Skip navigation
CLN bookstore

Harcourt Univ of Chicago Law School Reducing Mass Incarceration Lessons From the Deinstitutionalisation of Mental Hospitals in the 1960s 2011

Download original document:
Brief thumbnail
This text is machine-read, and may contain errors. Check the original document to verify accuracy.
CHICAGO 
JOHN M. OLIN LAW & ECONOMICS WORKING PAPER NO. 542 
(2D SERIES) 
PUBLIC LAW AND LEGAL THEORY WORKING PAPER NO. 335 

 

 
REDUCING MASS INCARCERATION:  
LESSONS FROM THE DEINSTITUTIONALIZATION OF MENTAL 
HOSPITALS IN THE 1960S 
 

Bernard E. Harcourt 
 
 
 
THE LAW SCHOOL 
THE UNIVERSITY OF CHICAGO  
 
January 2011 
 
This paper can be downloaded without charge at the John M. Olin Program in Law and 
Economics Working Paper Series: http://www.law.uchicago.edu/Lawecon/index.html and at the 
Public Law and Legal Theory Working Paper Series:  
http://www.law.uchicago.edu/academics/publiclaw/index.html 
and The Social Science Research Network Electronic Paper Collection. 

Electronic copy available at: http://ssrn.com/abstract=1748796

DRAFT: 1/21/2011
© Bernard E. Harcourt

=
=
obar`fkd=j^pp=fk`^o`bo^qflkW=
ibpplkp=colj=qeb=abfkpqfqrqflk^ifw^qflk=lc=jbkq^i=elpmfq^ip=fk=qeb=NVSMpK==
_Éêå~êÇ=bK=e~êÅçìêíN=
=
=
få= ~= ãÉëë~ÖÉ= íç= `çåÖêÉëë= áå= NVSPI= mêÉëáÇÉåí= gçÜå= cK= hÉååÉÇó= çìíäáåÉÇ= ~= ÑÉÇÉê~ä= éêçÖê~ã=
ÇÉëáÖåÉÇ= íç= êÉÇìÅÉ= Äó= Ü~äÑ= íÜÉ= åìãÄÉê= çÑ= éÉêëçåë= áå= ÅìëíçÇóK= qÜÉ= áåëíáíìíáçåë= ~í= áëëìÉ= ïÉêÉ= ëí~íÉ=
Üçëéáí~äë= ~åÇ= ~ëóäìãë= Ñçê= íÜÉ= ãÉåí~ääó= áääI= ~åÇ= íÜÉ= åìãÄÉê= çÑ= ëìÅÜ= éÉêëçåë= áå= ÅìëíçÇó= ï~ë=
ëí~ÖÖÉêáåÖäó= ä~êÖÉI= áå= Ñ~Åí= Åçãé~ê~ÄäÉ= íç= ÅçåíÉãéçê~êó= äÉîÉäë= çÑ= ã~ëë= áåÅ~êÅÉê~íáçå= áå= éêáëçåë= ~åÇ=
à~áäëK=mêÉëáÇÉåí=hÉååÉÇóÛë=ãÉëë~ÖÉ=íç=`çåÖêÉëëÔíÜÉ=Ñáêëí=~åÇ=éÉêÜ~éë=çåäó=éêÉëáÇÉåíá~ä=ãÉëë~ÖÉ=íç=
`çåÖêÉëë= íÜ~í= ÇÉ~äí= ÉñÅäìëáîÉäó= ïáíÜ= íÜÉ= áëëìÉ= çÑ= áåëíáíìíáçå~äáò~íáçå= áå= íÜáë= ÅçìåíêóÔéêçéçëÉÇ=
êÉéä~ÅáåÖ= ëí~íÉ= ãÉåí~ä= Üçëéáí~äë= ïáíÜ= Åçããìåáíó= ãÉåí~ä= ÜÉ~äíÜ= ÅÉåíÉêëI= ~= éêçÖê~ã= ìäíáã~íÉäó=
Éå~ÅíÉÇ= Äó= `çåÖêÉëë= áå= NVSP= ìåÇÉê= íÜÉ= `çããìåáíó= jÉåí~ä= eÉ~äíÜ= `ÉåíÉêë= ^ÅíK= mêÉëáÇÉåí=
hÉååÉÇóÛë=ãÉëë~ÖÉ=íç=`çåÖêÉëë=ï~ë=ëíê~áÖÜíÑçêï~êÇW=
fÑ=ïÉ=ä~ìåÅÜ=~=Äêç~Ç=åÉï=ãÉåí~ä=ÜÉ~äíÜ=éêçÖê~ã=åçïI=áí=ïáää=ÄÉ=éçëëáÄäÉ=ïáíÜáå=~=ÇÉÅ~ÇÉ=çê=
íïç=íç=êÉÇìÅÉ=íÜÉ=åìãÄÉê=çÑ=é~íáÉåíë=åçï=ìåÇÉê=ÅìëíçÇá~ä=Å~êÉ=Äó=RM=éÉêÅÉåí=çê=ãçêÉK=j~åó=
ãçêÉ=ãÉåí~ääó=áää=Å~å=ÄÉ=ÜÉäéÉÇ=íç=êÉã~áå=áå=íÜÉáê=ÜçãÉë=ïáíÜçìí=Ü~êÇëÜáé=íç=íÜÉãëÉäîÉë=çê=
íÜÉáê= Ñ~ãáäáÉëK= qÜçëÉ= ïÜç= ~êÉ= Üçëéáí~äáòÉÇ= Å~å= ÄÉ= ÜÉäéÉÇ= íç= êÉíìêå= íç= íÜÉáê= çïå=
ÅçããìåáíáÉëKKK=`Éåíê~ä=íç=~=åÉï=ãÉåí~ä=ÜÉ~äíÜ=éêçÖê~ã=áë=ÅçãéêÉÜÉåëáîÉ=Åçããìåáíó=Å~êÉK=
jÉêÉäó=éçìêáåÖ=cÉÇÉê~ä=ÑìåÇë=áåíç=~=Åçåíáåì~íáçå=çÑ=íÜÉ=çìíãçÇÉÇ=íóéÉ=çÑ=áåëíáíìíáçå~ä=Å~êÉ=
ïÜáÅÜ=åçï=éêÉî~áäë=ïçìäÇ=ã~âÉ=äáííäÉ=ÇáÑÑÉêÉåÅÉKO=
=
mêÉëáÇÉåí=hÉååÉÇóÛë=~ëéáê~íáçå=çÑ=~=RM=éÉêÅÉåí=ÇêçéI=áí=íìêåë=çìíI=ìåÇÉêÉëíáã~íÉÇ=íÜÉ=ÉñíÉåí=
çÑ= ÇÉáåëíáíìíáçå~äáò~íáçå= íÜ~í= ïçìäÇ= í~âÉ= éä~ÅÉK= qÜÉ= é~ëë~ÖÉ= çÑ= íÜÉ= `çããìåáíó= jÉåí~ä= eÉ~äíÜ=
`ÉåíÉêë=^Åí=áå=NVSP=ïçìäÇ=ÄÉ=ÑçääçïÉÇ=Äó=íÜÉ=ä~êÖÉëí=áåëíáíìíáçå~ä=ãáÖê~íáçå=íÜ~í=Ü~ë=ÉîÉê=çÅÅìêêÉÇ=
áå= íÜáë= ÅçìåíêóK= aìêáåÖ= íÜÉ= éÉêáçÇ= NVSR= íç= NVTRI= íÜÉ= áåé~íáÉåí= éçéìä~íáçå= áå= ëí~íÉ= ~åÇ= Åçìåíó=
P
ãÉåí~ä= Üçëéáí~äë= ïçìäÇ= éäìããÉí= ~= ëíìååáåÖ= RVKP= éÉêÅÉåíK = qÜÉ= ãÉ~å= ÇÉÅêÉ~ëÉ= éÉê= óÉ~ê= çîÉê= íÜ~í=
                                                            
1

Professor and Chair, Department of Political Science, and Julius Kreeger Professor of Law, University of Chicago.
I am deeply grateful to Carol Steiker for organizing and hosting this remarkable symposium, to Charles Ogletree for
commenting on a draft of this essay at the symposium, to Philip Heymann, Mark Kleinman, Adriaan Lanni, Louis
Michael Seidman, Jeannie Suk, and Andrew Taslitz for extremely helpful comments and discussion on the draft, and
to Chris Berk and Alyssa Kate Ogawa for extraordinary research assistance.
2
Quoted in William Gronfein, “Incentives and Intentions in Mental Health Policy: A Comparison of Medicaid and
Community Mental Health Programs,” 26 J Health & Social Behavior 3, 192-206 (1985), at p. 196; see also Henry
Foley and Steven Sharfstein, Madness and Government, Wash D.C.: American Psychiatric Association (1983), at
page 166.
3
Gronfein, “Incentives and Intentions,” 1985 at p. 196 (Table 1).

Electronic copy available at: http://ssrn.com/abstract=1748796

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

éÉêáçÇ=ïçìäÇ=êÉ~ÅÜ=~äãçëí=V=éÉêÅÉåíKQ=aìêáåÖ=íÜÉ=åÉñí=ÑáîÉ=óÉ~êëI=Ñêçã=NVTR=íç=NVUMI=íÜÉ=Çêçé=áå=
áåé~íáÉåí=éçéìä~íáçåë=ïçìäÇ=ÅçåíáåìÉI=Ççïå=~åçíÜÉê=OUKV=éÉêÅÉåíKR=^ää=áå=~ääI=Ñêçã=NVRR=íç=NVUMI=
S
íÜÉ=åìãÄÉê=çÑ=éÉêëçåë=áåëíáíìíáçå~äáòÉÇ=áå=ãÉåí~ä=ÜÉ~äíÜ=Ñ~ÅáäáíáÉë=ÇÉÅäáåÉÇ=Äó=TR=éÉêÅÉåíK =
=
qêìíÜ=ÄÉ=íçäÇI=ÇÉáåëíáíìíáçå~äáò~íáçå= Ü~Ç=ÄÉÖìå=É~êäáÉêI=áå=~Äçìí=NVRRI=ïáíÜ=~å=É~êäó=çåëÉí=
Çêçé= çÑ= ~Äçìí= NR= éÉêÅÉåí= çîÉê= íÜÉ= éÉêáçÇ= NVRR= íç= NVSRK= jçêÉçîÉêI= íÜÉ= ãçëí= êÉäá~ÄäÉ= êÉëÉ~êÅÜ=
~ííêáÄìíÉë=íÜÉ=ëÜ~êé=ÇÉÅäáåÉë=çîÉê=íÜÉ=éÉêáçÇ=NVRR=íç=NVUM=íç=ëÉîÉê~ä=ä~êÖÉê=Ñ~ÅíçêëI=åçí=ãÉêÉäó=íÜÉ=
é~ëë~ÖÉ= áå= NVSP=çÑ=íÜÉ= `çããìåáíó=jÉåí~ä= eÉ~äíÜ= `ÉåíÉêë= ^ÅíI= åçê= íÜÉ= ê~éáÇ= ~ÅÅçãéäáëÜãÉåí= çÑ=
Ñìääó=ÑìåÇÉÇ=Åçããìåáíó=ãÉåí~ä=ÜÉ~äíÜ=ÅÉåíÉêë=Äó=NVSRK=^=Ñ~ê=ä~êÖÉê=ëÉí=çÑ=ëçÅáÉí~ä=ÅÜ~åÖÉë=ïÉêÉ=~í=
éä~óI=áåÅäìÇáåÖ=íÜÉ=êÉçêÖ~åáò~íáçå=çÑ=íÜÉ=éëóÅÜá~íêáÅ=éêçÑÉëëáçåI=ëÜáÑíáåÖ=îáÉïë=çå=ãÉåí~ä=áääåÉëëI=Å~êÉ=
~åÇ=íêÉ~íãÉåíI=íÜÉ=~ÑíÉêëÜçÅâ=çÑ=tçêäÇ=t~ê=ffI=ÅÜ~åÖáåÖ=ëí~íÉ=éçäáÅáÉëI=ÑáëÅ~ä=ÅêáëÉëI=~åÇ=~ãÄáíáçìë=
ÑÉÇÉê~ä=áåíÉêîÉåíáçåëKT=fÑ=çåÉ=ïÉêÉ=íç=å~êêçï=íÜÉëÉ=Ñ~Åíçêë=ÇçïåI=Ä~ëÉÇ=çå=íÜÉ=äÉ~ÇáåÖ=ëçÅá~ä=ëÅáÉåíáÑáÅ=
ÉîáÇÉåÅÉI=íÜêÉÉ=ïçìäÇ=ëí~åÇ=çìíW=ÑáêëíI=íÜÉ=ÇÉîÉäçéãÉåí=~åÇ=ìëÉ=çÑ=éëóÅÜá~íêáÅ=ãÉÇáÅáåÉë=~ë=íêÉ~íãÉåí=
Ñçê= ÉîÉå= ëÉîÉêÉ= ãÉåí~ä= áääåÉëëX= ëÉÅçåÇI= íÜÉ= ÇÉîÉäçéãÉåí= çÑ= ÑÉÇÉê~ä= ëçÅá~ä= ïÉäÑ~êÉ= éêçÖê~ãë= EëìÅÜ=~ë=
jÉÇáÅ~áÇ= ~åÇ= jÉÇáÅ~êÉF= íÜ~í= ÅêÉ~íÉÇ= Ñáå~åÅá~ä= áåÅÉåíáîÉë= íç= ÅÜ~ååÉä= Å~êÉ= Ñçê= íÜÉ= ãÉåí~ääó= áää= íç=
~äíÉêå~íáîÉ=ëÉííáåÖëX=~åÇI=íÜáêÇI=ÅÜ~åÖáåÖ=ëçÅáÉí~ä=éÉêÅÉéíáçåë=çÑ=ãÉåí~ä=áääåÉëëI=ÅçìéäÉÇ=ïáíÜ=éìÄäáÅ=
~ï~êÉåÉëë=çÑ=íÜÉ=éêçÄäÉãë=~åÇ=~ÄìëÉë=ÉåÇÉãáÅ=íç=íÜÉ=ëóëíÉã=çÑ=áåëíáíìíáçå~äáòÉÇ=Å~êÉI=íÜ~í=êÉëìäíÉÇ=áå=
éçäáíáÅ~ä=~åÇ=äÉÖ~ä=ÅÜ~ääÉåÖÉë=êÉÖ~êÇáåÖ=íÜÉ=Å~êÉ=~åÇ=ëí~íìë=çÑ=íÜÉ=ãÉåí~ääó=áääK==
_ìí=ÉîÉå=íÜçìÖÜ=íÜÉ=ÜáëíçêáÅ~ä=êÉÅçêÇ=áë=ÅçãéäÉñI=çåÉ=ëáãéäÉ=Ñ~Åí=êÉã~áåëW= qÜáë=Åçìåíêó=Ü~ë=
ÇÉáåëíáíìíáçå~äáòÉÇ=ÄÉÑçêÉK=^ë=ïÉ=íÜáåâ=~Äçìí=ã~ëë=áåÅ~êÅÉê~íáçå=íçÇ~ó=~åÇ=Üçï=íç=êÉÇìÅÉ=çìê=éêáëçå=
éçéìä~íáçåëI= áí= áë= ìëÉÑìä= íç= êÉÅ~ää= ëçãÉ= äÉëëçåë= Ñêçã= íÜ~í= ÜáëíçêóK= tÜ~íI= áÑ= ~åóíÜáåÖI= Å~å= ïÉ= äÉ~êå=
Ñêçã=ÇÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMë\=jçêÉ=éêÉÅáëÉäóI=ãáÖÜí=~åó=çÑ=íÜÉ=ÑçêÅÉë=íÜ~í=ÜÉäéÉÇ=ëÉí=çÑÑ=
~åÇ= ëÜ~éÉ= ÇÉáåëíáíìíáçå~äáò~íáçå= áå= íÜÉ= NVRMë= ÅçåíêáÄìíÉ= íç= ~= êÉÇìÅíáçå= çÑ= çìê= éêáëçå= éçéìä~íáçå=
íçÇ~ó\= ^äíÉêå~íáîÉäóI= ~êÉ= íÜÉêÉ= ~ëéÉÅíë= íç= ÄÉ= ~îçáÇÉÇ= Ñêçã= çìê= É~êäáÉê= ÉñéÉêáÉåÅÉ= ïáíÜ=
ÇÉáåëíáíìíáçå~äáò~íáçå= çê= ï~óë= íç= ÇÉÅ~êÅÉê~íÉ= áå= ~= ãçêÉ= ëìÅÅÉëëÑìä= ã~ååÉê= íçÇ~ó\= qÜÉëÉ= ~êÉ= íÜÉ=
èìÉëíáçåë=íÜ~í=ãçíáî~íÉ=íÜáë=Éëë~óK=
lÇÇäóI= êÉä~íáîÉäó= äáííäÉ= Ü~ë= ÄÉÉå= ïêáííÉå= çå= íÜÉ= é~ê~ääÉä= ÄÉíïÉÉå= ãÉåí~ä= Üçëéáí~ä=
ÇÉáåëíáíìíáçå~äáò~íáçå= ~åÇ= íÜÉ= ÅçåíÉãéçê~êó= éêçÄäÉã= çÑ= ã~ëë= áåÅ~êÅÉê~íáçåK= b~êäó= çåI= íÜÉêÉ= ïÉêÉ=
                                                            
4

8.59 percent to be exact. Id.
Id.
6
Id. at 192.
7
Gerald Grob explores these and more factors in remarkable detail in his lengthy and masterful work, From Asylum
to Community: Mental Health Policy in Modern America, Princeton University Press 1991. Other important
contributions include, among others, William Gronfein, “Incentives and Intentions,” 1985 (exploring the role of
Medicaid and Medicare, and larger government interventions); William Gronfein, Psychotropic Drugs and the
Origins of Deinstitutionalization, 32 Social Problems 5, 439 (1985) (exploring the role of medication); Joseph
Morrissey, “Deinstitutionalizing the Mentally Ill: Processes, Outcomes, and New Directions,” 147-76, in Walter
Gove, ed., Deviance and Mental Illness, Beverly Hills: Sage Publications 1982 (exploring professional
reorganization and rivalries); Paul Lerman, Deinstitutionalization and the Welfare State, New Brunswick: Rutgers
University Press 1982 (exploring the shifts in the welfare states); Andrew Scull, Decarceration: Community
Treatment and the Deviant--A Radical View, Englewood Cliffs, NJ: Prentice-Hall 1977 (exploring the fiscal crisis
effects).
5

