Both the scope and effects of deinstitutionalization have been dramatic. This volume examines both positive and negative effects of this mass movement of persons with severe mental illness out of the state hospitals and into the community. The chapters address the following issues: the use of community alternatives to state hospitalization; the very large numbers of persons with severe mental illness who have found their way into the criminal justice system, why this has happened, and what to do about it; the community treatment of mentally ill offenders; how to prevent inappropriate entry of mentally ill persons into the criminal justice system; the value of mental health consultation in courtroom settings; the therapeutic use of mental health conservatorship; and finally, psychiatric rehabilitation. Although deinstitutionalization for the most part can result in a much richer life experience in the community, much more needs to be done to make that occur. This is the 90th issue of the Jossey-Bass series New Directions for Mental Health Services.

Table of Contents:
EDITORS' NOTES (H. Richard Lamb, Linda E. Weinberger). 1. Deinstitutionalization at the Beginning of the New Millennium (H. Richard Lamb). This overview of deinstitutionalization explores its accomplishments and disappointments. 2. The New State Mental Hospitals in the Community (H. Richard Lamb). Serious problems result when the use of community alternatives to state hospitalization, often driven by lower costs and an ideology that highly structured care is seldom needed, is not adequate to meet the needs of those who are mentally ill. 3. Persons with Severe Mental Illness in Jails and Prisons: A Review (H. Richard Lamb, Linda E. Weinberger). One of the greatest problems of deinstitutionalization has been the very large number of persons with severe mental illness who have entered the criminal justice system instead of the mental health system. 4. Community Treatment of Severely Mentally Ill Offenders Under the Jurisdiction of the Criminal Justice System: A Review (H. Richard Lamb, Linda E. Weinberger, Bruce H. Gross). Community treatment of severely mentally ill offenders who fall under the jurisdiction of the criminal justice system has important differences from treatment of nonoffenders. It is critical to identify a treatment philosophy that strikes a balance between individual rights and public safety and includes clear treatment goals. 5. Outcome for Psychiatric Emergency Patients Seen by an Outreach Police-Mental Health Team (H. Richard Lamb, Roderick Shaner, Diana M. Elliott, Walter J. DeCuir Jr., James T. Foltz). Outreach emergency teams comprising police officers and mental health professionals can help to avoid criminalization of the mentally ill. 6. Court Intervention to Address the Mental Health Needs of Mentally Ill Offenders (H. Richard Lamb, Linda E. Weinberger, Cynthia Reston-Parham). Mental health consultation is provided to a municipal court that recommends court-mandated interventions for mentally ill persons who have committed minor crimes. This study demonstrates that a significantly better outcome results when the judge not only mandates but monitors mental health treatment. 7. Therapeutic Use of Conservatorship in the Treatment of Gravely Disabled Psychiatric Patients (H. Richard Lamb, Linda E. Weinberger). Mental health conservatorship can play an important role in the clinical management and treatment of persons with severe mental illness. 8. A Century and a Half of Psychiatric Rehabilitation in the United States (H. Richard Lamb). After a brief history, the chapter describes important modalities and models of psychiatric rehabilitation. INDEX.