial social environment of large state mental hospitals was seen as iatrogenic. Nonetheless, research in both periods indicated the benefit of socially supportive environments in the hospital, while research on programs for deinstitutionalized patients and for homeless persons indicated the value of comparable features in community programs.

While the process of deinstitutionalization is largely concluded, research should focus on identifying features of the social environment that can maximize rehabilitation.

The debate over the merits of hospital-based and community-based mental health services is misplaced; policies should instead focus on the alternatives for providing socially supportive environments. Deinstitutionalization in the absence of socially supportive programs has been associated with increased rates of homelessness and incarceration among those most chronically ill.

A comprehensive analysis of deinstitutionalization that highlights flaws in prior sociological perspectives and charts a new direction for scholarship.

The medical suppression of female sexuality in Victorian society has long been the subject of historical and cultural scholarship, with documentation not only of textual threats by religious and medical “experts,” but also of surgical assaults on female reproductive systems (Longo, 1979, 1986; Scull & Favreau, 1986; Sheehan, 1997). Less well known is the apparent obverse: the use of medical techniques to stimulate the female genitalia as a means of treating hysteria and other mental disorders (Maines, 1999; Schleiner, 1995). In this paper, I trace the cultural history (mainly Anglo-American) of the psychiatric enhancement, as well as repression, of female sexual pleasure, through various genital treatments, including the surgical and the electrical.¹ I then make the case that these “opposite” treatments are, in the context of Victorian society, two sides of the same coin of the patriarchal, medical control of female sexuality.²

The work of Michel Foucault is taken as inspiration for a study of the organizational field of asylums, prisons, orphanages, and other carceral organizations operating in New York City in 1888. Foucault argues that institutional power is organized into dually ordered system of truth and power. Using text data describing the clients and institutional technologies (organizational “power signatures”) of 168 organizations, we apply structural equivalence methods to unpack speech activity, showing that as Foucault suggests, there may be dually ordered sub-domains of truth and power that help define the underlying logic of this institutional field.

We compare the deinstitutionalization of psychiatric patients and the developmentally disabled in the United States and demonstrate that there were two path-dependent processes with significant qualitative and quantitative differences, ultimately leading to better outcomes for developmentally disabled individuals.

Using secondary literature, we construct a sustained comparison of the two processes in terms of outcomes, timing, tempo, extent, funding, demographic composition, and investment in community services. We then reconstruct the strategies of de-stigmatization and framings of moral worth deployed in the two cases, analyzing their effects on deinstitutionalization in terms of conceptions of risk, rights, and care.

Deinstitutionalization began later for developmentally disabled individuals than for psychiatric patients, and was a more gradual, protracted process. It was not driven by fiscal conservatism, discharges, and the trans-institutionalization of the senile aged, as was deinstitutionalization for psychiatric patients, but primarily by the prevention of institutionalization of young children, and increased investment in infrastructure. Consequently, the deinstitutionalization of the developmentally disabled was far more thorough and successful. The process was shaped by the framing of the developmentally disabled as “forever children” by parents’ organizations that demanded a balance between autonomy, protection, and the provision of care. In contrast, the deinstitutionalization of psychiatric patients was shaped by their framing as autonomous citizens temporarily suffering from “mental health problems” that could be prevented, treated, and cured. This frame foregrounded the right to choose (and also refuse) treatment, while undervaluing the provision of care.

It is widely recognized by scholars that superhero stories tend to glorify vigilante justice; after all, these stories often maintain that extralegal acts of violence are necessary for combatting existential threats to personal and public safety. This scholarly common sense fosters a widespread dismissal of superhero stories as uncomplicated apologia for an authoritarian politics of law and order that is animated by hatred of unpopular people and ideas. However, some prominent contemporary Batman stories, including those told in the graphic novels of Grant Morrison and in the blockbuster movies of Christopher Nolan, are ambivalent: in their portraits of Batman and Joker as dark twins and secret colleagues, these stories both legitimize and challenge the countersubversive politics of American law and order.

Disability as a consequential social characteristic has not drawn sociologists’ contemporary attention in the way that race, class, gender, and sexuality have. In order to understand why, it is instructive to analyze how disability has been framed since the inception of the American Sociological Society, now known as the American Sociological Association.

Our findings are based on an intensive, systematic, and comprehensive content analysis of 10 years of the Proceedings from the American Sociology Society’s Annual Meetings, 1906–1915.

Three key themes emerged from the content analysis of the proceedings of the first 10 years of the papers delivered at the Annual Meetings (1906–1915). First, people with disabilities were largely invisible in those papers. Second, influenced strongly by a social reform agenda which stressed progress and the powerful eugenics movement of the time, those early presenters who addressed people with disabilities in their papers vilified them. Third, their denigration was met largely with silence in the printed commentary which followed in the proceedings.

In order to understand the present limited attention to disability, researchers need to know the historical context.

Although there have been a number of thoughtful books, edited volumes and review essays exploring the history of the discipline of sociology, none of them have attended to the history of disability within the field. This paper contributes to that historical understanding.

This exploratory study, a Ph.D. dissertation completed at the University of Western Ontario in 2013, examines the materially embedded relations of power between library users and staff in public libraries and how building design regulates spatial behavior according to organizational objectives. It considers three public library buildings as organization spaces (Dale & Burrell, 2008) and determines the extent to which their spatial organizations reproduce the relations of power between the library and its public that originated with the modern public library building type ca. 1900. Adopting a multicase study design, I conducted site visits to three, purposefully selected public library buildings of similar size but various ages. Site visits included: blueprint analysis; organizational document analysis; in-depth, semi-structured interviews with library users and library staff; cognitive mapping exercises; observations; and photography.

Despite newer approaches to designing public library buildings, the use of newer information technologies, and the emergence of newer paradigms of library service delivery (e.g., the user-centered model), findings strongly suggest that the library as an organization still relies on many of the same socio-spatial models of control as it did one century ago when public library design first became standardized. The three public libraries examined show spatial organizations that were designed primarily with the librarian, library materials, and library operations in mind far more than the library user or the user’s many needs. This not only calls into question the public library’s progressiveness over the last century but also hints at its ability to survive in the new century.

Deafness and hearing impairments have a very interesting and ancient history. The term hearing impairments is used here to refer to any dysfunction of the hearing organ, regardless of the etiology, degree of hearing loss, and service provision implications. The history of hearing impairments can be traced back to centuries before Christ (BC). For instance, around 1000 BC a Hebrew law provided those with deafness and hearing impairments limited rights to own property and marry. Nonetheless, although this law protected people with hearing impairments from being cursed and maltreated by others, it did not grant them full participation in rituals of the temple (ASLInfo, 2010). People with hearing impairments were considered to be “subnormal” by great philosophers of that time. For instance, between 427 and 347 BC, Plato's philosophy of innate intelligence was the vogue. It claimed that all intelligence was present at birth. Therefore, all people were born with ideas and languages in their minds and required only time to demonstrate their outward sign of intelligence through speech. People with hearing impairments could not speak and were therefore considered incapable of rational thoughts and ideas. Indeed in 355 BC Aristotle was reported to have claimed that those who were born deaf would become stupid and incapable of reason. According to him, people with hearing impairments could not be educated because without the ability to hear, people could not learn. Greek which was spoken in his society was considered the perfect language and all people who did not speak Greek including people with deafness were considered Barbarians (ASLInfo, 2010).