2 

Electronic copy available at: http://ssrn.com/abstract=1748796

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ëçãÉ= ïêáíáåÖë= áå= íÜÉ= ä~íÉ= NVTMë= çå= ÇÉÅ~êÅÉê~íáçå= íáÉÇ= íç= íÜÉ= éêáëçå= ~Äçäáíáçå= ãçîÉãÉåí= íÜ~í=
ÉñéäçêÉÇ= íÜÉ= éêçÄäÉã= íÜêçìÖÜ= íÜÉ= äÉåë= çÑ= ãÉåí~ä= ÜÉ~äíÜ= ÇÉáåëíáíìíáçå~äáò~íáçåIU= Äìí= Ñçê= íÜÉ= ãçëí=
é~êíI= íÜçëÉ= áåíÉêîÉåíáçåë= ïÉêÉ= åçí= ä~ëíáåÖK= ^= åìãÄÉê= çÑ= ëÅÜçä~êë= ~í= íÜÉ= íáãÉ= éêÉÇáÅíÉÇ= íÜ~í= éêáëçå=
ÇÉÅ~êÅÉê~íáçå=ïçìäÇ=Ñçääçï=áå=íÜÉ=ÑççíëíÉéë=çÑ=íÜÉ=ÇÉáåëíáíìíáçå~äáò~íáçå=çÑ=ãÉåí~ä=Üçëéáí~äë=Ea~îáÇ=
oçíÜã~å=ï~ë=éêçÄ~Ääó=íÜÉ=ÄÉëí=Éñ~ãéäÉ=çÑ=íÜáëFI=Äìí=íÜÉó=ïÉêÉ=éêçîÉå=ïêçåÖK=jçêÉ=êÉÅÉåíäóI=íÜÉêÉ=
Ü~ë= ÄÉÉå= ÉãéáêáÅ~ä= ~åÇ= íÜÉçêÉíáÅ~ä= ïçêâ= Çê~ïáåÖ= é~ê~ääÉäë= ÄÉíïÉÉå= íÜÉ= äÉîÉäë= çÑ= ãÉåí~ä= ÜÉ~äíÜ=
áåëíáíìíáçå~äáò~íáçå= áå= íÜÉ= ãáÇJíïÉåíáÉíÜ= ÅÉåíìêó= ~åÇ= éêáëçå= áåÅ~êÅÉê~íáçå= íçÇ~óIV= íÜçìÖÜ= íÜ~í=
êÉëÉ~êÅÜ= Ü~ë= åçí= Çê~ïå= é~ê~ääÉäë= êÉÖ~êÇáåÖ= ÇÉJáåëíáíìíáçå~äáò~íáçåK= pçãÉ= êÉëÉ~êÅÜÉêëI= ëìÅÜ= ~ë= j~êáÉ=
dçííëÅÜ~äâI= Ü~îÉ= ÄÉÖìå= íç= ãÉåíáçå= ÇÉáåëíáíìíáçå~äáò~íáçå= áå= íÜÉ= ÅçåíÉñí= çÑ= íÜÉ= ÅìêêÉåí= ÉÅçåçãáÅ=
Åêáëáë=~åÇ=áíë=áãé~Åí=çå=ã~ëë=áåÅ~êÅÉê~íáçåINM=~åÇ=ëÉîÉê~ä=óçìåÖÉê=ëÅÜçä~êëI=ÉëéÉÅá~ääó=^ååÉ=m~êëçåëI=~=
Üáëíçêó= Öê~Çì~íÉ= ëíìÇÉåí= ~í= íÜÉ= råáîÉêëáíó= çÑ= fääáåçáë= ~í= `ÜáÅ~Öç= ~åÇ= iá~í= _ÉåJjçëÜÉI= ~= ëçÅáçäçÖó=
Öê~Çì~íÉ=ëíìÇÉåí=~í=póê~ÅìëÉ=råáîÉêëáíóI=Ü~îÉ=çåÖçáåÖ=ÇçÅíçê~ä=êÉëÉ~êÅÜ=çå=íÜÉ=êÉä~íáçåëÜáé=ÄÉíïÉÉå=
ãÉåí~ä=ÜÉ~äíÜ=~åÇ=Åêáãáå~äáíóI=çê=Üçëéáí~äë=~åÇ=éêáëçåë=áå=íÜÉ=ä~íÉ=íïÉåíáÉíÜ=ÅÉåíìêóK=_ÉåJjçëÜÉI=Ñçê=
NN
áåëí~åÅÉI=áë=ìëáåÖ=íÜÉ=áÇÉ~=çÑ=ÇÉáåëíáíìíáçå~äáò~íáçå=~Åíáîáëã=~ë=~=ãçÇÉä=Ñçê=éêáëçå=~ÄçäáíáçåK =_ìí=~ää=
áå= ~ääI= íÜÉêÉ= áë= ëíáää= êÉä~íáîÉäó= äáííäÉ= áå= íÉêãë= çÑ= ëìëí~áåÉÇ= ÇáëÅìëëáçå= çÑ= íÜÉ= é~ê~ääÉäë= íç= ÄÉ= Çê~ïå= çê=
äÉëëçåë= íç= ÄÉ= äÉ~êåÉÇ= Ñêçã= ÇÉáåëíáíìíáçå~äáò~íáçåI= ã~âáåÖ= íÜáë= ~= êáéÉ= íçéáÅ= Ñçê= éêÉäáãáå~êó= ~å~äóëáë=
~åÇ=Ñçê=ÑìêíÜÉê=êÉëÉ~êÅÜK=qÜáë=Éëë~ó=ëÜçìäÇ=ÄÉ=ìåÇÉêëíççÇ=~ë=íÜÉ=ÑçêãÉêW=ëçãÉ=éêÉäáãáå~êó=íÜçìÖÜíë=
çå=íÜÉ=äÉëëçåë=~åÇ=éáíÑ~ääë=íç=ÄÉ=äÉ~êåÉÇ=Ñêçã=ÇÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMëK==
qÜÉ=Éëë~ó=ïáää=í~âÉ=~=íïçJÑçäÇ=~ééêç~ÅÜK=^ÑíÉê=íê~ÅáåÖ=ëçãÉ=çÑ=íÜÉ=ÜáëíçêáÅ~ä=Ä~ÅâÖêçìåÇ=áå=
m~êí= fI= íÜÉ= Éëë~ó= ïáää= ÉñéäçêÉ= ÑáêëíI= áå= m~êí= ffI= íÜÉ= íÜêÉÉ= äÉ~ÇáåÖ= Ñ~Åíçêë= íÜ~í= ïÉêÉ= áåëíêìãÉåí~ä= áå=
ÄêáåÖáåÖ= ~Äçìí= ÇÉáåëíáíìíáçå~äáò~íáçå= áå= íÜÉ= NVSMëI= áå= ~å= ÉÑÑçêí= íç= ÇáëÅÉêå= ïÜÉíÜÉê= íÜÉêÉ= ãáÖÜí= ÄÉ=
~åó=ìëÉÑìä=é~ê~ääÉäë=áå=íÜÉ=ÅçåíÉãéçê~êó=ÉÑÑçêí=íç=êÉÇìÅÉ=éêáëçå=éçéìä~íáçåëK=^äçåÖ=íÜáë=Ñáêëí=äáåÉ=çÑ=
áåèìáêóI=f=ïáää=ëìÖÖÉëí=ëÉîÉê~ä=éçëëáÄäÉ=~îÉåìÉë=ïçêíÜ=ÑìêíÜÉê=ÅçåëáÇÉê~íáçåÔ~ää=íÜÉ=ïÜáäÉ=êÉÅçÖåáòáåÖ=
íÜ~í=íÜÉêÉ=~êÉ=ÅäÉ~ê=Ç~åÖÉêë=~ëëçÅá~íÉÇ=ïáíÜ=É~ÅÜK==
                                                            
8

Some examples of this include Andrew Scull, Decarceration: Community Treatment and the Deviant--A Radical
View (1977) (viewing both the prison and the asylum as tools to manage capitalism’s “junk populations,” and
exploring both deinstitutionalization and decarceration as responses to capitalist crisis, from a Marxist surplus labor
analysis perspective); Benjamin Frank, The American Prison: The End of an Era (1979) (comparing different
potential advocacies in response to the demise of the rehabilitative ideal, and specifically contrasting prison
abolition to deinstitutionalization on page 80).
9
Bernard E. Harcourt, “From the Asylum to the Prison: Rethinking the Incarceration Revolution,” 84 Texas Law
Review 1751 - 1786 (2006), and Bernard E. Harcourt, “An Institutionalization Effect: The Impact of Mental
Hospitalization and Imprisonment on Homicide in the United States, 1934 – 2001,” forthcoming in Journal of Legal
Studies (January 2011). See also Steven Raphael, “The Deinstitutionalization of the Mentally Ill and Growth in the
U.S. Prison Populations: 1971 to 1996” (Sept. 2000) (unpublished manuscript), available at http://istsocrates.berkeley.edu/~raphael/raphael2000.pdf.
10
Marie Gottschalk, , “Cell Blocks & Red Ink: Mass Incarceration, The Great Recession & Penal Reform,”
Daedalus 139(3): 62-73 (2010). At pages 67-69 of her essay, Gottschalk discusses deinstitutionalization and argues
that it involved a complex set of factors including political leadership, psychiatric profession changes, media and
litigation, which represented a larger context that cannot be reduced to economic crisis.
11
Liat Ben-Moshe, a sociology graduate student at Syracuse University, has a conference paper from 2010 with a
very promising title, “Genealogies of Resistance to Incarceration: Abolition politics in anti-prison and deinstitutionalization activism in the U.S., 1950-present.” It appears that Ben-Moshe is indeed using the idea of
deinstitutionalization activism as a model for prison abolition.

3 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

cáêëíI= ïáíÜ= êÉÖ~êÇ= íç= íÜÉ= ìëÉ= çÑ= éêÉëÅêáÄÉÇ= ãÉÇáÅ~íáçåë= ~åÇ= çíÜÉê= ÄáçäçÖáÅ~ä= áåíÉêîÉåíáçåëI=
íÜÉêÉ= áë= ÅÉêí~áåäó=êççã=Ñçê=ÖêÉ~íÉê=~åÇ=áãéêçîÉÇ=éëóÅÜá~íêáÅ=Å~êÉ=~åÇ=íêÉ~íãÉåí=çÑ=éêáëçå=áåã~íÉëK=
qÜÉ= éêçéçêíáçå= çÑ= éêáëçåÉêë= ïáíÜ= ãÉåí~ä= ÜÉ~äíÜ= ÇáÑÑáÅìäíáÉë= Ñ~ê= ÉñÅÉÉÇë= íÜÉ= éêçÑÉëëáçå~ä= ~åÇ=
áåëíáíìíáçå~ä= Å~é~ÅáíáÉë= çÑ= ÇÉé~êíãÉåíë= çÑ= ÅçêêÉÅíáçå= áå= ãçëí= ëí~íÉëK= k~íìê~ääóI= íÜáë= ïçìäÇ= áåîçäîÉ=
íê~åëáåëíáíìíáçå~äáò~íáçåI= ê~íÜÉê= íÜ~å= ÇÉÅ~êÅÉê~íáçåX= Äìí= áí= áë= ìåèìÉëíáçå~Ääó= åÉÅÉëë~êó= íçÇ~óK=
jçêÉçîÉêI=áí=ãáÖÜí=~äëç=ÄÉ=ïçêíÜ=ÅçåëáÇÉêáåÖ=íÜÉ=éçíÉåíá~ä=áåÅêÉ~ëÉÇ=ìëÉ=çÑ=éêÉëÅêáÄÉÇ=ãÉÇáÅ~íáçåë=
Ñçê= ~ÖÖêÉëëáîÉ= ÄÉÜ~îáçêI= çå= ~= îçäìåí~êó= Ä~ëáëI= íç= ~ÇÇêÉëë= éêçÄäÉãë= çÑ= ÅçåÇìÅí= ÇáëçêÇÉêë= ~ë= ~å=
~äíÉêå~íáîÉ=íç=áåÅ~êÅÉê~íáçåK=aáîÉêëáçå~êó=éêçÖê~ãë=ãçÇÉäÉÇ=çå=çìíé~íáÉåí=ãÉåí~ä=ÜÉ~äíÜ=ÅäáåáÅë=~åÇ=
áåîçäîáåÖ=íÜÉ=~Çãáåáëíê~íáçå=çÑ=éêÉëÅêáÄÉÇ=ãÉÇáÅ~íáçåë=~äêÉ~Çó=ÉñáëíI=ÉëéÉÅá~ääó=Ñçê=óçìíÜI=~åÇ=ÅçìäÇ=
ÄÉ=ÇÉîÉäçéÉÇ=ÑìêíÜÉê=~åÇ=Éñé~åÇÉÇK=få=~=ëáãáä~ê=îÉáåI=íÜÉ=áåÅêÉ~ëÉÇ=ìëÉ=çÑ=dmp=ãçåáíçêáåÖ=~åÇ=çíÜÉê=
ÄáçãÉíêáÅ= ÇÉîáÅÉë= ÅçìäÇ= ëÉêîÉ= ~ë= ~= ëìÄëíáíìíÉ= íç= áåÅ~êÅÉê~íáçåK= cáå~ääóI= çå= íÜÉ= íçéáÅ= çÑ= ÅçåíêçääÉÇ=
ëìÄëí~åÅÉëI= ~= ãçîÉ= íçï~êÇ= íÜÉ= äÉÖ~äáò~íáçå= çÑ= ã~êáàì~å~= ~åÇ= çíÜÉê= äÉëëÉê= ÇêìÖë= ïçìäÇ= ~äëç= Ü~îÉ= ~=
ÇáêÉÅí=áãé~Åí=çå=êÉÇìÅáåÖ=çìê=éêáëçå=éçéìä~íáçåëK=
pÉÅçåÇI= ÑÉÇÉê~ä= äÉ~ÇÉêëÜáé= ÅçìäÇ= ÄÉ= ÉåÅçìê~ÖÉÇ= íç= ÅêÉ~íÉ= ÑÉÇÉê~ä= ÑìåÇáåÖ= áåÅÉåíáîÉë= Ñçê=
ÇáîÉêëáçå~êó= éêçÖê~ãëI= êÉÉåíêó= éêçÖê~ãëI= ~åÇ= çíÜÉê= ï~óë= çÑ= êÉáåíÉÖê~íáåÖ= çÑÑÉåÇÉêë= Eçê= ~îçáÇáåÖ=
áåÅ~êÅÉê~íáçå=Ñêçã=íÜÉ=çìíëÉíF=íÜ~í=ïçìäÇ=ÖáîÉ=ëí~íÉë=~=Ñáå~åÅá~ä=ãçíáîÉ=íç=ãçîÉ=éêáëçåÉêë=çìí=çÑ=íÜÉ=
éÉåáíÉåíá~êó=~åÇ=áåíç=çìíé~íáÉåí=éêçÖê~ãëK=qÜÉ=âÉó=î~êá~ÄäÉ=ÜÉêÉ=áë=íç=ÖáîÉ=ëí~íÉë=~å=ÉÅçåçãáÅ=~åÇ=
ÑáëÅ~ä= áåÅÉåíáîÉ= íç= ãçîÉ= ÅçåîáÅíë= çìí= çÑ= ëí~íÉ= éêáëçåë= ~åÇ= áåíç= åçåJÅìëíçÇá~ä= éêçÖê~ãë= Eçê= íç=
ÅáêÅìãîÉåí=íÜÉ=ÅçêêÉÅíáçå~ä=Ñ~ÅáäáíáÉë=Ñêçã=íÜÉ=çìíëÉíF=çå=íÜÉ=ãçÇÉä=çÑ=jÉÇáÅ~áÇ=êÉáãÄìêëÉãÉåí=Ñçê=
çìíé~íáÉåí=Åçããìåáíó=ãÉåí~ä=ÜÉ~äíÜ=íêÉ~íãÉåíK===
qÜáêÇI=ÜáÖÜJéêçÑáäÉ=äáíáÖ~íáçå=çÑ=éêáëçå=ÅçåÇáíáçåëI=çÑ=íÜÉ=é~ìÅáíó=çÑ=ãÉåí~ä=ÜÉ~äíÜ=íêÉ~íãÉåíI=
~åÇ= çÑ= éêáëçå= çîÉêÅêçïÇáåÖI= ~ë= ïÉää= ~ë= ÇçÅìãÉåí~êáÉë= çÑ= éêáëçå= äáÑÉ= ~äçåÖ= íÜÉ= äáåÉë= çÑ= cêÉÇÉêáÅâ=
táëÉã~åÛë= NVST= ÑáäãI= qáíáÅìí= cçääáÉëI= ëÜçìäÇ= Ñçêã= é~êí= çÑ= ~= ä~êÖÉê= ëíê~íÉÖó= íç= ëÜáÑí= íÜÉ= éìÄäáÅ=
éÉêÅÉéíáçå=çÑ=íÜçëÉ=éÉêëçåë=áåÅ~êÅÉê~íÉÇK=fåÅêÉ~ëÉÇ=éìÄäáÅ=~ï~êÉåÉëë=çÑ=íÜÉ=êÉ~äáíó=çÑ=éêáëçå=äáÑÉ=ÅçìäÇ=
ÅçåíêáÄìíÉ= íç= ÖêÉ~íÉê= ïáääáåÖåÉëë= íç= ëìééçêí= ÑÉÇÉê~ä= éçäáÅáÉë= ~áãÉÇ= ~í= ÜÉäéáåÖ= êÉÇìÅÉ= çìê= éêáëçå=
éçéìä~íáçåëK=^ää=çÑ=íÜÉëÉ=áÇÉ~ë=ã~ó=ïÉää=áåîçäîÉ=c~ìëíá~å=Ä~êÖ~áåëI=~åÇ=íÜÉ=Ç~åÖÉêë=~ëëçÅá~íÉÇ=ïáíÜ=
É~ÅÜ=~êÉ=~éé~êÉåíX=Äìí=ÖáîÉå=çìê=éêÉîáçìë=ÉñéÉêáÉåÅÉ=ïáíÜ=ÇÉáåëíáíìíáçå~äáò~íáçåI=íÜÉêÉ=áë=åç=êÉ~ëçå=íç=
ÄÉäáÉîÉ=íÜ~í=áí=áë=éçëëáÄäÉ=íç=êÉÇìÅÉ=éêáëçå=éçéìä~íáçåë=ïáíÜçìí=ÖÉííáåÖ=çìê=Ü~åÇë=ÇáêíóK==
få= m~êí= fffI= íÜÉ= Éëë~ó= íÜÉå= ~ÇÇêÉëëÉëI= ÉîÉå= ãçêÉ= ÇáêÉÅíäóI= íÜÉ= Ç~êâÉê= ëáÇÉë= çÑ=
ÇÉáåëíáíìíáçå~äáò~íáçåI=áå=~å=ÉÑÑçêí=íç=áÇÉåíáÑó=ãáëí~âÉë=Ñêçã=íÜÉ=é~ëí=~åÇ=éáíÑ~ääë=íç=~îçáÇK=eÉêÉI=íÜÉ=
íïç= ã~àçê= ~êÉ~ë= çÑ= ÅçåÅÉêå= ~êÉ= íÜÉ= áåÅêÉ~ëÉÇ= ê~Åá~äáò~íáçå= çÑ= íÜÉ= ãÉåí~ä= Üçëéáí~ä= éçéìä~íáçå= íÜ~í=
~ÅÅçãé~åáÉÇ=ÇÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMëI=~ë=ïÉää=~ë=íÜÉ=éêçÄäÉã=çÑ=íê~åëáåëíáíìíáçå~äáò~íáçå=
íÜ~í= Ü~ë= ÄÉÉå= ~äêÉ~Çó= áÇÉåíáÑáÉÇK= fí= ïçìäÇ= ÄÉ= ~ÄëçäìíÉäó= ÅêìÅá~äI= áå= ~åó= ÉÑÑçêí= íç= êÉÇìÅÉ= ã~ëë=
áåÅ~êÅÉê~íáçåI= íç= ~îçáÇ= ÄçíÜ= íÜÉ= ÑìêíÜÉê= ê~Åá~äáò~íáçå= çÑ= íÜÉ= éêáëçå= éçéìä~íáçå= ~åÇ= íÜÉ=
íê~åëáåëíáíìíáçå~äáò~íáçå= çÑ= éêáëçåÉêë= áåíç= çíÜÉê= Éèì~ääó= éêçÄäÉã~íáÅ= áåëíáíìíáçåëI= ëìÅÜ= ~ë= ÜçãÉäÉëë=
ëÜÉäíÉêë= çê= íÜÉ= âáåÇ= çÑ= ä~êÖÉ= ãÉåí~ä= áåëíáíìíáçåë= ÇÉéáÅíÉÇI= éêÉÅáëÉäóI= áå= ÇçÅìãÉåí~êáÉë= äáâÉ= qáíáÅìí=
cçääáÉëK==

4 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

qïç= Å~îÉ~íë= ÄÉÑçêÉ= f= ÄÉÖáåK= cáêëíI= áå= íÜáë= Éëë~óI= f= ëÉí= ~ëáÇÉ= íÜÉ= èìÉëíáçåë= ïÜÉíÜÉê= íç=
ÇÉÅ~êÅÉê~íÉ=~åÇ=Äó= Üçï=ãìÅÜK=f=êÉÅçÖåáòÉ=ïÉää=íÜ~í=íÜçëÉ=~êÉ=áãéçêí~åí=éêÉäáãáå~êó=èìÉëíáçåë=íÜ~í=
ïçìäÇ=åÉÉÇ=íç=ÄÉ=~ÇÇêÉëëÉÇ=Ñìääó=~åÇ=Ñê~åâäóK=eçïÉîÉêI=íÜÉó=ïçìäÇ=Å~ää=Ñçê=~=Ñ~ê=äÉåÖíÜáÉê=íêÉ~íãÉåí=
íÜ~å=f=ÅçìäÇ=éçëëáÄäó=ÖáîÉ=íÜÉã=áå=íÜáë=~êíáÅäÉK=^ÅÅçêÇáåÖäóI=f=~ÇÇêÉëë=ÜÉêÉ=çåäó=íÜÉ=èìÉëíáçå=çÑ= Üçï=
íç= ÇÉÅ~êÅÉê~íÉÔçêI= ãçêÉ= éêÉÅáëÉäóI= ïÜ~í= äÉëëçåë= íç= äÉ~êå= ~åÇ= éáíÑ~ääë= íç= ~îçáÇ= Ñêçã= çìê= éêÉîáçìë=
ÉñéÉêáÉåÅÉ=ïáíÜ=ÇÉáåëíáíìíáçå~äáò~íáçåK=pÉÅçåÇI=f=~äëç=ëÉí=~ëáÇÉ=ä~êÖÉê=ëçÅá~ä=íÜÉçêÉíáÅ=èìÉëíáçåë=~Äçìí=
íÜÉ= éçëëáÄáäáíó= çÑ= ÖÉåìáåÉ= ÇÉáåëíáíìíáçå~äáò~íáçåK= qÜÉ= Åä~ëëáÅ= íÉñíë= çÑ= ëçÅá~ä= íÜÉçêó= Ñêçã= íÜÉ= ãáÇ= íç=
ä~íÉJíïÉåíáÉíÜ=ÅÉåíìêó=íçäÇ=~=êÉä~íáîÉäó=ÅçåëáëíÉåí=ëíçêó=çÑ=íÜÉ=êáëÉ=~åÇ=Ñ~ää=çÑ=ÇáëÅêÉíÉ=áåëíáíìíáçåëI=~åÇ=
çÑ=íÜÉ=êÉã~êâ~ÄäÉ=Åçåíáåìáíó=çÑ=ÅçåÑáåÉãÉåí=~åÇ=ëçÅá~ä=ÉñÅäìëáçåÔÑêçã=íÜÉ==ä~ò~ê=ÜçìëÉë=Ñçê=äÉéÉêë=
çå= íÜÉ= çìíëâáêíë= çÑ= jÉÇáÉî~ä= ÅáíáÉëI= íç= íÜÉ= pÜáéë= çÑ= cççäë= å~îáÖ~íáåÖ= Ççïå= êáîÉêë= çÑ= oÉå~áëë~åÅÉ=
bìêçéÉI=íç=íÜÉ=Éëí~ÄäáëÜãÉåí=áå=íÜÉ=ëÉîÉåíÉÉåíÜ=ÅÉåíìêó=çÑ=íÜÉ=e∑éáí~ä=d¨å¨ê~ä=áå=m~êáëKNO=qÜÉêÉ=ã~ó=
ÄÉI= áå= Ñ~ÅíI= åç= íêìÉ= ÉëÅ~éÉ= Ñêçã= çìê= äÉîÉäë= çÑ= áåëíáíìíáçå~äáò~íáçåI= ~åÇ= íÜÉ= ~éé~êÉåí= íê~åëÑÉê= Ñêçã=
ãÉåí~ä=Üçëéáí~äë=íç=éêáëçåë=ã~ó=ÄÉ=~åçíÜÉê=áåÇáÅ~íçê=çÑ=íÜ~í=çãáåçìë=Ñ~ÅíK=_ìí=áå=íÜáë=Éëë~óI=f=ïáää=ëÉí=
~ëáÇÉ=íÜ~í=Ç~êâÉê=áåíÉêéêÉí~íáçå=~åÇI=~Ö~áåI=ÑçÅìë=çå=Üçï=ïÉ=ãáÖÜí=íêó=íç=ÇÉÅ~êÅÉê~íÉK==
fK eáëíçêáÅ~ä=_~ÅâÖêçìåÇ=
qÜáë= áë= åçí= íÜÉ= Ñáêëí= íáãÉ= íÜ~í= íÜÉ= råáíÉÇ= pí~íÉë= Ñ~ÅÉë= ã~ëë= áåëíáíìíáçå~äáò~íáçåK= ^ë= f= Ü~îÉ=
ÇÉãçåëíê~íÉÇ= ÉäëÉïÜÉêÉI= íÜÉ= äÉîÉä= çÑ= áåÅ~êÅÉê~íáçå= áå= íÜÉ= råáíÉÇ= pí~íÉë= íçÇ~ó= ã~íÅÜÉë= íÜÉ= äÉîÉä= çÑ=
íçí~ä=áåëíáíìíáçå~äáò~íáçå=Eáå=ãÉåí~ä=Üçëéáí~äë=~åÇ=éêáëçåëF=áå=íÜÉ=NVPMëI=QMë=~åÇ=RMëKNP=cçê=íÜçëÉ=ïÜç=
Ü~îÉ=åçí=ëÉÉå=íÜÉ=Öê~éÜ=ÄÉÑçêÉI=áí=Å~å=ÄÉ=ëçãÉïÜ~í=ëíêáâáåÖW=

                                                            
12

See generally Bernard E. Harcourt, “From the Asylum to the Prison: Rethinking the Incarceration Revolution,” 84
Texas Law Review 1751 - 1786 (2006); the specific reference here, of course, is to Michel Foucault, Madness and
Civilization (Richard Howard trans., Vintage Books 1988) (1961).
13
Harcourt, “From the Asylum to the Prison,” 2006; Bernard E. Harcourt, “An Institutionalization Effect: The
Impact of Mental Hospitalization and Imprisonment on Homicide in the United States, 1934 – 2001,” forthcoming
in Journal of Legal Studies (January 2011); Bernard E. Harcourt, The Illusion of Free Markets: Punishment and the
Myth of Natural Order, Cambridge: Harvard University Press 2011, p. 221-231.

