From Shelters to Streets: The Unintended Consequences of Deinstitutionalization
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
The deinstitutionalization movement, which began in the mid-20th century, shifted the care of individuals with severe mental illness from large psychiatric hospitals to community-based treatment. In Louisiana, this shift reached a turning point in the early 2010s, with the closure of several state-run psychiatric facilities, including the Eastern Louisiana Mental Health System and psychiatric services at the Louisiana State Penitentiary. While the goal was to provide care in the community, many individuals were left without proper support, contributing to a significant rise in homelessness among those with serious mental health issues. Today, about 30% of Louisiana's unhoused population is affected by severe mental illness. This literature review examines the history of deinstitutionalization, the role of psychotropic medications in this transition, and the ongoing struggles with medication non-adherence among unhoused individuals. Financial instability, limited access to healthcare, and fragmented mental health services often leave these individuals unable to manage their psychiatric conditions, leading to a cycle of worsening symptoms and prolonged homelessness. Research has shown that models like Housing First, which prioritize providing stable housing before addressing mental health and medication needs, can significantly improve outcomes for people with severe mental illness. These programs have been shown to reduce psychiatric symptoms and improve medication adherence. Additionally, the expansion of Medicaid in certain states has increased healthcare access for unhoused individuals, making treatment more accessible. This review emphasizes the need for an integrated approach that combines stable housing, accessible mental health services, and ongoing medication support to break the cycle of mental illness and homelessness for unhoused individuals in Louisiana.
Recommended Citation
Sistrunk, William; Roghani, Kimia; and Culotta, Joshua MD, "From Shelters to Streets: The Unintended Consequences of Deinstitutionalization" (2025). Dept. of Psychiatry Research Symposium. 12.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/12
From Shelters to Streets: The Unintended Consequences of Deinstitutionalization
Center for Advanced Learning and Simulation (CALS)
The deinstitutionalization movement, which began in the mid-20th century, shifted the care of individuals with severe mental illness from large psychiatric hospitals to community-based treatment. In Louisiana, this shift reached a turning point in the early 2010s, with the closure of several state-run psychiatric facilities, including the Eastern Louisiana Mental Health System and psychiatric services at the Louisiana State Penitentiary. While the goal was to provide care in the community, many individuals were left without proper support, contributing to a significant rise in homelessness among those with serious mental health issues. Today, about 30% of Louisiana's unhoused population is affected by severe mental illness. This literature review examines the history of deinstitutionalization, the role of psychotropic medications in this transition, and the ongoing struggles with medication non-adherence among unhoused individuals. Financial instability, limited access to healthcare, and fragmented mental health services often leave these individuals unable to manage their psychiatric conditions, leading to a cycle of worsening symptoms and prolonged homelessness. Research has shown that models like Housing First, which prioritize providing stable housing before addressing mental health and medication needs, can significantly improve outcomes for people with severe mental illness. These programs have been shown to reduce psychiatric symptoms and improve medication adherence. Additionally, the expansion of Medicaid in certain states has increased healthcare access for unhoused individuals, making treatment more accessible. This review emphasizes the need for an integrated approach that combines stable housing, accessible mental health services, and ongoing medication support to break the cycle of mental illness and homelessness for unhoused individuals in Louisiana.