This chapter explores how the 1980s hastened the shrinking of state mental health services and the rise of more punitive practices. President Ronald Reagan supported the continued downsizing of mental hospitals at both the state and federal levels. Homelessness and poverty became more immediate social concerns, since many states lacked adequate community-based mental health services. In Pennsylvania, Republican governor Dick Thornburgh closed mental hospitals and cut social welfare programs, strengthening neoliberalism in the state’s government. At the same time, he supported law and order policies and sentencing reforms, which targeted urban African American communities. The new prison construction siphoned money away from social welfare services. Many states even turned their abandoned mental institutions into prisons, and the chapter studies Farview State Hospital and the Retreat State Hospital as examples. In response, advocates at organizations such as the Mental Health Association of Southeastern Pennsylvania fought for the right to the least restrictive environment. They promoted adequate medical, mental health, and social services outside of institutions and worked in coalition with others to ethically close the Philadelphia State Hospital. This effort offered a model for alleviating the problems of deinstitutionalization.
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