5 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

=
cáÖìêÉ=NW=o~íÉë=çÑ=fåëíáíìíáçå~äáò~íáçå=áå=jÉåí~ä=fåëíáíìíáçåë=~åÇ=pí~íÉ=~åÇ=cÉÇÉê~ä=mêáëçåë=EéÉê=
NMMIMMM=~ÇìäíëF=
få=Ñ~ÅíI=ÉîÉå=áÑ=ïÉ=áåÅäìÇÉ=íÜÉ=à~áä=éçéìä~íáçåI=íÜÉ=Åçåíê~ëí=êÉã~áåë=êÉã~êâ~ÄäÉK=eÉêÉ=áë=íÜÉ=
ë~ãÉ=Öê~éÜI=áåÅäìÇáåÖ=íÜÉ=ê~íÉ=çÑ=à~áä=áåÅ~êÅÉê~íáçåW=
=

=
cáÖìêÉ=OW=o~íÉë=çÑ=fåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=råáíÉÇ=pí~íÉë=EáåÅäìÇáåÖ=à~áä=éçéìä~íáçåëF=
^ë=íÜáë=ÑáÖìêÉ=ÇÉãçåëíê~íÉëI=íÜÉ=É~êäáÉê=éÉêáçÇ=çÑ=ã~ëë=áåëíáíìíáçå~äáò~íáçå=ï~ë=ÑçääçïÉÇ=Äó=~=
Çê~ã~íáÅ=êÉÇìÅíáçå=áå=ãÉåí~ä=Üçëéáí~ä=éçéìä~íáçåë=áå=íÜÉ=NVSMë=~åÇ=TMëI=ïÜ~í=ïÉ=ìëì~ääó=êÉÑÉê=íç=~ë=
6 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

“ÇÉáåëíáíìíáçå~äáò~íáçåKÒ=NQ=qÜÉ=~ãçìåí=çÑ=ÇÉáåëíáíìíáçå~äáò~íáçå=ï~ë=êÉã~êâ~ÄäÉI=ïÜÉíÜÉê=çåÉ=ÑçÅìëÉë=
çå=ëí~íÉ=~åÇ=Åçìåíó=ãÉåí~ä=Üçëéáí~äë=~äçåÉ=çê=çå=íÜÉ=ä~êÖÉê=ëÉí=çÑ=áåëíáíìíáçåë=Ñçê=éÉêëçåë=ïáíÜ=ãÉåí~ä=
ÜÉ~äíÜ=éêçÄäÉãë=EáåÅäìÇáåÖ=áåëíáíìíáçåë=Ñçê=éÉêëçåë=ïáíÜ=ãÉåí~ä=êÉí~êÇ~íáçåI=s^=ãÉåí~ä=ÜÉ~äíÜ=ìåáíëI=
~åÇ=éêáî~íÉ=ãÉåí~ä=Üçëéáí~äëFI=~ë=ÇÉãçåëíê~íÉÇ=áå=cáÖìêÉ=PK=

=

=

cáÖìêÉ=PW=aáÑÑÉêÉåí=o~íÉë=çÑ=fåëíáíìíáçå~äáò~íáçå=áå=jÉåí~ä=fåëíáíìíáçåë=áå=íÜÉ=råáíÉÇ=pí~íÉë==
EéÉê=NMMIMMM=~ÇìäíëF=
^äíÜçìÖÜ=íÜÉ=~ëóäìã=~åÇ=íÜÉ=éÉåáíÉåíá~êó=ïÉêÉ=ÄçíÜ=Äçêå=áå=íÜÉ=É~êäó=åáåÉíÉÉåíÜJÅÉåíìêó=áå=
íÜÉ= råáíÉÇ= pí~íÉëI= íÜÉáê= ÖêçïíÜ= íê~àÉÅíçêáÉë= ÇáÑÑÉêÉÇ= ëáÖåáÑáÅ~åíäó= çîÉê= íÜÉ= íïÉåíáÉíÜ= ÅÉåíìêóÔ
êÉëìäíáåÖ=áå=íÜÉëÉ=ÇáîÉêÖÉåí=ÖêçïíÜ=ÅìêîÉëK=få=qÜÉ=aáëÅçîÉêó=çÑ=íÜÉ=^ëóäìãI=a~îáÇ=oçíÜã~å=éÉååÉÇ=
ïÜ~í=áë=ëíáää=ÅçåëáÇÉêÉÇ=íÜÉ=ã~ëíÉê=å~êê~íáîÉ=çÑ=íÜÉ=ÄáêíÜ=çÑ=íÜÉëÉ=áåëíáíìíáçåëI=ëéÉÅáÑáÅ~ääó=åçí=çåäó=íÜÉ=
ÉãÉêÖÉåÅÉ=çÑ=“éÉåáíÉåíá~êáÉë=Ñçê=íÜÉ=Åêáãáå~äÒ=~åÇ=“~ëóäìãë=Ñçê=íÜÉ=áåë~åÉIÒ=Äìí=~äëç=“~äãëÜçìëÉë=Ñçê=
NR
íÜÉ=éççêI=çêéÜ~å=~ëóäìãë=Ñçê=ÜçãÉäÉëë=ÅÜáäÇêÉåI=~åÇ=êÉÑçêã~íçêáÉë=Ñçê=ÇÉäáåèìÉåíëKÒ =qÜÉêÉ=ïÉêÉI=íç=
ÄÉ=ëìêÉI=~åíÉÅÉÇÉåíëKNS=lå=íÜÉ=`çåíáåÉåíI=íÜÉêÉ=ïÉêÉ=éÉå~ä=áåëíáíìíáçåë=~ë=Ñ~ê=Ä~Åâ=~ë=íÜÉ=É~êäó=NSMMë=
                                                            
14

The term “deinstitutionalization” is used in the research literature to refer to both the declining inpatient
population in mental institutions and the social and political policies that led to the declines in populations. William
Gronfein separates the two concepts into “operational deinstitutionalization,” the actual reductions in inpatient
populations, and “policy deinstitutionalization,” what he refers to as “the programs, policies, laws, and judicial
decisions which had such reductions as their aims.” William Gronfein, “Psychotropic Drugs and the Origins of
Deinstitutionalization,” 32 Social Problems 5, 439 (1985). For the purposes of this article, the term
“deinstitutionalization” is used primarily to refer to the decline in patient populations and the use of large-scale,
state-run psychiatric facilities for treatment of the mentally ill (what Gronfein refers to as “operational
deinstitutionalization”).
15
David Rothman, The Discovery of the Asylum, 1971 at xiii. Rebecca McLennan, in her 2008 book, similarly refers
to Rothman’s account as the “master narrative,” see McLennan, The Crisis of Imprisonment: Protest, Politics, and
the Making of the American Penal State, 1776-1941. Cambridge: Cambridge University Press 2008, at p. 7.
16
See Pieter Spierenburg, The Prison Experience: Disciplinary Institutions and Their Inmates in Early Modern
Europe. New Brunswick: Rutgers University Press, 1991, at p. 3-4 and Spierenburg, “Punishment, Power, and

7 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

EíÜÉ=^ãëíÉêÇ~ã= ê~ëéÜìóëI=íÜÉ=òìÅÜíÜ~ìë=áå=e~ãÄìêÖI=~åÇ=ëéáåÜçìëÉë=Ñçê=ïçãÉåI=Ñçê=áåëí~åÅÉFINT=~ë=
ïÉää= ~ë= íÜÉ= Ñ~ãçìë= e∑éáí~ä= d¨å¨ê~ä= áå= m~êáë= Éëí~ÄäáëÜÉÇ= áå= NSRS= Äó= içìáë= ufsXNU= ~åÇ= áå= íÜÉ=
áããÉÇá~íÉ= éçëíJoÉîçäìíáçå~êó=éÉêáçÇI=ëÉîÉê~ä=ëí~íÉë= ÉñéÉêáãÉåíÉÇ=ïáíÜ=ÜçìëÉë= çÑ= êÉéÉåí~åÅÉ=~åÇ=~=
éÉåáíÉåíá~ä=ëóëíÉã=çÑ=éìåáëÜãÉåíK=_ìí=íÜÉêÉ=ï~ëI=åÉîÉêíÜÉäÉëëI=áå=oçíÜã~åÛë=ïçêÇëI=~=“êÉîçäìíáçå=áå=
ëçÅá~ä=éê~ÅíáÅÉÒ=áå=íÜÉ=É~êäó=NUMMë=íÜ~í=éêçÇìÅÉÇ=ÄçíÜ=íÜÉ=~ëóäìã=~åÇ=íÜÉ=éÉåáíÉåíá~êóI=~ãçåÖ=çíÜÉê=
áåëíáíìíáçåëKNV=
få=Åçäçåá~ä=^ãÉêáÅ~I=Å~êÉ=Ñçê=ÇÉéÉåÇÉåí=éÉêëçåëI=ëìÅÜ=~ë=íÜÉ=ëÉîÉêÉäó=ãÉåí~ääó=áääI=Ü~Ç=Ñ~ääÉå=
éêÉÇçãáå~åíäó= çå= Ñ~ãáäó= ãÉãÄÉêë= çê= íÜÉ= äçÅ~ä= é~êáëÜKOM= táíÜ= íáãÉI= äçÅ~ä= ÖçîÉêåãÉåíë= ÄÉÖ~å= íç=
ON
~ëëìãÉ=êÉëéçåëáÄáäáíó=Ñçê=íÜÉ=Å~êÉ=çÑ=íÜÉ=ãÉåí~ääó=áää=ìåÇÉê=~=ëóëíÉã=çÑ=“éççê=ä~ïëKÒ =qÜÉ=ãÉåí~ääó=áää=
ïÉêÉ= ÜçìëÉÇ= áå= ~äãëÜçìëÉëI= éççêÜçìëÉëI= çê= à~áäëI= ~äçåÖëáÇÉ= çíÜÉê= éÉêëçåë= ìåÇÉê= ëìéÉêîáëáçå= çê=
ÇÉéÉåÇÉåÅóKOO=qÜÉëÉ=Ñ~ÅáäáíáÉë=ëÉêîÉÇ=ä~êÖÉäó=~å=áåÅ~é~Åáí~íáîÉ=ÑìåÅíáçåI=~åÇ=äáííäÉ=ÉÑÑçêí=ï~ë=ã~ÇÉ=íç=
OP
íêÉ~í=çê=éêçîáÇÉ=ãÉÇáÅ~ä=Å~êÉ=íç=íÜçëÉ=ÅçåÑáåÉÇK =qÜÉ=b~ëíÉêå=iìå~íáÅ=^ëóäìãI=íÜÉ=Ñáêëí=éëóÅÜá~íêáÅ=
Üçëéáí~ä= áå= ^ãÉêáÅ~I= çéÉåÉÇ= áå= NTTPI= ~åÇ= Äó= NUNSI= íïç= éëóÅÜá~íêáÅ= Üçëéáí~äë= ïÉêÉ= çéÉê~íáåÖ= áå=
råáíÉÇ=pí~íÉëKOQ=aìÉ=áå=é~êí=íç=ÉÑÑçêíë=çÑ=êÉÑçêãÉêëI=íÜÉ=åìãÄÉê=çÑ=Üçëéáí~äë=ÇÉîçíÉÇ=íç=íÜÉ=íêÉ~íãÉåí=
çÑ=ãÉåí~ä=áääåÉëë=ÄÉÖ~å=íç=Öêçï=~í=~Äçìí=íÜ~í=íáãÉK=_ó=NUSNI=íÜÉêÉ=ïÉêÉ=ÑçêíóJÉáÖÜí=éìÄäáÅ=éëóÅÜá~íêáÅ=
Üçëéáí~äëORX= Äó= NUUMI= ëÉîÉåíóJÑáîÉ= éìÄäáÅ= éëóÅÜá~íêáÅ= Üçëéáí~äë= ÜçìëÉÇ= QNIMMM= é~íáÉåíëKOS= qÜÉëÉ=
Üçëéáí~äë=ïÉêÉ=ëã~ää=áå=Åçãé~êáëçå=íç=íÜÉ=ãÉÖ~Jáåëíáíìíáçåë=íÜÉó=ïçìäÇ=ÄÉÅçãÉX=íÜÉ=ä~êÖÉëí=Üçëéáí~äI=
táää~êÇ= mëóÅÜá~íêáÅ= eçëéáí~ä= Ñçê= íÜÉ= fåë~åÉI= ÜçìëÉÇ= çåäó= NIRNP= é~íáÉåíë= áå= êÉëáÇÉåÅÉKOT= fí= ï~ëI=
ÜçïÉîÉêI= ÇìêáåÖ= íÜáë= éÉêáçÇ= íÜ~í= ~= ãçêÉ= ãÉÇáÅ~äáòÉÇ= åçíáçå= çÑ= ãÉåí~ä= áääåÉëë= ÄÉÖ~å= íç= éêÉî~áäI= áå=
í~åÇÉã= ïáíÜ= ~= ï~îÉ= çÑ= ëçÅá~ä= êÉÑçêã= áå= íÜÉ= råáíÉÇ= pí~íÉëK= oÉÑçêãÉêëI= ëìÅÜ= ~ë= açêçíÜó= aáñ= ~åÇ=

                                                                                                                                                                                                
History” Social Science History, Vol. 28, No. 4 (winter 2004), p. 607-636, at p. 616; Michel Foucault, Madness and
Civilization. Richard Howard, trans. New York: Vintage Books,1988 at p. 5 (originally published in French in 1961)
(on lazar houses for lepers on the outskirts of Medieval cities and the seventeenth century Hôpital Général in Paris);
Michael Ignatieff, A Just Measure of Pain: The Penitentiary in the Industrial Revolution, 1750-1850. New York:
Pantheon Books, 1978, at p. 11-14 (houses of correction and the Amsterdam Rasphouse); Adam Jay Hirsch, The
Rise of the Penitentiary: Prisons and Punishment in Early America. New Haven: Yale University Press, 1992, at p.
6-8 (discussing eighteenth century Massachusetts penal institutions).
17
Norval Morris and David Rothman, The Oxford History of the Prison: The Practice of Punishment in Western
Society. New York: Oxford University Press, 1995, at p. 68 (Spierenburg); see generally Spierenburg, The Prison
Experience, 1991, at 24.
18
Foucault, Madness and Civilization, 1988, p.37.
19
Rothman, Discovery of the Asylum, 1971, p. xiii.
20
Donna R. Kemp, Mental Health in America 2 (2007).
21
22

Gerald N. Grob, Mental Institutions in America 33 (1973).
Gerald N. Grob & Howard H. Goldman, The Dilemma of Mental Health Care Policy 3 (2006).

23

Gerald N. Grob, Mental Institutions in America 34 (1973).
E. Fuller Torrey, Out of the Shadows: Confronting America’s Mental Illness Crisis 81 (1997). Eastern Lunatic
Asylum only had 20 beds, and was not operating at full capacity until 1800.
25
Id. at 27.
26
Id. at 82. The total population of the United States at the time was 50 million people.
27
E. Fuller Torrey, Out of the Shadows 27 (1997)
24

