My Dad worked in Psychiatric centres, and He would take us there when it was hot, for a swim. I remember the institutionalised people who'd been there for decades...I also remember when they decided to 'de-institutionalise' these residents after a professor Dalton suggested that it would be a good idea.
The ex residents didn't have a chance once pushed out, away from the only place a lot of them called home.
Opinions will vary but I think that in the majority, it was the most unkindest cut of all. The majority wound up in gaol, with the harbour side land that was once their home, flogged off at unbelievable prices.
Some people are too frail psychologically to live in our societies and are more suited to being 'institutionalised'. Just an opinion.
Deinstitutionalization failed a lot of people and they ended up on the streets. However, it also did a lot of good.
"Care in the Community" was a move to shift people out of the local big old bins and let them live in the community which I think was the right thing to do for the majority. I totally agree that there is a small percentage of the population that needs a high level of supervision and often containment.
The idea on paper was noble enough and in the long term has seen a shift in how we treat people with mental illness. However, the whole process was largely driven by money.
The old bins were hugely expensive to run and in our western society that had to change. The bins also not only institutionalized the patients but the staff as well and some of the institutions could be brutal. Some of the stories from the old days of the '60s and 70's are shocking. This had to change.
The whole problem was that there was never enough community provision, (there's still nowhere near enough), to support people in the community. Supported accommodation, where a lot of people end up. often has unskilled and poorly trained staff doing heroic work to try and look after our long term mentally ill.
Care in the Community was a success for a lot of people that on paper nobody thought would be able to be safely looked after in the community. This was down to the monumental effort of nurses and support workers to make it work. Unsung heroes the lot of them.
It also let down many others as you say Mungo and they ended up on the streets.
A major problem is that drop-in centers, community groups, work programs, etc have been slashed by governments over the years because you can't quantify their importance to the accountants that run the health service. It's difficult to make a business case for funding, (business case should never be a term linked to health but it is). if you don't have the stats.
People with long term mental health issues, primarily psychosis who live in the community these drop-in centers are essential. Many have been closed down. People would use them daily as a place of refuge and safety and meet their friends - now they are gone.
If someone was starting to deteriorate people would notice and act on it. Close down that drop-in who is going to pick up on that? The Community nurse who only visits once a month?
It's worse now than it was with deinitialization due to the cuts. Although 30 years or so on we have established, ( albeit horribly under-resourced), community teams with experienced staff looking after people.
So yes institutions provided a very real asylum for some but it removed, essentially erased many people from their communities.