8 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

oÉîÉêÉåÇ=içìáë=aïáÖÜíI=Å~ääÉÇ=Ñçê=íÜÉ=éä~ÅÉãÉåí=çÑ=íÜÉ=ãÉåí~ääó=áää=áå=éìÄäáÅ=éëóÅÜá~íêáÅ=Ñ~ÅáäáíáÉëI=
“êáÖÜíäó=çêÖ~åáòÉÇ=eçëéáí~äëI=~Ç~éíÉÇ=íç=íÜÉ=ëéÉÅá~ä=Å~êÉ=çÑ=íÜÉ=éÉÅìäá~ê=ã~ä~Çó=çÑ=íÜÉ=fåë~åÉKÒOU==
lå= íÜÉ= éÉåáíÉåíá~êó= ëáÇÉI= ~= ÑÉï= âÉó= Ç~íÉë= ëáÖå~ä= íÜÉ= ÅçåíÉãéçê~êó= ÉãÉêÖÉåÅÉ= çÑ= íÜÉ=
éÉåáíÉåíá~êóK= `çåëíêìÅíáçå= çå= ^ìÄìêåÛë= Ñ~ãçìë= ÅÉääJÜçìëÉ= ÄÉÖ~å= áå= NUNV= ~åÇ= ï~ë= ÅçãéäÉíÉÇ= áå=
NUONK=qÜÉ=^ìÄìêå=ãçÇÉäÔíÜÉ=éÉåáíÉåíá~êó=ëóëíÉã=çÑ=Ç~óíáãÉ=ä~Äçê=áå=ÅçääÉÅíáîáíóI=Äìí=áå=ëáäÉåÅÉI=
ÑçääçïÉÇ= Äó= áëçä~íáçå= áå= ëáåÖäÉJã~å= ÅÉääëÔéêçîÉÇ= éçéìä~êI= ~åÇ= äÉÇ= íç= ~= ã~ëëáîÉ= ëéêÉÉ= çÑ= éêáëçå=
ÅçåëíêìÅíáçå=ÇìêáåÖ=íÜÉ=NUOMë=~åÇ=NUPMëI=~åÇ=íÜÉ=ÑçìåÇ~íáçå=Ñçê=çìê=ÅìêêÉåí=éêáëçå=ëóëíÉãK=páåÖJ
páåÖ=çéÉåÉÇ=áå=NUORI=`çååÉÅíáÅìí=ëí~êíÉÇ=ÄìáäÇáåÖ=tÉíÜÉêëÑáÉäÇ=áå=NUOTI=j~ëë~ÅÜìëÉííë=êÉçêÖ~åáòÉÇ=
OV
áíë=éêáëçå=~í=`Ü~êäÉëíçïå=áå=NUOVI=ÑçääçïÉÇ=Äó=fåÇá~å~I=táëÅçåëáåI=~åÇ=jáååÉëçí~=áå=íÜÉ=NUQMëK =
“_ÉíïÉÉå= NUOR= ~åÇ= NURMI= ëí~íÉ= éêáëçåë= çÑ= íÜÉ= ^ìÄìêå= íóéÉ= ïÉêÉ= Äìáäí= áå= j~áåÉI= j~êóä~åÇI= kÉï=
e~ãéëÜáêÉI=sÉêãçåíI=j~ëë~ÅÜìëÉííëI=`çååÉÅíáÅìíI=kÉï=vçêâI=íÜÉ=aáëíêáÅí=çÑ=`çäìãÄá~I=sáêÖáåá~I=
PM
qÉååÉëëÉÉI= içìáëá~å~I= jáëëçìêáI= fääáåçáëI= ~åÇ= lÜáçKÒ = få= ~ÇÇáíáçåI= oÜçÇÉ= fëä~åÇI= kÉï= gÉêëÉóI=
dÉçêÖá~= ~åÇ= hÉåíìÅâó= Äìáäí= éêáëçåë= çå= íÜÉ= ëçäáí~êó= ä~Äçê= ãçÇÉäI= ~åÇ= mÉååëóäî~åá~I= ïÜáÅÜ= Ü~Ç=
áåîÉåíÉÇ=íÜÉ=ëóëíÉã=çÑ=Ç~óJíáãÉ=ëçäáí~êó=ä~ÄçêI=~äëç=ÅçåëíêìÅíÉÇ=íÜÉ=b~ëíÉêå=pí~íÉ=mÉåáíÉåíá~êó=áå=íÜÉ=
ÜçéÉë=çÑ=êÉàìîÉå~íáåÖ=áíë=ãçÇÉä=Ñçê=çíÜÉêë=íç=ìëÉKPN==
“få= ~ääI= çåÉ= Å~å= éêçéÉêäó= ä~ÄÉä= íÜÉ= g~Åâëçåá~å= óÉ~êë= ÚíÜÉ= ~ÖÉ= çÑ= íÜÉ= ~ëóäìãIÛÒ= oçíÜã~å=
çÄëÉêîÉëKPO=lå=íÜáë=éçáåíI=íÜÉ=Üáëíçêá~åë=çÑ=íÜÉ=éÉåáíÉåíá~êó=~ÖêÉÉK=^Ç~ã=eáêëÅÜI=áå= qÜÉ=oáëÉ=çÑ=íÜÉ=
mÉåáíÉåíá~êó=ENVVOFI=ëáãáä~êäó=ëí~íÉë=íÜ~í=“qÜÉ=éÉåáíÉåíá~êó=Ü~Ç=áíë=ÜÉóÇ~ó=áå=íÜÉ=råáíÉÇ=pí~íÉë=áå=íÜÉ=
NUPMëK= c~ÅáäáíáÉë= éêçäáÑÉê~íÉÇI= íÜÉ= äáíÉê~íìêÉ= íÜêáîÉÇI= ~åÇ= îáëáíçêë= íê~îÉäÉÇ= ÖêÉ~í= Çáëí~åÅÉë= íç= îáÉï=
^ãÉêáÅ~å= éêáëçåë= áå= ~ÅíáçåKÒPP= oÉÄÉÅÅ~= jÅiÉåå~åI= áå= ÜÉê= OMMU= Äççâ= çå= íÜÉ= j~âáåÖ= çÑ= íÜÉ=
^ãÉêáÅ~å= mÉå~ä= pí~íÉI= ~äëç= íê~ÅÉë= íÜÉ= éÉåáíÉåíá~êó= ëóëíÉã= íç= “íÜÉ= ~ÖÉ= çÑ= g~ÅâëçåKÒPQ= bîÉå= máÉíÉê=
péáÉêÉåÄìêÖI=~=Üáëíçêá~å=çÑ=íÜÉ=É~êäó=ãçÇÉêå=éÉêáçÇ=ïÜç=éêÉÑÉêë=íç=êÉïáåÇ=íÜÉ=ÜáëíçêáÅ~ä=ÅäçÅâ=íç=íÜÉ=
NSMMëI=~Çãáíë=íÜ~í=áå=íÜÉ=råáíÉÇ=pí~íÉë=~=“êÉä~íáîÉäó=ÅçåÇÉåëÉÇ=íê~åëáíáçåÒ=íç=íÜÉ=éÉåáíÉåíá~êó=ãçÇÉä=
çÅÅìêêÉÇ=áå=íÜÉ=NUOMë=“ÇìÉ=íç=íÜÉ=é~êíáÅìä~ê=ÅáêÅìãëí~åÅÉë=çÑ=áíë=ÇÉîÉäçéãÉåíKÒPR=mÉå~ä=áåëíáíìíáçåë=
ÄÉÅ~ãÉI= áå= oçíÜã~åÛë= ïçêÇëI= éä~ÅÉë= çÑ= “Ñáêëí= êÉëçêíI= íÜÉ= éêÉÑÉêêÉÇ= ëçäìíáçå= íç= íÜÉ= éêçÄäÉãë= çÑ=
PS
éçîÉêíóI=ÅêáãÉI=ÇÉäáåèìÉåÅóI=~åÇ=áåë~åáíóKÒ =få= qÜÉ=fääìëáçå=çÑ=cêÉÉ=j~êâÉíëW=mìåáëÜãÉåí=~åÇ=íÜÉ=
jóíÜ=çÑ=k~íìê~ä=lêÇÉêI=f=çÑÑÉê=ëçãÉ=áåëáÖÜíë=áåíç=ïÜó=íÜÉ=~ÖÉ=çÑ=íÜÉ=~ëóäìã=ï~ë=Äçêå=ÇìêáåÖ=íÜÉ=
PT
j~êâÉí=oÉîçäìíáçåI=Äìí=ïáää=ãçîÉ=~äçåÖ=Ñ~ëíÉê=ÜÉêÉK =

                                                            
28

Gerald N. Grob & Howard H. Goldman, The Dilemma of Mental Health Care Policy 3 (2006).
Rothman, Discovery of the Asylum, 1971, p. 81.
30
McLennan 2008:63; see generally Lawrence M. Friedman, Crime and Punishment in American History. New
York: Basic Books, 1993, p. 77-82.
31
Id.
32
Rothman 1971:xiv.
33
Hirsch 1992:112.
34
McLennan 2008:54. See also James Q. Whitman, Harsh Justice. New York: Oxford University Press, 2008, p.
173-76.
35
Spierenburg 1991:3.
36
Rothman 1971:xiii.
37
Harcourt, Illusion of Free Markets, 2011, p. 208-220.
29

9 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

qÜÉ=ëìÄëÉèìÉåí=ÖêçïíÜ=ÅìêîÉë=çÑ=íÜÉ=íïç=áåëíáíìíáçåëI=ÜçïÉîÉêI=ÇáÑÑÉêÉÇ=ã~êâÉÇäóK=lå=íÜÉ=
éÉåáíÉåíá~êó= ëáÇÉI= íÜÉ= éçéìä~íáçå= êÉã~áåÉÇ= êÉä~íáîÉäó= Åçåëí~åí= ~ÑíÉê= íÜÉ= áåáíá~ä= ÇáëÅçîÉêóK= lÑÑáÅá~ä=
å~íáçå~ä=éêáëçå=Ç~í~=çåäó=Éñáëí=Ñçê=íÜÉ=éÉêáçÇ=ÄÉÖáååáåÖ=áå=NURMXPU=éêáçê=íç=íÜ~íI=ïÉ=Ü~îÉ=äçÅ~ä=Ç~í~I=
éêÉÇçãáå~åíäó=íÜÉ=éêçÇìÅí=çÑ=íÜÉ=mêáëçå=aáëÅáéäáåÉ=pçÅáÉíó=çÑ=_çëíçå=~åÇ=íÜÉ=mêáëçå=^ëëçÅá~íáçå=çÑ=
kÉï=vçêâI=ÄçíÜ=éêáî~íÉäóJçêÖ~åáòÉÇ=~ëëçÅá~íáçåë=áåíÉåÇÉÇ=íç=ãçåáíçê=íÜÉ=ÖêçïíÜ=çÑ=éêáëçåëK=qÜÉëÉ=
ëçìêÅÉë= êÉîÉ~ä= íÜ~íI= ~í= íÜÉ= ÄáêíÜ= çÑ= íÜÉ= éÉåáíÉåíá~êó= ÇìêáåÖ= íÜÉ= Ñáêëí= Ü~äÑ= çÑ= íÜÉ= åáåÉíÉÉåíÜ= ÅÉåíìêóI=
ëí~íÉ=éêáëçå=éçéìä~íáçåë=~åÇ=ê~íÉë=ÖêÉï=ÉåçêãçìëäóI=äÉ~ÇáåÖ=íç=íÜÉ=ÜáÖÜ=å~íáçå~ä=Åçìåíë=ÄÉÖáååáåÖ=áå=
NURM=~åÇ=êÉ~ÅÜáåÖ=~=ÜáÖÜ=éçáåí=áå=NUTMK=cêçã=íÜÉ=ÜáÖÜ=éçáåí=áå=NUTMI=ÜçïÉîÉêI=éêáëçå=ê~íÉë=áå=íÜÉ=
råáíÉÇ= pí~íÉë= ïçìäÇ= ÉëëÉåíá~ääó= êÉã~áå= êÉä~íáîÉäó= ëí~ÄäÉI= ïáíÜ= ëçãÉ= ÑäìÅíì~íáçåëI= ìåíáä= íÜÉ= éêáëçå=
Éñéäçëáçå=áå=íÜÉ=NVTMëK=cáÖìêÉ=Q=ÅÜ~êíë=íÜÉ=ÖêçïíÜ=çÑ=íÜÉ=éêáëçå=éçéìä~íáçå=çîÉê=íÜáë=éÉêáçÇK==

=
cáÖìêÉ=QW=mêáëçå=o~íÉ=áå=pí~íÉ=~åÇ=cÉÇÉê~ä=mêáëçåë=Ñêçã=NURM=íç=OMMU=EéÉê=NMMIMMM=éÉêëçåëFK==
=
få=Åçåíê~ëíI=íÜÉ=éçéìä~íáçå=áå=éëóÅÜá~íêáÅ=áåëíáíìíáçåë=ÉñéÉêáÉåÅÉÇ=~=éÉêáçÇ=çÑ=ê~éáÇ=ÖêçïíÜ=
íçï~êÇ= íÜÉ= ÉåÇ= çÑ= íÜÉ= åáåÉíÉÉåíÜ= ÅÉåíìêó= ~åÇ= áåíç= íÜÉ= Ñáêëí= Ü~äÑ= çÑ= íÜÉ= íïÉåíáÉíÜK= cêçã= NUUM= íç=
NVRRI=íÜÉ=åìãÄÉê=çÑ=é~íáÉåíë=êÉëáÇáåÖ=áå=éëóÅÜá~íêáÅ=Ñ~ÅáäáíáÉë=êçëÉ=Ñêçã=~Äçìí=QNIMMM=íç=çîÉê=Ü~äÑ=~=
ãáääáçåK= qÜáë= êÉéêÉëÉåíÉÇ= ~= íÜáêíÉÉåJÑçäÇ= áåÅêÉ~ëÉ= áå= íÜÉ= áåé~íáÉåí= éçéìä~íáçåI= ïÜáäÉ= íÜÉ= íçí~ä=
PV
éçéìä~íáçå= çÑ= íÜÉ= råáíÉÇ= pí~íÉë= ÖêÉï= ~= äáííäÉ= ãçêÉ= íÜ~å= íÜêÉÉÑçäÇK = qÜÉ= ëáòÉ= çÑ= íÜÉ= Ñ~ÅáäáíáÉë=
íÜÉãëÉäîÉë= ~äëç= ÖêÉï= Çê~ã~íáÅ~ääóK= cçê= Éñ~ãéäÉI= kÉï= vçêâÛë=oçÅâä~åÇ= pí~íÉ= eçëéáí~ä= ÜçìëÉÇ= çîÉê=
                                                            
38

Margaret Werner Cahalan, Historical Corrections Statistics in the United States, 1850-1984. Rockville, MD:
Westat, Inc, 1986, p. 1-28.
39
E. Fuller Torrey, Out of the Shadows 82 (1997); see also Gronfein, “Incentives and Intentions,” 1985, 194.

10 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

VIMMM= é~íáÉåíëI= ~åÇ= çîÉê= NQIMMM= é~íáÉåíë= äáîÉÇ= áå= máäÖêáã= pí~íÉ= eçëéáí~äKQM= `çããÉåí~íçêë= Ü~îÉ=
éêçéçëÉÇ=ëÉîÉê~ä=Éñéä~å~íáçåë=Ñçê=íÜáë=êáëÉ=áå=áåëíáíìíáçå~ä=éçéìä~íáçåK=låÉ=ëíìÇó=äáëíÉÇ=ëÉîÉå=Ñ~Åíçêë=
ÅçåíêáÄìíáåÖ=íç=íÜÉ=éçéìä~íáçå=ÖêçïíÜ=áå=áåëíáíìíáçåëW=“EäF=ÖÉåÉê~ä=éçéìä~íáçå=ÖêçïíÜX=EOF=íÜÉ=~ÖáåÖ=
çÑ=íÜÉ=ÖÉåÉê~ä=éçéìä~íáçåX=EPF=íÜÉ=Åçåëí~åí=éêÉëëìêÉë=çÑ=çîÉêÅêçïÇáåÖ=~åÇ=åÉÉÇ=ÉñÅÉÉÇáåÖ=Å~é~ÅáíóX=
EQF=éìÄäáÅ=~åÇ=éêçÑÉëëáçå~ä=ÅçåÑáÇÉåÅÉ=áåI=~åÇ=ïáääáåÖåÉëë=íç=ìíáäáòÉI=ãÉåí~ä=Üçëéáí~äëX=ERF=~=Äêç~ÇÉê=
ÅçåÅÉéíáçå=çÑ=ãÉåí~ä=áääåÉëëX=ESF=~å=áåÅêÉ~ëáåÖäó=äçåÖ=Çìê~íáçå=çÑ=ëí~ó=Ñçê=ãÉåí~ä=áääåÉëë=êÉÅçîÉêóX=~åÇ=
ETF= ÇÉÅêÉ~ëÉÇ= íçäÉê~åÅÉ= Ñçê= ÇÉîá~åí= ÄÉÜ~îáçê= ~åÇ= éÉêÜ~éë= ÜáÖÜÉê= ê~íÉë= çÑ= ãÉåí~ä= áääåÉëëKÒQN= líÜÉêë=
Ü~îÉ=éçáåíÉÇ=íç=áåëíáíìíáçå~äáò~íáçå=~ë=~=êÉëéçåëÉ=íç=“íÜÉ=ä~Åâ=çÑ=ÉÑÑÉÅíáîÉ=~åÇ=ä~ëíáåÖ=íêÉ~íãÉåíë=Ñçê=
ëÉêáçìë=ãÉåí~ä=áääåÉëëI=~åÇ=íÜÉ=éêÉëëìêÉ=ÄêçìÖÜí=íç=ÄÉ~ê=Äó=Ñ~ãáäáÉë=~åÇ=ÅçããìåáíáÉë=ïÜç=ï~åíÉÇ=~=
ë~ÑÉ=ëÜÉäíÉê=Ñçê=ëÉêáçìëäó=ÇáëíìêÄÉÇ=ãÉãÄÉêëKÒ= QO=líÜÉêëI=ëìÅÜ=~ë=qÜçã~ë=pò~ëò=~åÇ=qÜçã~ë=pÅÜÉÑÑI=
îáÉï=íÜÉ=êáëÉ=áå=áåëíáíìíáçå~äáòÉÇ=éçéìä~íáçå=ãçêÉ=ëâÉéíáÅ~ääóI=îáÉïáåÖ=íÜÉ=êáëÉ=áå=íÜÉ=éçéìä~íáçå=çÑ=
íÜÉ=“ãÉåí~ääó=áääÒ=~ë=“~=Ñçêã=çÑ=ëçÅá~ä=ä~ÄÉäáåÖ=xÇÉëáÖåÉÇ=íçz=ëìééêÉëë=åçåÅçåÑçêãáëí=ÄÉÜ~îáçêKÒQP==
^ë=ÑáÖìêÉ=P=ëÜçïëI=~ÑíÉê=éÉ~âáåÖ=áå=NVRRI=áåé~íáÉåí=éçéìä~íáçåë=áå=ãÉåí~ä=Üçëéáí~ä=ÄÉÖ~å=íç=
ëÜçï=~=ëíêáâáåÖ=~åÇ=ëíÉ~Çó=Ççïåï~êÇ=íêÉåÇK=få=NVRRI=ãçêÉ=íÜ~å=RRUIMMM=é~íáÉåíë=êÉëáÇÉÇ=áå=éìÄäáÅ=
QQ
ãÉåí~ä= Üçëéáí~äëX= Äó= OMMMI= íÜáë= éçéìä~íáçå= Ü~Ç= Ñ~ääÉå= íç= RRIMMMK = qÜÉ= ~îÉê~ÖÉ= ëáòÉ= çÑ= íÜÉ= ëí~íÉ=
QR
Üçëéáí~ä=Ü~Ç=Ñ~ääÉå=Ñêçã=çîÉê=OIMMM=êÉëáÇÉåíë=íç=äÉëë=íÜ~å=RMMK ==
ffK bñéäçêáåÖ=íÜÉ=j~àçê=cçêÅÉë=qÜ~í=`çåíêáÄìíÉÇ=íç=aÉáåëíáíìíáçå~äáò~íáçå=
tÜ~í=Éñéä~áåë=íÜ~í=êÉã~êâ~ÄäÉ=Çêçé=áå=íÜÉ=åìãÄÉê=~åÇ=ê~íÉ=çÑ=ãÉåí~ä=é~íáÉåíëI=~åÇ=ÅçìäÇ=
íÜÉêÉ= ÄÉ= ~åó= é~ê~ääÉä= ÑçêÅÉë= ~í= éä~ó= íçÇ~ó= áå= íÜÉ= éêáëçå= ÅçåíÉñí\= qÜÉ= Ñáêëí= í~ëâ= çÑ= íÜáë= Éëë~ó= áë= íç=
~ÇÇêÉëë= íÜáë= èìÉëíáçåÔíç= ~å~äóòÉ= íÜÉ= ëíìååáåÖ= ÇÉÅêÉ~ëÉ= áå= ãÉåí~ä= Üçëéáí~ä= éçéìä~íáçåë= ~åÇ= íÜÉ=
ÑçêÅÉë= íÜ~í= ÄêçìÖÜí= áí= ~ÄçìíI= áå= çêÇÉê= íç= ÉñéäçêÉ= ïÜÉíÜÉê= íÜÉ= Ñ~Åíçêë= íÜ~í= áåÑäìÉåÅÉÇ=
ÇÉáåëíáíìíáçå~äáò~íáçå= áå= íÜÉ= NVSMë= ÅçìäÇ= éçëëáÄäó= êÉä~íÉ= íç= çìê= ÅìêêÉåí= ëáíì~íáçå= çÑ= ã~ëë=
áåÅ~êÅÉê~íáçåK= f= ïáää= éêçÅÉÉÇ= áå= íïç= ëíÉéëI= ÑçÅìëáåÖ= Ñáêëí= çå= íÜÉ= NVSMë= ~åÇ= íÜÉå= ~å~äóòáåÖ= éçëëáÄäÉ=
áãéäáÅ~íáçåë=Ñçê=çìê=ÅçåíÉãéçê~êó=ëáíì~íáçåK==
^K qÜÉ=j~àçê=c~Åíçêë=fåÑäìÉåÅáåÖ=aÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMëK==
qÜÉ=ãçëí=êÉäá~ÄäÉ=ëçÅá~ä=ëÅáÉåíáÑáÅ=êÉëÉ~êÅÜ=ÅçåîÉêÖÉë=çå=íÜêÉÉ=ã~àçê=ëçÅá~ä=~åÇ=éçäáíáÅ~ä=ÑçêÅÉë=
íÜ~í= ÅçåíêáÄìíÉÇ= íç= ÇÉáåëíáíìíáçå~äáò~íáçå= ÇìêáåÖ= íÜÉ= NVRMëI= SMë= ~åÇ= TMëW= íÉÅÜåçäçÖáÅ~ä=
                                                            
40

Torrey, Out of the Shadows, 1997, at 82.
George W. Dowdall, “Mental Hospitals and Deinstitutionalization,” in Handbook of the Sociology of Mental
Health 520, 520-521 (Carol S. Aneshenel & Jo C. Phelan eds., 1999). It is worth noting that this study took place
after World War II, as the war itself greatly impacted subsequent mental health policy.
42
William Gronfein, “Incentives and Intentions”, 1985, p. 194.
43
Gerald N. Grob & Howard H. Goldman, The Dilemma of Mental Health Care Policy 52-53 (2006); Thomas
Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (1961); Thomas J. Scheff, Being
Mentally Ill: A Sociological Theory (1966).
41

44

Id. at 15.
Dowdall, “Mental Hospitals and Deinstitutionalization,” in Handbook of the Sociology of Mental Health 520, 526
(Carol S. Aneshenel & Jo C. Phelan eds., 1999).

45

11 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

~Çî~åÅÉãÉåíë=áå=ÇêìÖ=íÜÉê~éó=Ñçê=íêÉ~íãÉåí=çÑ=ãÉåí~ä=áääåÉëëI=ÉÅçåçãáÅ=áåÅÉåíáîÉë=íç=ëÜáÑí=Å~êÉ=Ñçê=
íÜÉ=ãÉåí~ääó=áää= íç=ÅçããìåáíóJÄ~ëÉÇ=çìíé~íáÉåí=Ñ~ÅáäáíáÉëI=~åÇ=ÅÜ~åÖáåÖ=ëçÅáÉí~ä=~ííáíìÇÉë=êÉÖ~êÇáåÖ=
ãÉåí~ä= áääåÉëëK=f=ïáää=~ÇÇêÉëë=É~ÅÜ=çÑ=íÜÉëÉ=áå=íìêåI=áå=çêÇÉê=íç=íÜÉå=ÉñéäçêÉ=ïÜÉíÜÉê=íÜÉó=éçáåí= íç=
ìëÉÑìä=ÇáêÉÅíáçåë=íçÇ~óK=
~K aêìÖë=~åÇ=íÜÉ=aÉîÉäçéãÉåí=çÑ=mëóÅÜá~íêáÅ=jÉÇáÅ~íáçå=
mêáçê= íç= íÜÉ= ÇÉîÉäçéãÉåí= çÑ= éëóÅÜá~íêáÅ= ÇêìÖ= íÜÉê~éóI= íÜÉ= ãçëí= ïáÇÉäó= ìëÉÇ= íêÉ~íãÉåíë= Ñçê=
ãÉåí~ä= áääåÉëë= áåÅäìÇÉÇ= ÉäÉÅíêçÅçåîìäëáîÉ= íÜÉê~éóI= áåëìäáå= Åçã~= íÜÉê~éóI= ~åÇ= äçÄçíçãóKQS= qÜÉëÉ=
íêÉ~íãÉåíë=Ü~Ç=ëáÖåáÑáÅ~åí=ëáÇÉ=ÉÑÑÉÅíëI=áåÅäìÇáåÖ=Äê~áå=Ç~ã~ÖÉI=~åÇ=ïÉêÉ=éêçîáÇÉÇ=çå=~å=áåé~íáÉåí=
Ä~ëáëK= qêÉ~íãÉåí= Ñçê= íÜÉ= ãÉåí~ääó= áää= ìåÇÉêïÉåí= ê~éáÇ= ÅÜ~åÖÉ= áå= íÜÉ= NVRMëI= ÜçïÉîÉêI= ïáíÜ= íÜÉ=
áåíêçÇìÅíáçå=çÑ=éëóÅÜá~íêáÅ=ãÉÇáÅ~íáçåK=få=NVRQI=ÅÜäçêçéêçã~òáåÉI=ã~êâÉíÉÇ=ìåÇÉê=íÜÉ=íê~ÇÉ=å~ãÉ=
qÜçê~òáåÉI=ÄÉÅ~ãÉ=íÜÉ=Ñáêëí=ïáÇÉäó=~î~áä~ÄäÉ=~åíáéëóÅÜçíáÅ=ãÉÇáÅ~íáçåKQT=qÜçìÖÜ=çêáÖáå~ääó=ÇÉîÉäçéÉÇ=
íç= ëÉÇ~íÉ= é~íáÉåíë= ìåÇÉêÖçáåÖ= ëìêÖÉêóI= ÅÜäçêéêçã~òáåÉ= Ü~Ç= íê~åèìáäáòáåÖ= ÉÑÑÉÅíë= íÜ~í= äÉÇ= íç= áíë=
~Çãáåáëíê~íáçå= Ñçê= ãÉåí~ä= áääåÉëëK= _ó= NVRSI= çîÉê= íïç= ãáääáçå= é~íáÉåíë= Ü~Ç= ÄÉÉå= éêÉëÅêáÄÉÇ=
ÅÜäçêçéêçã~òáåÉQU= ~åÇ= ~í= äÉ~ëí= PT= ëí~íÉë= ïÉêÉ= ìëáåÖ= ÅÜäçêéêçã~òáåÉ= çê= ~= ëáãáä~ê= ~åíáéëóÅÜçíáÅ=
ãÉÇáÅ~íáçå=áå=íÜÉáê=ëí~íÉ=ãÉåí~ä=Üçëéáí~äëKQV==
qÜÉ= É~êäó= ~Ççéíáçå= çÑ= ÅÜäçêçéêçã~òáåÉ= ï~ë= ÇìÉI= áå= é~êíI= íç= ÉñíÉåëáîÉ= ã~êâÉíáåÖ= ~åÇ=
äçÄÄóáåÖ=ÉÑÑçêíë=Äó=pãáíÜI=häáåÉ=~åÇ=cêÉåÅÜ=i~Äë=EíÜÉ=ã~åìÑ~ÅíìêÉê=çÑ=qÜçê~òáåÉF=Ñçê=íÜÉ=ìëÉ=çÑ=íÜÉ=
RM
ÇêìÖ= áå= éëóÅÜá~íêáÅ= Ñ~ÅáäáíáÉëK = cçê= íÜÉ= áåëíáíìíáçåëI= íÜÉ= åÉï= ÇêìÖ= íÜÉê~éó= ï~ë= ÉñíêÉãÉäó= ~ííê~ÅíáîÉ=
ÄÉÅ~ìëÉ=áí=“~ééÉ~êÉÇ=íç=çÑÑÉê=~=ëçäìíáçå=íç=çåÉ=çÑ=íÜÉ=éêçÄäÉãë=íÜ~í=Ü~Ç=éÉêÉååá~ääó=éä~ÖìÉÇ=íÜÉ=ëí~íÉ=
Üçëéáí~äW=íÜÉ=ã~áåíÉå~åÅÉ=çÑ=çêÇÉêKÒRN=qÜÉ=êáëÉ=áå=é~íáÉåí=éçéìä~íáçåë=áå=ëí~íÉ=Üçëéáí~äë=Ü~Ç=äÉÑí=íÜÉ=
Ñ~ÅáäáíáÉë=ïáíÜ=ÅÜêçåáÅ=ëÅ~êÅáíó=áå=Üìã~å=~åÇ=éÜóëáÅ~ä=êÉëçìêÅÉëI=~åÇ=íÜÉ=ìëÉ=çÑ=ãÉÇáÅ~íáçå=~ääçïÉÇ=
íÜÉ=Üçëéáí~äë=íç=ã~å~ÖÉ=ãçêÉ=é~íáÉåíë=ïáíÜ=äÉëë=ëí~ÑÑÔ~åÇ=ÉîÉå=íç=~ääçï=ëçãÉ=é~íáÉåíë=íç= ã~å~ÖÉ=
RO
íÜÉáê=çïå=ëÉîÉêÉ=éëóÅÜçíáÅ=ëóãéíçãëK =aêìÖ=íÜÉê~éó=~äëç=çÑÑÉêÉÇ=~=íêÉ~íãÉåí=Ñçê=ãÉåí~ä=áääåÉëë=íÜ~í=
ÅçìäÇ=ÄÉ=éêçîáÇÉÇ=çå=~å=çìíJé~íáÉåí=Ä~ëáëK==
^äíÜçìÖÜ=ëÉîÉê~ä=ëÅÜçä~êë=Ü~îÉ=åçíÉÇ=íÜ~í=íÜÉ=áåíêçÇìÅíáçå=~åÇ=ìëÉ=çÑ=íÜÉ=ÇêìÖë=ÇáÇ=åçí=áíëÉäÑ=
RP
Å~ìëÉ= ~= ëáÖåáÑáÅ~åí= êÉÇìÅíáçå= áå= é~íáÉåí= éçéìä~íáçåI = íÜÉ= ~î~áä~Äáäáíó= çÑ= íÜÉ= éëóÅÜá~íêáÅ= ãÉÇáÅ~íáçå=
Ü~Ç=~=ëáÖåáÑáÅ~åí=áãé~Åí=çå=éìÄäáÅ=éÉêÅÉéíáçå=~åÇ=éìÄäáÅ=éçäáÅó=~ë=ïÉääK=q~åÖáÄäÉ=ãÉÇáÅ~äáò~íáçåI=áå=
                                                            
46

William Gronfein, “Psychotropic Drugs and the Origins of Deinstitutionalization,” 1985, p. 444.

47

E. Fuller Torrey, “Out of the Shadows,” 1997, p. 99.

48

Id.
Gronfein, “Psychotropic Drugs and the Origins of Deinstitutionalization,”, 1985, p. 441.

49
50

Id. at 441-42.
Id. at 442.
52
David A. Rochecroft, From Poorhouses to Homelessness: Policy Analysis and Mental Health Care 215 (1983).
Previous treatments, like electroconvulsive therapy, could only be provided on an inpatient basis.
51

53

Gronfein, “Psychotropic Drugs and the Origins of Deinstitutionalization,” 1985, p. 448; Torrey, Out of the
Shadows, 1997, p. 99-100.

12 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

íÜÉ=Ñçêã=çÑ=~=éáääI=éêçãçíÉÇ=íÜÉ=ãÉåí~ääó=áää=“íç=íÜÉ=ëí~íìë=çÑ=é~íáÉåíë=áå=íÜÉ=ÉóÉë=çÑ=ã~åó=ãÉãÄÉêë=
çÑ=íÜÉ=éìÄäáÅKÒRQ=^ë=ëçãÉ=êÉëÉ~êÅÜÉêë=Ü~îÉ=åçíÉÇI=“íê~åèìáäáòáåÖ=ÇêìÖë=~ÑÑÉÅíÉÇ=íÜÉ=Åäáã~íÉ=çÑ=çéáåáçå=
RR
áå=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉ=áå=~=ï~ó=íÜ~í=Å~êêáÉÇ=ÄÉóçåÇ=íÜÉáê=î~äìÉ=~ë=ãÉÇáÅ~ä=~ééäáÅ~íáçåëKÒ =“xjzÉåí~ä=
ÜÉ~äíÜ= éêçÑÉëëáçå~äë= ÄÉÖ~å= íç= ~ÇîçÅ~íÉ= Åçããìåáíó= Å~êÉI= áå= é~êíI= ÄÉÅ~ìëÉ= íÜÉ= áåíêçÇìÅíáçå= çÑ=
éëóÅÜçíêçéáÅ=ãÉÇáÅ~íáçåë=ÅçåíêáÄìíÉÇ=ëáÖåáÑáÅ~åíäó=íç=íÜÉ=ëóëíÉã~íáÅ=ã~å~ÖÉãÉåí=çÑ=ã~åó=ëÉîÉêÉäó=
éëóÅÜçíáÅ=é~íáÉåíë=~åÇ=ã~ÇÉ=ÇáëÅÜ~êÖáåÖ=íÜÉã=Ä~Åâ=íç=íÜÉ=Åçããìåáíó=éçëëáÄäÉKÒRS===
=mçäáÅó= ã~âÉêë= ~äëç= äççâÉÇ= íç= éëóÅÜá~íêáÅ= ãÉÇáÅáåÉ= íç= ãçîÉ= áåëíáíìíáçå~äáòÉÇ= é~íáÉåíëI= åç=
äçåÖÉê= ÅçåëáÇÉêÉÇ= áåÅìê~ÄäÉ= çê= ìåíêÉ~í~ÄäÉI= Ä~Åâ= áåíç= íÜÉ= ÅçããìåáíóK= qÜìëI= íÜÉ= ãçîÉ= ~ï~ó= Ñêçã=
áåëíáíìíáçå~äáòÉÇ= ãÉåí~ä= ÜÉ~äíÜÅ~êÉ= ï~ë= ÜÉ~îáäó= áåÑäìÉåÅÉÇ= Äó= íÜÉ= ÇÉîÉäçéãÉåí= çÑ= éëóÅÜá~íêáÅ=
ãÉÇáÅ~íáçåI= åçí= çåäó= ÄÉÅ~ìëÉ= áí= ~ääçïÉÇ= çìíJé~íáÉåí= Å~êÉ= Ñçê= ãÉåí~ä= áääåÉëë= Äìí= ~äëç= ÄÉÅ~ìëÉ= áí=
ÅÜ~åÖÉÇ= éìÄäáÅ= ~åÇ= éçäáíáÅ~ä= ëÉåíáãÉåí= êÉÖ~êÇáåÖ= íÜÉ= ãÉåí~ääó= áääK= ^ë= dêçåÑÉáå= ïêáíÉëI= “íÉëíáãçåó=
Ñêçã=~=åìãÄÉê=çÑ=ëçìêÅÉë=ÇçÉë=áåÇáÅ~íÉ=íÜ~í=íÜÉ=~ÇîÉåí=çÑ=éëóÅÜçíêçéáÅ=ãÉÇáÅ~íáçåë=ï~ë=äáåâÉÇ=íç=
íÜÉ= ÉãÉêÖÉåÅÉ= çÑ= ~= åÉï= éÜáäçëçéÜó= êÉÖ~êÇáåÖ= ïÜ~í= ï~ë= éçëëáÄäÉ= ~åÇ= ÇÉëáê~ÄäÉ= áå= íÜÉ= éêçîáëáçå= çÑ=
ãÉåí~ä=ÜÉ~äíÜ=Å~êÉ=Ñçê=íÜÉ=ëÉêáçìëäó=ãÉåí~ääó=áääKÒRT=
ÄK cáå~åÅá~ä=fåÅÉåíáîÉëW=cÉÇÉê~ä=éêçÖê~ãë=~åÇ=ÅçëíJëÜáÑíáåÖ=áåÅÉåíáîÉë=
^= ëÉÅçåÇ= ã~àçê= ÅçåíêáÄìíáåÖ= Ñ~Åíçê= íç= ÇÉáåëíáíìíáçå~äáò~íáçå= ï~ë= ÑÉÇÉê~ä= áåáíá~íáîÉ= ~åÇ=
áåíÉêîÉåíáçåë=ÄÉÖáååáåÖ=áå=íÜÉ=É~êäó=NVSMëK=få=NVSPI=mêÉëáÇÉåí=hÉååÉÇó=éêçéçëÉÇ=íÜÉ=`çããìåáíó=
jÉåí~ä= eÉ~äíÜ= `ÉåíÉêë= ^Åí= ïáíÜ= íÜÉ= áÇÉ~= çÑ= ÅêÉ~íáåÖ= ÅçããìåáíóJÄ~ëÉÇ= ãÉåí~ä= ÜÉ~äíÜ= ÅÉåíÉêë= íç=
éêçîáÇÉ=ÅçãéêÉÜÉåëáîÉ=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉKRU=fåíÉêÉëíáåÖäóI=mêÉëáÇÉåí=hÉååÉÇó=~ííêáÄìíÉÇ=íÜÉ=éä~å=íç=
“íÜÉ= åÉï= ÇêìÖë= ~ÅèìáêÉÇ= ~åÇ= ÇÉîÉäçéÉÇ= áå= êÉÅÉåí= óÉ~êë= ïÜáÅÜ= ã~âÉ= áí= éçëëáÄäÉ= Ñçê= ãçëí= çÑ= íÜÉ=
ãÉåí~ääó=áää=íç=ÄÉ=ëìÅÅÉëëÑìääó=~åÇ=èìáÅâäó=íêÉ~íÉÇ=áå=íÜÉáê=çïå=ÅçããìåáíáÉë=~åÇ=êÉíìêåÉÇ=íç=~=ìëÉÑìä=
éä~ÅÉ= áå= ëçÅáÉíóKÒRV= qÜÉ= ÉÑÑÉÅí= çÑ= íÜÉ= äÉÖáëä~íáçå= ïçìäÇ= ÄÉ= íç= ëÜáÑí= ÑìåÇáåÖ= Ñêçã= íÜÉ= ëí~íÉë= íç= íÜÉ=
ÑÉÇÉê~ä=ÖçîÉêåãÉåíK==
SM
SN
qÜÉ= é~ëë~ÖÉ= áå= NVSR= çÑ= jÉÇáÅ~áÇ = ~åÇ= jÉÇáÅ~êÉ = êÉáåÑçêÅÉÇ= íÜáë= íêÉåÇK= få= çêÇÉê= íç= í~âÉ=
~Çî~åí~ÖÉ= çÑ= ÑÉÇÉê~ä= jÉÇáÅ~áÇ= ÑìåÇáåÖI= ëí~íÉë= Ü~Ç= áåÅÉåíáîÉë= íç= ãçîÉ= é~íáÉåíë= çìí= çÑ= ëí~íÉ= ãÉåí~ä=
SO
Üçëéáí~äë= ~åÇ= áåíç= çíÜÉê= áåëíáíìíáçåë= íÜ~í= ïÉêÉ= ëìÄëáÇáòÉÇ= ïáíÜ= ÑÉÇÉê~ä= ãçåÉóK = qÜÉëÉ= éêçÖê~ãë=
éìêéçëÉÑìääó= ÉñÅäìÇÉÇ= é~óãÉåíë= íç= “áåëíáíìíáçåë= Ñçê= íÜÉ= íêÉ~íãÉåí= çÑ= ãÉåí~ä= ÇáëÉ~ëÉÒ= ÄÉÅ~ìëÉ= íÜÉ=

                                                            
54

Rochecroft, Poorhouses, p. 39; Roberts, 1967, p. 25.
Rochecroft, From Poorhouses to Homelessness, 1983, p. 38
56
Id.
57
Gronfein, “Psychotropic Drugs,” 1985, p. 450.
58
Bernard L. Bloom, Community Mental Health 20 (2d ed.1984).
59
Gronfein, “Psychotropic Drugs,” 1985, p. 450.
55

60

Medicaid provides selected health care to the indigent, regardless of age, and is funded jointly by contributions
from federal and state governments.
61
Medicare is a federally funded and administered health-insurance program that provides selected health care to
“all persons over age 65 who are eligible for Social Security benefits, regardless of income.” Gronfein, “Incentives
and Intentions,” 1985, p. 200.
62
Gronfein, “Incentives and Intentions,” (citing United States Senate Subcommittee on Long-Term Care)

13 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

éêçÖê~ãë= ïÉêÉ= åçí= ÇÉëáÖåÉÇ= íç= ëìééä~åí= ëí~íÉ= Åçåíêçä= ~åÇ= Ñáå~åÅáåÖ= çÑ= éëóÅÜá~íêáÅ= Ñ~ÅáäáíáÉëKSP= ^ë= ~=
êÉëìäíI= ëí~íÉë= ÄÉÖ~å= ãçîáåÖ= é~íáÉåíë= çìí= çÑ= ëí~íÉ= ãÉåí~ä= Üçëéáí~äë= ~åÇ= áåíç= åìêëáåÖ= ÜçãÉëI= çê=
éëóÅÜá~íêáÅ=ï~êÇë=çÑ=ÖÉåÉê~ä=Üçëéáí~äë=íÜ~í=ïÉêÉ=ÜÉ~îáäó=ëìÄëáÇáòÉÇ=ïáíÜ=ÑÉÇÉê~ä=ãçåÉóK=líÜÉê=ÑÉÇÉê~ä=
éêçÖê~ãëI=ëìÅÜ=~ë=pìééäÉãÉåí~ä=pÉÅìêáíó=fåÅçãÉ=EppfFI=éêçîáÇÉÇ=ÇáêÉÅí=ÄÉåÉÑáíë=íç=íÜÉ=ãÉåí~ääó=áää=áå=
íÜÉ= ÅçããìåáíóK= ^ë= ëçãÉ= ëÅÜçä~êë= Ü~îÉ= åçíÉÇI= “pí~íÉ= áåÅÉåíáîÉë= Ñçê= ÅçëíJëÜáÑíáåÖ= íç= íÜÉ= ÑÉÇÉê~ä=
ÖçîÉêåãÉåí= êÉëáÇÉ= ~äãçëí= ÉñÅäìëáîÉäó= áå= íÜÉ= ÇáëÅÜ~êÖÉ= çÑ= é~íáÉåíë= Ñêçã= ëí~íÉ= Üçëéáí~äëI= ïÜç= íÜÉå=
ÄÉÅçãÉ=ÉäáÖáÄäÉ=Ñçê=ppfI=jÉÇáÅ~áÇI=ÑççÇ=ëí~ãéë=~åÇ=çíÜÉê=ÑÉÇÉê~ä=ÄÉåÉÑáíëKÒSQ===
få= ëÜçêíI= íÜÉ= Éñé~åëáçå= çÑ= ÑÉÇÉê~ä= ëçÅá~ä= ïÉäÑ~êÉ= éêçÖê~ãë= ÅçåíêáÄìíÉÇ= íç=
ÇÉáåëíáíìíáçå~äáò~íáçå= Äó= ÅêÉ~íáåÖ= Ñáå~åÅá~ä= áåÅÉåíáîÉë= Ñçê= ëí~íÉë= íç= ÅÜ~åÖÉ= íÜÉ= äçÅìë= çÑ= Å~êÉ= çÑ= íÜÉ=
ãÉåí~ääó=áää=~ï~ó=Ñêçã=ëí~íÉ=áåëíáíìíáçåëKSR=qÜÉ=ÉãéáêáÅ~ä=ÉîáÇÉåÅÉ=ÄÉ~êë=íÜáë=çìíK=pí~íáëíáÅ~ä=~å~äóëÉë=
ÅçåÑáêã= íÜ~í= “ëí~íÉë= ïáíÜ= ÖêÉ~íÉê= jÉÇáÅ~áÇ= áåîçäîÉãÉåí= ëÜçïÉÇ= ä~êÖÉê= áåé~íáÉåí= ÇÉÅäáåÉë= çîÉê= íÜÉ=
SS
ë~ãÉ=éÉêáçÇKÒ =jìÅÜ=çÑ=íÜáë=ï~ëI=å~íìê~ääóI=íê~åëáåëíáíìíáçå~äáò~íáçåI=ÉëéÉÅá~ääó=áåíç=åìêëáåÖ=ÜçãÉëI=
ïÜáÅÜ=f=ÇáëÅìëë=ä~íÉêX=Äìí=áí=ÇáÇ=Ñ~Åáäáí~íÉ=ÇÉáåëíáíìíáçå~äáò~íáçåK=
ÅK `Ü~åÖáåÖ=pçÅá~ä=^ííáíìÇÉë=íçï~êÇë=jÉåí~ä=fääåÉëë=
qçÖÉíÜÉêI= íÜÉëÉ= íêÉåÇë= ÜÉäéÉÇ= êÉëÜ~éÉ= ëçÅá~ä= ~åÇ= Åìäíìê~ä= éÉêÅÉéíáçåë= çÑ= ãÉåí~ä= áääåÉëëK=
mëóÅÜá~íêáÅ= ãÉÇáÅ~íáçå= ~åÇ= ÖêçïáåÖ= âåçïäÉÇÖÉ= ~Äçìí= íÜÉ= ÄáçÅÜÉãáÅ~ä= Å~ìëÉë= çÑ= ãÉåí~ä= áääåÉëë=
ÅçåíêáÄìíÉÇ=íç=ê~áëáåÖ=ìåÇÉêëí~åÇáåÖ=~åÇ=ëóãé~íÜó=Ñçê=íÜÉ=ãÉåí~ääó=áääI=~åÇ=çÑÑÉêÉÇ=éêççÑ=íÜ~í=åçí=
~ää= ãÉåí~ä= áääåÉëë=ï~ë=áåÅìê~ÄäÉK=qÜÉëÉ=ÅÜ~åÖáåÖ= éÉêÅÉéíáçåë= ïÉêÉ=áå= é~êí=Å~í~äóòÉÇ=Äó=tçêäÇ= t~ê=
ffÔáå=ëÉîÉê~ä=ï~óëK=cáêëíI=~ééêçñáã~íÉäó=NO=éÉêÅÉåí=çÑ=íÜçëÉ=Çê~ÑíÉÇ=ÄÉíïÉÉå=NVQO=~åÇ=NVQR=ïÉêÉ=
ÑçìåÇ= ìåÑáí= íç= ëÉêîÉ= Ñçê= éëóÅÜá~íêáÅ= çê= åÉìêçäçÖáÅ~ä= êÉ~ëçåëKST= ^ÇÇáíáçå~ääóI= PT= éÉêÅÉåí= çÑ= ëçäÇáÉêë=
SU
ÇáëÅÜ~êÖÉÇ= ÇìêáåÖ= íÜÉ= ï~ê= Ñçê= Çáë~Äáäáíó= ïÉêÉ= ÇáëÅÜ~êÖÉÇ= Ñçê= ãÉåí~ä= áääåÉëëK = qÜÉ= éÉêî~ëáîÉåÉëë= çÑ=
ãÉåí~ä= áääåÉëë= ~ãçåÖ= ÉåäáëíÉÇ= ãÉåI= ~= ëóãé~íÜÉíáÅ= Öêçìé= áå= íÜÉ= ÉóÉë= çÑ= íÜÉ= ÖÉåÉê~ä= éìÄäáÅI= ÜÉäéÉÇ=
êÉÇìÅÉ=ëíáÖã~=~Ö~áåëí=íÜÉ=ãÉåí~ääó=áääI=ïÜáäÉ=~äëç=ê~áëáåÖ=~ï~êÉåÉëë=çÑ=íÜÉ=éêÉî~äÉåÅÉ=çÑ=ãÉåí~ä=áääåÉëë=
áå=íÜÉ=ÖÉåÉê~ä=éçéìä~íáçåK=
tçêäÇ=t~ê=ff=~äëç=Ü~Ç=íÜÉ=áåÇáêÉÅí=ÉÑÑÉÅí=çÑ=ê~áëáåÖ=éìÄäáÅ=~ï~êÉåÉëë=~Äçìí=íÜÉ=íêÉ~íãÉåí=çÑ=
íÜÉ= ãÉåí~ääó= áää= áå= ëí~íÉ= áåëíáíìíáçåëK= aìêáåÖ= íÜÉ= ï~êI= ÅçåëÅáÉåíáçìë= çÄàÉÅíçêëI= áå= äáÉì= çÑ= ãáäáí~êó=
ëÉêîáÅÉI=ïçêâÉÇ=~ë=~ííÉåÇ~åíë=áå=ãÉåí~ä=Üçëéáí~äë=íÜ~í=Ü~Ç=ÄÉÉå=äÉÑí=ìåÇÉêëí~ÑÑÉÇ=Äó=íÜÉ=ï~ê=ÉÑÑçêíëK=
bñéçëÉÇ=íç=íÜÉ=åÉÖäÉÅíI=~ÄìëÉI=~åÇ=ÇÉÑáÅáÉåÅáÉë=áå=Å~êÉ=Ñçê=íÜÉ=ãÉåí~ääó=áääI=ã~åó=íêáÉÇ=íç=êÉÑçêã=íÜÉ=
                                                            
63

Torrey, Out of the Shadows, 1997, p. 102.
Id.
65
As a historical side note, some have theorized that institutionalization of the mentally ill in state psychiatric
facilities was also driven by cost-shifting incentives. State-run institutions emerged as a replacement to locally
funded workhouses and almshouses, thus shifting the cost of care for the mentally ill from local to state
governments. Gerald N. Grob, Mental Institutions in America 1-35 (1973).
64

66
67
68

Gronfein 201
Rochecroft, From Poorhouses to Homelessness, 1983, p. 34.
Id.

14 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

íêÉ~íãÉåí= çÑ= íÜÉ= ãÉåí~ääó= áääI= çÑíÉå= ~ÅíáåÖ= ~ë= ïÜáëíäÉÄäçïÉêë= ~åÇ= ê~áëáåÖ= éìÄäáÅ= ~ï~êÉåÉëë= çÑ= íÜÉ=
ÅçåÇáíáçåë=áå=íÜçëÉ=áåëíáíìíáçåëKSV=få=íÜÉ=Ñ~ää=çÑ=NVQPI=Ñçê=Éñ~ãéäÉI=íÜÉ=`äÉîÉä~åÇ=mêÉëë=éìÄäáëÜÉÇ=~=
ëÉêáÉë=çÑ=~êíáÅäÉë=~Äçìí=áåÜìã~åÉ=ÅçåÇáíáçåë=ïáíÜáå=`äÉîÉä~åÇ=pí~íÉ=eçëéáí~äI=Ä~ëÉÇ=çå=íÜÉ=~ÅÅçìåí=
çÑ= íÜÉ= ÅçåëÅáÉåíáçìë= çÄàÉÅíçêë= ëÉêîáåÖ= áå= íÜÉ= Üçëéáí~äKTM= qÜÉ= Éñéçë¨= ìäíáã~íÉäó= äÉÇ= íç= ~= Öê~åÇ= àìêó=
áåîÉëíáÖ~íáçåI=~åÇ=íÜÉ=ÑáêáåÖ=çÑ=íÜÉ=Üçëéáí~äÛë=ëìéÉêáåíÉåÇÉåíK==
líÜÉê= ÅêáíáÅ~ä= ~ÅÅçìåíë= çÑ= íÜÉ= ÅçåÇáíáçåë= áå= áåëíáíìíáçåë= ~äëç= êÉÅÉáîÉÇ= ëáÖåáÑáÅ~åí= éìÄäáÅ=
~ííÉåíáçåK= ^= ëÉêáÉë= çÑ= ~êíáÅäÉë= éìÄäáëÜÉÇ= áå= oÉ~ÇÉêÛë= aáÖÉëí= ÇÉëÅêáÄÉÇ= “ÜìåÇêÉÇë= çÑ= å~âÉÇ= ãÉåí~ä=
é~íáÉåíë= ÜÉêÇÉÇ= áåíç= ÜìÖÉI= Ä~êå= äáâÉI= ÑáäíÜJáåÑÉëíÉÇ= ï~êÇëI= áå= ~ää= ÇÉÖêÉÉë= çÑ= ÇÉíÉêáçê~íáçåI= ìåíÉåÇÉÇ=
TN
~åÇ=ìåíêÉ~íÉÇI=ëíêáééÉÇ=çÑ=ÉîÉêó=îÉëíáÖÉ=çÑ=Üìã~å=ÇÉÅÉåÅóI=ã~åó=áå=ëí~ÖÉë=çÑ=ëÉãáJëí~êî~íáçåKÒ =iáÑÉ=
j~Ö~òáåÉ= éìÄäáëÜÉÇ= “_ÉÇä~ã= NVQSIÒ= ~å= Éñéçë¨= íÜ~í= Ü~Ç= Öê~éÜáÅ= ~åÇ= ÇáëíìêÄáåÖ= éÜçíçë=
~ÅÅçãé~åóáåÖ= íÜÉ= ÇÉëÅêáéíáçå= çÑ= íÜÉ= éççê= íêÉ~íãÉåí= çÑ= ãÉåí~ääó= áää= é~íáÉåíëKTO= “qÜÉëÉ= íïç= ~êíáÅäÉëI=
~ééÉ~êáåÖ= áå= íïç= çÑ= íÜÉ= ã~Ö~òáåÉë= ïáíÜ= íÜÉ= ïáÇÉëí= ÅáêÅìä~íáçå= áå= íÜÉ= råáíÉÇ= pí~íÉëI= íêáÖÖÉêÉÇ= ~=
îçäÅ~åç=çÑ=ÉñéçëÉë=~åÇ=ÑÉ~íìêÉ=~êíáÅäÉë=áå=çíÜÉê=ã~Ö~òáåÉë=~åÇ=íÜÉ=Ç~áäó=éêÉëë=ïÜáÅÜ=ÅçåíáåìÉÇ=Ñçê=
ëÉîÉê~ä=óÉ~êëKÒTP=mÉêëçå~ä=~ÅÅçìåíë=çÑ=áåëíáíìíáçå~äáòÉÇ=äáÑÉ=Ñêçã=ÑçêãÉê=é~íáÉåíë=~åÇ=~ííÉåÇ~åíëI=ëìÅÜ=
~ë=j~êó=g~åÉ=t~êÇÛë=qÜÉ=på~âÉ=máíI=póäîá~=mä~íÜÛë=qÜÉ=_Éää=g~êI=~åÇ=hÉå=hÉëÉóÛë=låÉ=cäÉï=lîÉê=íÜÉ=
`ìÅâççÛë=kÉëíI=~ë=ïÉää=~ë=ÇçÅìãÉåí~êó=Ñáäãë=ëìÅÜ=~ë=cêÉÇÉêáÅâ=táëÉã~åÛë=NVST=qáíáÅìí=cçääáÉëI=Ö~îÉ=
ÇÉî~ëí~íáåÖ= áåëáÖÜí= áåíç= áåëíáíìíáçå~ä= äáÑÉK= ^ííÉåíáçå= Ñêçã= íÜÉ= éçéìä~ê= ãÉÇá~= ëÉÉãë= íç= Ü~îÉ= Ü~Ç= ~å=
ÉÑÑÉÅíX= ëìêîÉó= Ç~í~= Ñêçã= íÜÉ= éÉêáçÇ= ÅçåÑáêãë= ~= éçëáíáîÉ= ëÜáÑí= áå= éìÄäáÅ= çéáåáçå= “áå= íÉêãë= çÑ= ÄÉííÉê=
éìÄäáÅ=ìåÇÉêëí~åÇáåÖ=çÑ=ãÉåí~ä=áääåÉëë=~åÇ=ÖêÉ~íÉê=íçäÉê~åÅÉ=çê=~ÅÅÉéí~åÅÉ=çÑ=íÜÉ=ãÉåí~ääó=áääKÒTQ=^åÇ=
íÜÉ= áåÅêÉ~ëÉÇ= ~ÅÅÉéí~åÅÉ= ~åÇ= ìåÇÉêëí~åÇáåÖ= çÑ= íÜÉ= ãÉåí~ääó= áääI= ÅçìéäÉÇ= ïáíÜ= îáîáÇ= ÇÉéáÅíáçåë= çÑ=
~ÄìëÉ=áå=áåëíáíìíáçåëI=ëé~êâÉÇ=éìÄäáÅ=çìíÅêó=~Ö~áåëí=áåëíáíìíáçå~ä=éëóÅÜá~íêáÅ=Å~êÉK====
oÉîáäÉÇ=áå=íÜÉ=éçéìä~ê=éêÉëëI=ãÉåí~ä=áåëíáíìíáçåë=~äëç=êÉÅÉáîÉÇ=ÅêáíáÅáëã=áå=áåíÉääÉÅíì~ä=ÅáêÅäÉëK=
pçãÉI= ëìÅÜ= ~ë= qÜçã~ë= pò~ëò= áå= Üáë= áåÑäìÉåíá~ä= Äççâ= qÜÉ= jóíÜ= çÑ= jÉåí~ä= fääåÉëëITR= ëìÖÖÉëíÉÇ= íÜ~í=
ãÉåí~ä=áääåÉëë=ï~ë=~=ëçÅá~ä=ÅçåëíêìÅí=ìëÉÇ= íç= Åçåíêçä= ~åÇ= äáãáí= ÇÉîá~åÅó= áå= íÜÉ= éçéìä~íáçåKTS=líÜÉê=
áåÑäìÉåíá~ä= ïçêâëI= ëìÅÜ= ~ë= ^äÑêÉÇ= pí~åíçå= ~åÇ= jçêêáë= pÅÜï~êíòÛë= qÜÉ= jÉåí~ä= eçëéáí~ä= ~åÇ= bêîáåÖ=
dçÑÑã~åÛë= ^ëóäìãëI= ëìÖÖÉëíÉÇ= íÜ~í= áåëíáíìíáçå~äáò~íáçå= áíëÉäÑ= ïçêëÉåÉÇ= ãÉåí~ä= áääåÉëëK= píáää= çíÜÉê=
TT
ÅêáíáÅ~ä=ïçêâëI=ëìÅÜ=~ë=a~îáÇ=oçíÜã~åÛë= qÜÉ=aáëÅçîÉêó=çÑ=íÜÉ=^ëóäìãI =jáÅÜÉä=cçìÅ~ìäíÛë=j~ÇåÉëë=
                                                            
69

See generally, Alex Sareyan, The Turning Point (1994) (discussing how WWII conscientious objectors played a
significant role in exposing the poor treatment of institutionalized patients).
70
Alex Sareyan, The Turning Point 65-71 (1994).
71
Joseph Halpern et al., The Myths of Deinstitutionalization: Policies for the Mentally Disabled 3 (1980).
72
Gerald N. Grob & Howard H. Goldman, The Dilemma of Mental Health Care Policy 3 (2006).
73
74

Nina Ridenour, Mental Health in the United States: A Fifty-year History 107 (1961).
Rochecroft, From Poorhouses to Homelessness, 1983, p. 52.

75

Thomas Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (1961) (arguing against
modern psychiatry and denying the existence of mental illness).

76

See generally Gerald N. Grob, Mental Illness and American Society 1875-1940 15 (1983).
77. David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (1971).

15 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

~åÇ= `áîáäáò~íáçåITU= ~åÇ= dÉê~äÇ= dêçÄÛë= qÜÉ= pí~íÉ= ~åÇ= íÜÉ= jÉåí~ääó= fääITV= ê~áëÉÇ= èìÉëíáçåë= ~Äçìí= íÜÉ=
Åçåíáåìáíó= çÑ= ÅçåÑáåÉãÉåí= ~Åêçëë= ÇáÑÑÉêÉåí= êÉ~äãëI= ÉëéÉÅá~ääó= íÜÉ= ~ëóäìã= ~åÇ= íÜÉ= éêáëçåK= oáëáåÖ=
ëÉåíáãÉåí= ~Ö~áåëí= íÜÉ= ìëÉ= çÑ= áåëíáíìíáçåë= Ñçê= éëóÅÜá~íêáÅ= íêÉ~íãÉåíI= ÄìííêÉëëÉÇ= Äó= âåçïäÉÇÖÉ= çÑ= íÜÉ=
éççê=ÅçåÇáíáçåë=ïáíÜáå=áåëíáíìíáçåëI=ÉåÖÉåÇÉêÉÇ=~=êÉÑçêã=ãçîÉãÉåí=Ñçê=Åçããìåáíó=ãÉåí~ä=ÜÉ~äíÜI=
~å=~äíÉêå~íáîÉ=~ééêç~ÅÜ=íÜ~í=Ñ~îçêÉÇ=“~=ãçêÉ=ÇÉÅÉåíê~äáòÉÇI=ëÜçêíJíÉêãI=íêÉ~íãÉåíJçêáÉåíÉÇ=ëóëíÉã=çÑ=
ãÉåí~ä= ÜÉ~äíÜ= Å~êÉ= ëÉêîáÅÉëÒ= çîÉê= “äçåÖJíÉêã= ÅìëíçÇá~ä= Å~êÉÒ= áå= áåëíáíìíáçåëKUM= qÜÉëÉ= Åìäíìê~ä= ëÜáÑíëI=
ÄçíÜ=áå=éìÄäáÅ=ìåÇÉêëí~åÇáåÖ=çÑ= ãÉåí~ä=áääåÉëëI=~åÇ=áå=éÉêÅÉéíáçå=çÑ=áåëíáíìíáçå~äáòÉÇ=íêÉ~íãÉåí=çÑ=
íÜÉ=ãÉåí~ääó=áääI=ÅçåíêáÄìíÉÇ=íç=íÜÉ=ÇÉéçéìä~íáçå=íêÉåÇ=áå=áåëíáíìíáçåëK=====
få= ÅçåÅÉêí= ïáíÜ= ÅÜ~åÖáåÖ= ëçÅá~ä= éÉêÅÉéíáçåë= çÑ= íÜÉ= ãÉåí~ääó= áää= ~åÇ= ãÉåí~ä= ÜÉ~äíÜ= Å~êÉI=
ÇÉîÉäçéãÉåíë=ïáíÜáå=íÜÉ=ä~ï=êÉÖ~êÇáåÖ=ÅçåÑáåÉãÉåí=~åÇ=íêÉ~íãÉåí=çÑ=íÜÉ=ãÉåí~ääó=áää=~ÅÅÉäÉê~íÉÇ=íÜÉ=
íêÉåÇ= çÑ= ÇÉáåëíáíìíáçå~äáò~íáçåK= táíÜ= íÜÉ= éçäáíáÅ~ä= Ä~ÅâÇêçé= çÑ= íÜÉ= `áîáä= äáÄÉêíáÉë= ãçîÉãÉåíI=
~ÇîçÅ~íÉë=Ñçê=íÜÉ=ãÉåí~ääó=áää=îáÉïÉÇ=áåëíáíìíáçå~äáòÉÇ=Å~êÉ=åçí=~ë=~å=~ëóäìã=íç=éêçíÉÅí=íÜÉ=ãÉåí~ääó=
áääI=Äìí=~ë=~å=áåíêìëáçå=çå=íÜÉ=äáÄÉêíó=~åÇ=~ìíçåçãó=çÑ=íÜÉ=ãÉåí~ääó=áääI=~åÇ=íÜÉó=ëçìÖÜí=äÉÖ~ä=êÉÑçêãë=
êÉëíêáÅíáåÖ= áåîçäìåí~êó= éëóÅÜá~íêáÅ= íêÉ~íãÉåíKUN= páãáä~ê= íç= íÜÉ= k^^`mÛë= ëíê~íÉÖó= íç= ÉåÇ= ëÅÜççä=
ëÉÖêÉÖ~íáçåI= ~ÇîçÅ~íÉë= Ñçê= íÜÉ= ãÉåí~ääó= áää= ìëÉÇ= äáíáÖ~íáçå= íç= ÅÜáé= ~ï~ó= ~í= íÜÉ= äÉÖ~ä= ÑçìåÇ~íáçåë= çÑ=
áåëíáíìíáçå~ä=éëóÅÜá~íêáÅ=Å~êÉ=Äó=ÅÜ~ääÉåÖáåÖ=íÜÉ=éêçÅÉÇìêÉë=ÖçîÉêåáåÖ=ÅçããáíãÉåí=~åÇ=íêÉ~íãÉåíK==
^ÇîçÅ~íÉë= Ñáêëí= éìëÜÉÇ= Ñçê= ÜÉáÖÜíÉåÉÇ= éêçÅÉÇìê~ä= ÇìÉ= éêçÅÉëë= éêçíÉÅíáçåë= ïáíÜ= êÉÖ~êÇ= íç=
áåîçäìåí~êó= ÅçããáíãÉåíK= ^= ÜÉáÖÜíÉåÉÇ= ëí~åÇ~êÇ= Ñçê= ÅçããáíãÉåí= ïçìäÇ= Ü~îÉ= Ü~Ç= ÇáêÉÅí= ~åÇ=
Çê~ã~íáÅ=ÉÑÑÉÅíë=çå=íÜÉ=áåëíáíìíáçå~äáòÉÇ=éçéìä~íáçåI=ÄÉÅ~ìëÉ=íÜÉ=ãçëí=Åçããçå=é~íÜ=íç=~Çãáëëáçå=íç=
ãÉåí~ä= Üçëéáí~äë= ï~ë= áåîçäìåí~êó= ÅçããáíãÉåí= íÜêçìÖÜçìí= íÜÉ= É~êäó= é~êí= çÑ= íÜÉ= íïÉåíáÉíÜ= ÅÉåíìêó=
~åÇ= ïÉää= áåíç= íÜÉ= NVSMëK= UO= få= Ñ~ÅíI= áå= NVPVI= Ñçê= áåëí~åÅÉI= ~Äçìí= VM= éÉêÅÉåí= çÑ= ~ää= ~Çãáëëáçåë= ïÉêÉ=
UP
áåîçäìåí~êó= ÅçããáíãÉåíëK = få= lÛ`çååçê= îK= açå~äÇëçåI= íÜÉ= pìéêÉãÉ= `çìêí= ÜÉäÇ= íÜ~í= íÜÉ= ëí~íÉ=
ÅçìäÇ= åçí= “Åçåëíáíìíáçå~ääó= ÅçåÑáåÉ= ïáíÜçìí= ãçêÉ= ~= åçåÇ~åÖÉêçìë= áåÇáîáÇì~ä= ïÜç= áë= Å~é~ÄäÉ= çÑ=
ëìêîáîáåÖ=ë~ÑÉäó=áå=ÑêÉÉÇçã=Äó=ÜáãëÉäÑ=çê=ïáíÜ=íÜÉ=ÜÉäé=çÑ=ïáääáåÖ=~åÇ=êÉëéçåëáÄäÉ=Ñ~ãáäó=ãÉãÄÉêë=çê=
ÑêáÉåÇëKÒUQ=líÜÉê=Å~ëÉë=íÜ~í=ÑçääçïÉÇI=ëìÅÜ=~ë= ^ÇÇáåÖíçå=îK=qÉñ~ë=EêÉèìáêáåÖ=“ÅäÉ~ê=~åÇ=ÅçåîáåÅáåÖÒ=
ÉîáÇÉåÅÉ= áÑ= ~= éêçÅÉÉÇáåÖ= ã~ó= êÉëìäí= áå= áåÇÉÑáåáíÉ= ÅçåÑáåÉãÉåíFI= áãéçëÉÇ= ÑìêíÜÉê= ÇìÉ= éêçÅÉëë=
UR
êÉèìáêÉãÉåíë=çå=áåîçäìåí~êó=ÅçããáíãÉåí=éêçÅÉÇìêÉëK ==
                                                            
78. Michel Foucault, Madness and Civilization (Richard Howard trans., Vintage Books 1988) (1961).
79. Gerald N. Grob, The State and the Mentally Ill: A History of Worcester State Hospital in Massachusetts 1830–
1920 (1966).
80

Bernard L. Bloom, Community Mental Health 20 (2d ed.1984).
See, for example, Stephen T. Morse, A Preference for Liberty: The Case against Involuntary Commitment of the
Mentally Disordered, 70 Cal. L. Rev. 54 (1982); Torrey, Out of the Shadows, 1997, p. 142.

81

82

William Gronfein, “Incentives and Intentions,” 1985, p. 194.

83

Id.
422 U.S. 563, 575 (1975).
85
Stephen Rachlin, “The Influence of Law on Deinstitutionalization,” in Deinstitutionalization 41, 46-51 (Leona L.
Barasch ed., 1983).
84

16 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

^ÇîçÅ~íÉë= íÜÉå= ëçìÖÜí= íç= ÉñÉêí= éêÉëëìêÉ= çå= áåëíáíìíáçåë= íç= êÉäÉ~ëÉ= é~íáÉåíë= íÜêçìÖÜ= íÜÉ=
Éëí~ÄäáëÜãÉåí=çÑ=ãáåáã~ääó=~ÇÉèì~íÉ= ëí~åÇ~êÇë=çÑ=Å~êÉI=çê=“êáÖÜí=íç=íêÉ~íãÉåíKÒ=få=NVTOI=íÜÉ=cáÑíÜ=
`áêÅìáí= áå= tó~íí= îK= píáÅâåÉóI= ÑáåÇáåÖ= íÜÉ= íêÉ~íãÉåí= çÑ= é~íáÉåíë= áå= ^ä~Ä~ã~= ìåÅçåëíáíìíáçå~äI= ÜÉäÇ=
íÜ~í=íÜÉ=Åçåëíáíìíáçå=Öì~ê~åíÉÉë=~=êáÖÜí=íç=íêÉ~íãÉåí=~åÇ=Ü~Äáäáí~íáçå=Ñçê=Åáîáääó=ÅçããáííÉÇ=éÉêëçåë=áå=
ëí~íÉ= áåëíáíìíáçåëKUS= _ÉÅ~ìëÉ= íÜÉ= ëí~íÉ= ï~ë= ìå~ÄäÉ= íç= ãÉÉí= íÜÉ= àìÇáÅá~ääóJã~åÇ~íÉÇ= ëí~åÇ~êÇë= çÑ=
ãáåáã~ääó= êÉèìáêÉÇ= Å~êÉI= íÜçìë~åÇë= çÑ= é~íáÉåíë= ïÉêÉ= êÉäÉ~ëÉÇKUT= qÜÉ= êÉãÉÇóI= ÇÉéçéìä~íáçåI= ï~ë= ~å=
áåíÉåíáçå~ä= çìíÅçãÉX= ~= êáÖÜí= íç= íêÉ~íãÉåí= íÜ~í= ëÉí= ~å= ìå~íí~áå~ÄäÉ= ëí~åÇ~êÇ= çÑ= Å~êÉ= ï~ë= ëÉÉåI= Äó=
~ÇîçÅ~íÉëI= ~ë= “íÜÉ= ÄÉëí= ï~ó= íç= ÇÉáåëíáíìíáçå~äáòÉ= íÜçìë~åÇë= çÑ= éÉçéäÉKÒUU= qÜÉëÉ= ÇÉÅáëáçåëI= ïÜáÅÜ=
ÜÉáÖÜíÉåÉÇ= íÜÉ= éêçÅÉÇìêÉë= êÉèìáêÉÇ= Ñçê= ÅçããáíãÉåí= ~åÇ= íÜÉ= ëí~åÇ~êÇë= çÑ= Å~êÉ= Ñçê= íÜÉ= ÅçããáííÉÇ=
“ÉñÉêíÉÇ= ÅçåíáåìáåÖ= éêÉëëìêÉ= çå= ëí~íÉ= Üçëéáí~ä= éÜóëáÅá~åë= ~åÇ= ~Çãáåáëíê~íçêë= íç= ÇáëÅÜ~êÖÉ= ÉñáëíáåÖ=
é~íáÉåíë=~åÇ=êÉàÉÅí=åÉï=çåÉëKÒUV=
qÜÉêÉ=ïÉêÉI=áå=ëìãI=~=åìãÄÉê=çÑ=áåíÉêïçîÉå=Ñ~Åíçêë=íÜ~í=ÅçåîÉêÖÉÇ=áå=íÜÉ=éÉêáçÇ=ÑçääçïáåÖ=
tçêäÇ= t~ê= ff= íÜ~í= ïçìäÇI= íçÖÉíÜÉêI= ëÜáÑí= éìÄäáÅ= éçäáÅó= ~ï~ó= Ñêçã= ãÉåí~ä= áåëíáíìíáçå~äáò~íáçå= ~åÇ=
ÜÉäé=ÅçåíêáÄìíÉ=íç=íÜÉ=ã~ëëáîÉ=ÇÉáåëíáíìíáçå~äáò~íáçå=íÜ~í=íççâ=éä~ÅÉ=ÇìêáåÖ=íÜÉ=éÉêáçÇ=NVRR=íç=NVUMK=
qÜçìÖÜ=f=Ü~îÉ=ÑçÅìëÉÇ=çå=íÜÉ=íÜêÉÉ=äÉ~ÇáåÖ=Ñ~Åíçêë=áÇÉåíáÑáÉÇ=áå=íÜÉ=êÉëÉ~êÅÜ=äáíÉê~íìêÉI=çíÜÉê=ÑçêÅÉë=
ïÉêÉ=~äëç=~í=éä~óK=dÉê~äÇ=dêçÄI=íÜÉ=äÉ~ÇáåÖ=ëÅÜçä~ê=çå=íÜÉ=íçéáÅI=ëìãã~êáòÉë=íÜÉ=ïáÇÉê=ä~åÇëÅ~éÉ=~ë=
ÑçääçïëW=
cáêëíI= íÜÉ= ÉñéÉêáÉåÅÉ= çÑ= tçêäÇ= t~ê= ff= ~ééÉ~êÉÇ= íç= ÇÉãçåëíê~íÉ= íÜÉ= ÉÑÑáÅ~Åó= çÑ= Åçããìåáíó=
~åÇ= çìíé~íáÉåí= íêÉ~íãÉåí= çÑ= ÇáëíìêÄÉÇ= éÉêëçåëK= pÉÅçåÇI= ~= ëÜáÑí= áå= éëóÅÜá~íêáÅ= íÜáåâáåÖ=
ÑçëíÉêÉÇ=êÉÅÉéíáîáíó=íçï~êÇ=~=éëóÅÜçÇóå~ãáÅ=~åÇ=éëóÅÜç~å~äóíáÅ=ãçÇÉä=íÜ~í=ÉãéÜ~ëáòÉÇ=äáÑÉ=
ÉñéÉêáÉåÅÉë= ~åÇ= íÜÉ= êçäÉ= çÑ= ëçÅáçÉåîáêçåãÉåí~ä= Ñ~ÅíçêëK= qÜáêÇI= íÜÉ= ÄÉäáÉÑ= íÜ~í= É~êäó=
áåíÉêîÉåíáçå=áå=íÜÉ=Åçããìåáíó=ïçìäÇ=ÄÉ=ÉÑÑÉÅíáîÉ=áå=éêÉîÉåíáåÖ=ëìÄëÉèìÉåí=Üçëéáí~äáò~íáçå=
ÄÉÅ~ãÉ= éçéìä~êI= ~= ÄÉäáÉÑ= ÑçëíÉêÉÇ= Äó= éëóÅÜá~íêáëíë= ~åÇ= çíÜÉê= ãÉåí~ä= ÜÉ~äíÜ= éêçÑÉëëáçå~äë=
áÇÉåíáÑáÉÇ= ïáíÜ= ~= éìÄäáÅ= ÜÉ~äíÜ= çêáÉåí~íáçåK= cçìêíÜI= ~= éÉêî~ëáîÉ= Ñ~áíÜ= ÇÉîÉäçéÉÇ= íÜ~í=
éëóÅÜá~íêó=ï~ë=~ÄäÉ=íç=áÇÉåíáÑó=E~åÇ=éêÉëìã~Ääó=~ãÉäáçê~íÉF=íÜçëÉ=ëçÅá~ä=~åÇ=ÉåîáêçåãÉåí~ä=
ÅçåÇáíáçåë= íÜ~í= éä~óÉÇ= ~å= áãéçêí~åí= êçäÉ= áå= íÜÉ= ÉíáçäçÖó= çÑ= ãÉåí~ä= áääåÉëëÉëK= cáÑíÜI= íÜÉ=
áåíêçÇìÅíáçå= çÑ= éëóÅÜçäçÖáÅ~ä= ~åÇ= ÄáçäçÖáÅ~ä= íÜÉê~éáÉë= EáåÅäìÇáåÖI= Äìí= åçí= äáãáíÉÇ= íçI=
éëóÅÜçíêçéáÅ=ÇêìÖëF=ÜÉäÇ=çìí=íÜÉ=éêçãáëÉ=çÑ=~=ãçêÉ=åçêã~ä=ÉñáëíÉåÅÉ=Ñçê=áåÇáîáÇì~äë=çìíëáÇÉ=
ãÉåí~ä=Üçëéáí~äëK=cáå~ääóI=~å=ÉåÜ~åÅÉÇ=ëçÅá~ä=ïÉäÑ~êÉ=êçäÉ=Ñçê=íÜÉ=ÑÉÇÉê~ä=ÖçîÉêåãÉåí=åçí=çåäó=
ÄÉÖ~å=íç=ÇáãáåáëÜ=íÜÉ=~ìíÜçêáíó=çÑ=ëí~íÉ=ÖçîÉêåãÉåíë=Äìí=~äëç=Ü~ëíÉåÉÇ=íÜÉ=íê~åëáíáçå=Ñêçã=
~å=áåëíáíìíáçå~ääó=Ä~ëÉÇ=íç=~=ÅçããìåáíóJçêáÉåíÉÇ=éçäáÅóKVM==
_K aê~ïáåÖ=m~ê~ääÉäë=ïáíÜ=íÜÉ=`ìêêÉåí=páíì~íáçå=çÑ=j~ëë=fåÅ~êÅÉê~íáçå=
                                                            
86
87
88
89
90

344 F. Supp. 373 (M. D. Ala 1972).
Torrey, Out of the Shadows, 1997, p. 144.
Id. at 144 n13.
Id. at p. 145.
Grob, From Asylum to Community, 1991, at page 4.

17 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

f=ïáää=íìêåI=åçïI=íç=çìê=ÅìêêÉåí=ëáíì~íáçåI=áå=çêÇÉê=íç=ÉñéäçêÉ=ïÜÉíÜÉê=íÜÉëÉ=Ñ~Åíçêë=êÉëçå~íÉ=
áå=íçÇ~óÛë=ÅçåíÉñí=~åÇ=ïÜÉíÜÉê=íÜÉó=ãáÖÜí=ÅçåÅÉáî~Ääó=éçáåí=ìë=áå=ìëÉÑìä=ÇáêÉÅíáçåë=íç=ÜÉäé=~ääÉîá~íÉ=
íÜÉ=éêçÄäÉã=çÑ=ã~ëë=áåÅ~êÅÉê~íáçåK==
~K mêÉëÅêáÄÉÇ=aêìÖë=~åÇ=líÜÉê=_áçäçÖáÅ~ä=fåíÉêîÉåíáçåë=
lå= íÜÉ= èìÉëíáçå= çÑ= éêÉëÅêáéíáçå= ÇêìÖë= ~åÇ= ãÉåí~ä= ÜÉ~äíÜ= íêÉ~íãÉåíI= íïç= íÜáåÖë= ~êÉ= èìáíÉ=
ÅäÉ~êW==cáêëíI=íÜÉ=ÅçåÇáíáçå=çÑ=ãÉåí~ääó=áää=éêáëçåÉêë=áå=ëí~íÉ=ÅçêêÉÅíáçå~ä=ëóëíÉãë=~åÇ=Åçìåíó=à~áäë=áë=çÑ=
áåÅêÉ~ëáåÖ=ÅçåÅÉêå=å~íáçåïáÇÉK=qÜÉ=ëíçêáÉë=çÑ=áåÇáîáÇì~ä=áåã~íÉë=~êÉ=ÜçêêáÑóáåÖK=^=éêáëçå=áåã~íÉ=áå=
g~ÅâëçåI=jáÅÜáÖ~åÔïÜç=~ìíÜçêáíáÉë=ÇÉëÅêáÄÉÇ=~ë=“ÑäçêáÇäó=éëóÅÜçíáÅÒÔÇáÉÇ=áå=Üáë=ëÉÖêÉÖ~íáçå=ÅÉääI=
å~âÉÇI=ëÜ~ÅâäÉÇ=íç=~=ÅçåÅêÉíÉ=ëä~ÄI=äóáåÖ=áå=Üáë=çïå=ìêáåÉI=ëÅÜÉÇìäÉÇ=Ñçê=~=ãÉåí~ä=ÜÉ~äíÜ=íê~åëÑÉê=íÜ~í=
VN
åÉîÉê= Ü~ééÉåÉÇK = ^åçíÜÉê= áåã~íÉI= ëÅÜáòçéÜêÉåáÅI= ÖçìÖÉÇ= Üáë= ÉóÉë= çìí= ~ÑíÉê= ï~áíáåÖ= ïÉÉâë= Ñçê=
íê~åëÑÉê=íç=~=ãÉåí~ä=Üçëéáí~ä=áå=`äÉ~êï~íÉêI=cäçêáÇ~KVO=jÉ~åïÜáäÉI=íÜÉ=ÜÉ~Ç=çÑ=cäçêáÇ~Ûë=ëçÅá~ä=ëÉêîáÅÉë=
ï~ë= ÑçêÅÉÇ= íç= êÉëáÖå= ~Äêìéíäó= áå= OMMS= ~ÑíÉê= ÄÉáåÖ= ÑáåÉÇ= AUMIMMM= ~åÇ= Ñ~ÅáåÖ= Åêáãáå~ä= ÅçåíÉãéí=
ÅÜ~êÖÉë=Ñçê=Ñ~áäáåÖ=íç=íê~åëÑÉê=ëÉîÉêÉäó=ãÉåí~ääó=áää=à~áä=áåã~íÉë=íç=ëí~íÉ=Üçëéáí~äëKVP=dáîÉå=íÜÉ=é~ìÅáíó=
çÑ= ãÉåí~ä= ÜÉ~äíÜ= Å~êÉ= Ñçê= éêáëçåÉêëI= áí= áë= ÇáÑÑáÅìäí= íç= ÖÉí= ~= ÖççÇ= ëÉåëÉ= çÑ= Üçï= ã~åó= áåã~íÉë= Ü~îÉ=
ëÉêáçìë=ãÉåí~ä=ÜÉ~äíÜ=ÅçåÇáíáçåëK=tÜ~í=ïÉ=âåçï=áë=íÜ~íI=~í=íÜÉ=íìêå=çÑ=íÜÉ=íïÉåíáÉíÜ=ÅÉåíìêóI=íÜÉêÉ=
ï~ë= ~= ÜáÖÜ= äÉîÉä= çÑ= Çá~ÖåçëÉÇ= ãÉåí~ääó= áää= çÑÑÉåÇÉêë= áå= éêáëçåë= ~åÇ= à~áäë= áå= íÜÉ= råáíÉÇ= pí~íÉëÔ
OUPIUMM=áå=NVVUÔêÉéêÉëÉåíáåÖ=NSB=çÑ=à~áä=~åÇ=ëí~íÉ=éêáëçå=áåã~íÉëKVQ=tÉ=~äëç=âåçï=íÜ~íI=~ÅÅçêÇáåÖ=
íç= ~= ëíìÇó= êÉäÉ~ëÉÇ= Äó= íÜÉ= gìëíáÅÉ= aÉé~êíãÉåí= áå= pÉéíÉãÄÉê= OMMSI= RS= éÉêÅÉåí= çÑ= áåã~íÉë= áå= ëí~íÉ=
éêáëçåë= ~åÇ= SQ= éÉêÅÉåí= çÑ= áåã~íÉë= ~Åêçëë= íÜÉ= Åçìåíêó= êÉéçêíÉÇ= ãÉåí~ä= ÜÉ~äíÜ= éêçÄäÉãë= ïáíÜáå= íÜÉ=
é~ëí= óÉ~êXVR= ãìÅÜ= çÑ= íÜáë= áë= ~ëëçÅá~íÉÇ= ïáíÜ= ÇÉéêÉëëáçåI= ~åÇ= íÜ~í= ÇÉéêÉëëáçå= ã~ó= ÄÉ= Å~ìëÉ= Äó= íÜÉ=
áåëíáíìíáçå~äáò~íáçå= áíëÉäÑK= räíáã~íÉäóI= áí= áë= ÉñíêÉãÉäó= Ü~êÇ= íç= èì~åíáÑó= ÅçêêÉÅíäó= íÜÉ= åìãÄÉê= çÑ=
ÇÉí~áåÉÇ=áåã~íÉë=ïÜç=åÉÉÇI=Äìí=~êÉ=åçí=êÉÅÉáîáåÖ=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉ=~åÇ=ãÉÇáÅ~íáçåK=_ìí=íÜÉêÉ=áë=åç=
èìÉëíáçå= íÜ~í= íÜÉ= åìãÄÉê= áë= îÉêó= ÜáÖÜ= ~åÇ= íÜ~í= íêÉ~íãÉåí= ~åÇ= ãÉÇáÅ~íáçå= ÅçìäÇ= ëìÄëíáíìíÉ= Ñçê=
ÅçåíáåìÉÇ=ÇÉíÉåíáçå=áå=ã~åó=Å~ëÉëI=ïÜáÅÜ=ïçìäÇ=å~íìê~ääó=ÜÉäé=~ääÉîá~íÉ=ã~ëë=áåÅ~êÅÉê~íáçåK==
qÜÉ=ëÉÅçåÇ=íÜáåÖ=íÜ~í=áë=ÅäÉ~ê=áë=íÜ~í=íÜÉ=ìëÉ=çÑ=éêÉëÅêáÄÉÇ=ãÉÇáÅ~íáçå=áå=íÜÉ=råáíÉÇ=pí~íÉë=
Ü~ë=áåÅêÉ~ëÉÇ=ã~êâÉÇäó=ëáåÅÉ=íÜÉ=NVRMëK=qçÇ~óI=~ÅÅçêÇáåÖ=íç=Ç~í~=Ñêçã=íÜÉ=aÉé~êíãÉåí=çÑ=eÉ~äíÜ=
~åÇ=eìã~å=pÉêîáÅÉëI=~Äçìí=Ü~äÑ=çÑ=~ää=^ãÉêáÅ~åë=í~âÉ=~í=äÉ~ëí=çåÉ=éêÉëÅêáéíáçå=ÇêìÖI=ïáíÜ=~Äçìí=çåÉ=
VS
áå=ëáñ=^ãÉêáÅ~åë=í~âáåÖ=íÜêÉÉ=çê=ãçêÉ=ãÉÇáÅ~íáçåëK =fí=áë=éêçÄ~Ääó=Ñ~áê=íç=ë~ó=íÜ~í=íÜÉ=råáíÉÇ=pí~íÉë=
                                                            
91

Libby Sander, “Inmate’s Death in Solitary Cell Prompts Judge to Ban Restraints,” New York Times, November 15,
2006.
92
Abby Goodnough, “Officials Clash Over Mentally Ill in Florida Jails,” New York Times, November 15, 2006.
93
Alisa Ulferts, “Head of DCF is fined $80,000,” New York Times, December 1, 2006.
94
Paula M. Ditton, Bureau of Justice Statistics, U.S. Dep’t of Justice, Special Report: Mental Health and the
Treatment of Inmates and Probationers 3 (1999), available at http://www.ojp.usdoj.gov/bjs/pub/pdf/mhtip.pdf.
95

Erik Eckholm, “Inmates Report Mental Illness at High Levels,” New York Times, September 7, 2006.
See Health, United States, 2004, Report of the US Department of Health and Human Services, updated at
http://www.cdc.gov/nchs/data/hus/hus09.pdf#executivesummary. See also ABC News Report here:
http://abclocal.go.com/kabc/story?section=news/health&id=6143292
;
Bloomberg
Report
here:
http://www.bloomberg.com/news/2010-09-02/prescription-drug-use-rose-to-include-half-of-americans-in-2008-u-ssays.html. For a fascinating discussion of the implications and outsourcing of pharmaceutical trials, see Kaushik
96

18 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

áë=çåÉ=çÑ=íÜÉ=ãçëí=ãÉÇáÅ~íÉÇ=å~íáçåë=áå=íÜÉ=ïçêäÇ=íçÇ~óK=kçïI=íç=ÄÉ=ëìêÉI=íÜÉ=çîÉê~ää=êáëÉ=áå=íÜÉ=ìëÉ=
çÑ=éêÉëÅêáéíáçå=ãÉÇáÅ~íáçåë=ÅçáåÅáÇÉÇ=ïáíÜ=íÜÉ=ëÜ~êé=áåÅêÉ~ëÉ=áå=íÜÉ=éêáëçå=éçéìä~íáçå=çîÉê=íÜÉ=é~ëí=
Ñçêíó= óÉ~êëK= pçI= ãçêÉ= ÇêìÖë= ~êÉ= åçí= åÉÅÉëë~êáäó= ~= é~å~ÅÉ~K= eçïÉîÉêI= íÜÉêÉ= áë= åç= ï~ó= çÑ= âåçïáåÖI=
ïáíÜçìí=ÑìêíÜÉê=êÉëÉ~êÅÜI=ïÜÉíÜÉê=íÜÉ=éçéìä~íáçåë=~í=êáëâ=çÑ=áåÅ~êÅÉê~íáçå=~êÉ=~ãçåÖ=íÜçëÉ=ïÜç=Ü~îÉ=
ÉñéÉêáÉåÅÉÇ= áåÅêÉ~ëÉÇ= ìëÉ= çÑ= éêÉëÅêáéíáçå= ÇêìÖëI= åçê= ïÜÉíÜÉê= íÜÉ= áåÅêÉ~ëÉÇ= ìëÉ= çÑ= éêÉëÅêáéíáçå=
ãÉÇáÅ~íáçå= ~Åíì~ääó= Ç~ãéÉåÉÇ= éêáëçå= ÖêçïíÜK= fÑ= áåÇÉÉÇ= íÜÉ= ÅçêêÉä~íáçå= ÄÉíïÉÉå= ãÉÇáÅ~íáçå= ~åÇ=
éêáëçå= éçéìä~íáçå= çéÉê~íÉë= íÜêçìÖÜ= ÅêáãáåçÖÉåáÅ= ÄÉÜ~îáçêÔáå= çíÜÉê= ïçêÇëI= áÑ= ïÉ= ~ëëìãÉ= ~= ÇáêÉÅí=
ÅêáãÉ= ~åÇ= éìåáëÜãÉåí= åÉñìëI= ïÜáÅÜ= áë= ~= êÉä~íáîÉäó= ëáãéäáëíáÅ= ~ëëìãéíáçåÔïÉ= ëíáää= Çç= åçí= âåçï=
ïÜÉíÜÉê=íÜÉ=áåÅêÉ~ëÉÇ=ìëÉ=çÑ=ãÉÇáÅ~íáçå=çîÉê=íÜÉ=ä~ëí=RM=óÉ~êë=~Åíì~ääó=Ç~ãéÉåÉÇ=éêáëçå=ÖêçïíÜ=çê=
Ü~Ç=åç=ÉÑÑÉÅíI=ÖáîÉå=íÜÉ=ëáãìäí~åÉáíó=éêçÄäÉãW=áí=áë=ÉåíáêÉäó=éçëëáÄäÉ=íÜ~í=íÜÉ=éêáëçå=éçéìä~íáçå=ÅçìäÇ=
Ü~îÉ=êáëÉå=ÉîÉå=ãçêÉ=áÑ=íÜÉêÉ=Ü~Ç=ÄÉÉå=äÉëë=ÖÉåÉê~äáòÉÇ=ìëÉ=çÑ=éêÉëÅêáÄÉÇ=ãÉÇáÅ~íáçåK==
låÉ=èìÉëíáçå=íç=éçëÉI=íÜÉåI=áë=ïÜÉíÜÉê=íÜÉ=ÉåÜ~åÅÉÇ=ìëÉ=çÑ=ãÉÇáÅ~íáçåë=ãáÖÜí=ÅçåíêáÄìíÉ=íç=
ÇÉáåëíáíìíáçå~äáò~íáçå=çÑ=çìê=éêáëçåë\=qÜÉêÉ=~êÉ=êÉ~ëçåë=íç=íÜáåâ=íÜ~í=áí=ãáÖÜíK=qÜÉ=ìëÉ=çÑ=qÜçê~òáåÉ=
íç=íêÉ~í=îáçäÉåí=~åÇ=~åíáJëçÅá~ä=ÄÉÜ~îáçê=Ü~ë=ÄÉÅçãÉ=Åçããçåéä~ÅÉ=ÄçíÜ=áå=~åÇ=çìíëáÇÉ=çÑ=íÜÉ=éêáëçå=
ÅçåíÉñíVTÔ~åÇ= áí= áë= åçí= áããÉÇá~íÉäó= ~éé~êÉåí= íÜ~í= áåÅêÉ~ëÉÇI= îçäìåí~êó= ãÉÇáÅ~äáò~íáçå= ïçìäÇ= ÄÉ=
ãçê~ääóI= ÉíÜáÅ~ääóI= çê= éçäáíáÅ~ääó= ïçêëÉ= íÜ~å= ÑçêÅáÄäÉ= ÇÉíÉåíáçå= áå= éêáëçåK= qÜáë= ê~áëÉë= ÅçãéäÉñ=
èìÉëíáçåë=~Äçìí=éêáëçåÉêë=~åÇ=ÅçåëÉåíÔèìÉëíáçåë=íÜ~í=f=ÉñéäçêÉ=ÉäëÉïÜÉêÉKVU=_ìí=íÜÉ=~äíÉêå~íáîÉë=~êÉ=
åçí=ïáíÜçìí=íÜÉáê=çïå=éêçÄäÉãëÔãçê~äI=ÉíÜáÅ~äI=~åÇ=éçäáíáÅ~äK=mÉêÜ~éë=áí=áëI=áå=íÜÉ=ÉåÇI=~=c~ìëíá~å=
Ä~êÖ~áåI=Äìí=çåÉ=ïçêíÜ=í~âáåÖK=
qÜÉêÉ=~êÉ=~=åìãÄÉê=çÑ=çíÜÉê=ÇáëÅêÉíÉ=éçéìä~íáçåë=íÜ~í=ÅçìäÇ=ÄÉI=~åÇ=áå=Ñ~Åí=íçÇ~ó=~êÉ=ÄÉáåÖ=
í~êÖÉíÉÇ= Ñçê= áåÅêÉ~ëÉÇ= éÜ~êã~ÅÉìíáÅ~ä= áåíÉêîÉåíáçåëK= qÜÉ= Ñáêëí= áåîçäîÉë= ëÉñì~ä= çÑÑÉåÇÉêëK= qÜÉêÉ= Ü~ë=
ÄÉÉå= ~= äçí= çÑ= êÉëÉ~êÅÜ= áåîÉëíáÖ~íáåÖ= íÜÉ= éçëëáÄáäáíó= ~åÇ= ÉÑÑÉÅíáîÉåÉëë= çÑ= ÄáçäçÖáÅ~ä= áåíÉêîÉåíáçåëI=
áåÅäìÇáåÖ= íÉëíçëíÉêçåÉJäçïÉêáåÖ= Üçêãçå~ä= íêÉ~íãÉåíëI= ïáíÜ= ~å= ÉóÉ= íç= êÉÇìÅáåÖ= ëÉñì~ä= çÑÑÉåÇÉê=
êÉÅáÇáîáëãK= mÜ~êã~ÅçäçÖáÅ~ääóJÄ~ëÉÇ= íêÉ~íãÉåí= çéíáçåë= Ü~îÉ= ÄÉÉå= ÇÉîÉäçéÉÇ= áå= ~å= ÉÑÑçêí= íç=
ÅÜÉãáÅ~ääó=~äíÉê=ëÉñì~ä=ÇêáîÉë=~åÇ=çÑÑÉåÇáåÖ=ÄÉÜ~îáçêK=pçãÉ=çÑ=íÜÉ=éÜ~êã~ÅçäçÖáÅ~ä=ÇÉîÉäçéãÉåíë=áå=
íÜáë=~êÉ~=áåÅäìÇÉ=íÜÉ=ÇÉîÉäçéãÉåí=çÑ=ëÉäÉÅíáîÉ=ëÉêçíçåáå=êÉJìéí~âÉ=áåÜáÄáíçêë=EppofëFI=ïÜáÅÜ=~êÉ=~äëç=
ìëÉÇ= ~ë= ~åíáJÇÉéêÉëë~åíë= Ñçê= íÜÉ= íêÉ~íãÉåí= çÑ= ~åñáÉíó= ~åÇ= çíÜÉê= éÉêëçå~äáíó= ÇáëçêÇÉêëX=
éëóÅÜçëíáãìä~åíëX= Üçêãçå~ä= íêÉ~íãÉåí= ÉñéÉêáãÉåíëX= ~åÇ= ~åíá~åÇêçÖÉå= íêÉ~íãÉåí= EdåoeëFI= ïÜáÅÜ=

                                                                                                                                                                                                
Sunder Rajan’s article in the New Left Review titled “Biocapital: Indian Clinical Trials and Surplus Health” available
here: http://www.forliberation.org/site/archive/issue0807/article020807.htm.
97
See generally Eric Silver, Richard B. Felson, and Matthew Vaneseltine, “The Relationship between Mental Health
Problems and Violence among Criminal Offenders,” Criminal Justice and Behavior 35, no. 4 (2008): 405-26; Tony
Butler, Peter W. Schofield, David Greenberg, Stephen H. Allnutt, Devon Indig, Vaughan Carr, Catherine D'Este,
Philip B. Mitchell, Lee Knight, and Andrew Ellis, “Reducing Impulsivity in Repeat Violent Offenders: An Open
Label Trial of a Selective Serotonin Reuptake Inhibitor,” Australian and New Zealand Journal of Psychiatry 44, no.
12 (2010): 1137-43.
98
Bernard E. Harcourt, “Making Willing Bodies: Manufacturing Consent Among Prisoners and Soldiers, Creating
Human Subjects, Patriots, and Citizens,” work-in-progress paper to be presented at the New School Conference on
The Body and the State on February 11, 2011.

19 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

~êÉ=ÜçêãçåÉ=êÉÅÉéíçê=~åí~Öçåáëí=ÅçãéçìåÇë=íÜ~í=ÜÉäé=éêÉîÉåí=çê=áåÜáÄáí=íÜÉ=ÄáçäçÖáÅ=ÉÑÑÉÅíë=çÑ=ã~äÉ=
ëÉñì~ä=ÜçêãçåÉëKVV=
^=ëÉÅçåÇ=í~êÖÉí=éçéìä~íáçå=áë=àìîÉåáäÉ=çÑÑÉåÇÉêëKNMM=få=íÜáë=ÅçåíÉñíI=íÜÉêÉ=Ü~ë=~=ÄÉÉå=~=äçí=çÑ=
êÉëÉ~êÅÜ= ÑçÅìëÉÇ= çå=“ÅçåÇìÅí= ÇáëçêÇÉêÒ= ~åÇ= íÜÉ= ÇÉîÉäçéãÉåí= çÑ= ~åíáã~åáÅ= ãÉÇáÅ~íáçåë= Ñçê= ÅÉêí~áå=
Ñçêãë=çÑ=ÜóéÉê~Åíáîáíó=ÇáëçêÇÉêëI=~ë=ïÉää=~ë=íÜÉ=ìëÉ=çÑ=éëóÅÜçäçÖáÅ~ä=~ëëÉëëãÉåíë=äáâÉ=íÜÉ=jpvpfJO=~åÇ=
j^vpfJO= íç= áÇÉåíáÑó= éçíÉåíá~ä= àìîÉåáäÉ= çÑÑÉåÇÉêë= ~åÇ= íÜÉå= ÑáåÇ= ÇáîÉêëáçå~êó= éêçÖê~ãë= Ñçê= íÜÉãK=
qÜÉëÉ= ÇáîÉêëáçå~êó= éêçÖê~ãë= çÑíÉå= áåîçäîÉ= çìíé~íáÉåí= éêçÖê~ãë= íÜ~í= áåÅçêéçê~íÉ= íÜÉ= ìëÉ= çÑ=
ãÉÇáÅ~íáçåK= ^= ÖççÇ= Éñ~ãéäÉ= áë= íÜÉ= tê~é^êçìåÇ= jáäï~ìâÉÉ= éêçÖê~ãI= ïáååÉê= áå= OMMV= çÑ= íÜÉ=
e~êî~êÇ= gch= pÅÜççä= fååçî~íáçåë= áå= ^ãÉêáÅ~å= dçîÉêåãÉåí= ~ï~êÇI= ~å= çìíé~íáÉåí= ã~å~ÖÉÇ= Å~êÉ=
éêçÖê~ã=íÜ~í=áë=çéÉê~íÉÇ=Äó=íÜÉ=jáäï~ìâÉÉ=`çìåíó=_ÉÜ~îáçê~ä=eÉ~äíÜ=aáîáëáçå=~åÇ=íÜ~í=áë=ÇÉëáÖåÉÇ=
íç=éêçîáÇÉ=áåÇáîáÇì~äáòÉÇ=Å~êÉ=íç=óçìíÜë=ïáíÜ=ãÉåí~ä=ÜÉ~äíÜ=~åÇ=Éãçíáçå~ä=åÉÉÇëKNMN=^=íÜáêÇ=í~êÖÉíÉÇ=
éçéìä~íáçå= áåîçäîÉë= íÜÉ= çìíé~íáÉåí= íêÉ~íãÉåí= çÑ= ÇêìÖ= ~ÇÇáÅíáçåK= cçê= åçåJîáçäÉåí= ÇêìÖ= çÑÑÉåÇÉêëI=
íÜÉêÉ= ~êÉ= åçï= ïÉääJÉëí~ÄäáëÜÉÇ= çìíé~íáÉåí= íêÉ~íãÉåíë= ìëáåÖ= ãÉíÜ~ÇçåÉI= ÄìéêÉåçêéÜáåÉI= äçÑÉñáÇáåÉI=
~åÇ=å~äíêÉñçåÉX=~ë=ïÉää=~ë=ÇáîÉêëáçå~êó=éêçÖê~ãë=~åÇ=î~êáçìë=çìíé~íáÉåí=Å~êÉ=éêçÖê~ãëKNMO==
qÜÉ=ãçÇÉä=íÜêçìÖÜçìí=íÜÉëÉ=î~êáçìë=ÇÉîÉäçéãÉåíëI=ÉëëÉåíá~ääóI=áë=íç=áÇÉåíáÑó=éÜóëáçäçÖáÅ~ä=çê=
ÄáçäçÖáÅ~ä= Å~ìëÉë= çÑ= îáçäÉåí= ÄÉÜ~îáçê= ~åÇ= íç= ìëÉ= ãÉÇáÅ~íáçå= íç= ãçÇáÑó= íÜçëÉ= Å~ìë~ä= ~ÖÉåíëK= qÜáë=
~ééêç~ÅÜ= Å~å= ÄÉ= ëÉÉå= ~í= ïçêâI= Ñçê= Éñ~ãéäÉI= áå= íÜÉ= êÉëÉ~êÅÜ= çÑ= gÉ~å= aÉÅÉíóI= ~= éëóÅÜçäçÖáëí= ~í= íÜÉ=
råáîÉêëáíó= çÑ= `ÜáÅ~ÖçK= eáë= êÉëÉ~êÅÜ= ÑçÅìëÉë= çå= ~ÇçäÉëÅÉåíë= ïáíÜ= “ÅçåÇìÅí= ÇáëçêÇÉêÒ= çê= “`aIÒ= ~=
ãÉåí~ä=ÇáëçêÇÉê=ÇÉÑáåÉÇ=Äó=“~=äçåÖëí~åÇáåÖ=é~ííÉêå=çÑ=îáçä~íáçåë=çÑ=êìäÉë=~åÇ=ä~ïëÒ=~åÇ=ÅÜ~ê~ÅíÉêáòÉÇ=
Äó= ëóãéíçãë= ëìÅÜ= ~ë= “éÜóëáÅ~ä= ~ÖÖêÉëëáçåI= ã~åáéìä~íáîÉ= äóáåÖI= íÜÉÑíI= ÑçêÅÉÇ= ëÉñI= ÄìääóáåÖI= êìååáåÖ=
~ï~ó= Ñêçã= ÜçãÉ= çîÉêåáÖÜíI= ~åÇ= ÇÉëíêìÅíáçå= çÑ= éêçéÉêíóKÒNMP= aÉÅÉíó= ~åÇ= Üáë= ÅçääÉ~ÖìÉë= ÉñéäçêÉ= íÜÉ=
åÉìê~ä=êÉëéçåëÉë=çÑ=~ÇçäÉëÅÉåíë=íç=Éãé~íÜóJÉäáÅáíáåÖ=~åÇ=ëóãé~íÜóJÉäáÅáíáåÖ=ëíáãìäáI=ëìÅÜ=~ë=íÜÉ=ëáÖÜí=
çÑ=ëçãÉçåÉ=áå=é~áå=EíÜÉ=áã~ÖÉ=çÑ=ëçãÉçåÉ=Ü~îáåÖ=íÜÉáê=ÑáåÖÉêë=ëíìÅâ=áå=~=Å~ê=ÇççêI=Ñçê=áåëí~åÅÉFK=qÜÉ=
áÇÉ~=áë=íç=ëÉÉ=ïÜÉíÜÉê=é~áåÑìä=ëáíì~íáçåë=íêáÖÖÉê=ÇáÑÑÉêÉåí=~Åíáîáíó=áå=íÜÉ=Äê~áåK=rëáåÖ=åÉìêçJáã~ÖáåÖI=
íÜÉáê=ëíìÇáÉë=íêó=íç=ÇáÑÑÉêÉåíá~íÉ=ÄÉíïÉÉå=Äê~áå=~Åíáîáíó=áå=àìîÉåáäÉë=ïáíÜ=ÅçåÇìÅí=ÇáëçêÇÉê=îÉêëìë=íÜçëÉ=
ïáíÜçìí=ÅçåÇìÅí=ÇáëçêÇÉêK=qÜÉ=Öç~äI=ìäíáã~íÉäóI=áë=íç=áÇÉåíáÑó=ÇáÑÑÉêÉåí=åÉìê~ä=é~íÜï~óëI=áå=çêÇÉê=íç=
íÜÉå= ÉñéäçêÉ= éçëëáÄäÉ= íêÉ~íãÉåí= ~ÇÇêÉëëÉÇ= íç= íÜçëÉ= Äê~áå= ~ÅíáîáíáÉëK= ^ë= aÉÅÉíó= ïêáíÉëI= “_áçäçÖáÅ~ä=
                                                            
99

One of the leading researchers here is Martin Kafka. See generally Peer Briken and Martin P. Kafka,
“Pharmacological Treatments for Paraphilic Patients and Sexual Offenders,” Current Opinion in Psychiatry 20, no.
6 (2007): 609-13.
100
See generally Christopher A. Mallett, Patricia Stoddard Dare, and Mamadou M. Seck, “Predicting Juvenile
Delinquency: The Nexus of Childhood Maltreatment, Depression and Bipolar Disorder,” Criminal Behaviour and
Mental Health 19, no. 4 (2009): 235-46; Jean Decety, Kalina J. Michalska, Yuko Akitsuki, and Benjamin B. Lahey,
“Atypical Empathic Responses in Adolescents with Aggressive Conduct Disorder: A Functional MRI
Investigation,” Biological Psychology 80, no. 2 (2009): 203-11.
101
See http://county.milwaukee.gov/WraparoundMilwaukee/WraparoundAward.htm
102
See generally Steven S. Martin, Clifford A. Butzin, Christine A. Saum, and James A. Inciardi, “Three-Year
Outcomes of Therapeutic Community Treatment for Drug-Involved Offenders in Delaware: From Prison to Work
Release to Aftercare,” The Prison Journal 79, no. 3 (1999): 294-320; Michelle A. Lang and Belenko Steven,
“Predicting Retention in a Residential Drug Treatment Alternative to Prison Program,” Journal of substance abuse
treatment 19, no. 2 (2000): 145-60; Jason Luty, “What Works in Drug Addiction?” Adv Psychiatr Treat 9, no. 4
(2003): 280-88.
103
Decety et al., “Atypical Empathic Responses,” 2009, p. 203.

20 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ëíìÇáÉë= çÑ= `a= ëÜçìäÇ= äÉ~Ç= íç= åÉï= ~ééêç~ÅÜÉë= íç= áíë= íêÉ~íãÉåíI= ÄçíÜ= Äó= ìåÇÉêëí~åÇáåÖ= íÜÉ=
ãÉÅÜ~åáëãë= ìåÇÉêéáååáåÖ= `a= ~åÇ= Äó= ã~íÅÜáåÖ= íêÉ~íãÉåíë= íç= ëéÉÅáÑáÅ= ÇÉÑáÅáíë= áå= ÇáÑÑÉêÉåí=
áåÇáîáÇì~äë= ïáíÜ= íÜáë= ÜÉíÉêçÖÉåÉçìë= ÇáëçêÇÉêKÒNMQ= lêI= áå= çíÜÉê= ïçêÇëI= íç= áÇÉåíáÑó= ~åÇ= íêÉ~í= Äê~áå=
é~íÜï~óë=áå=çêÇÉê=íç=~äíÉê=ÄÉÜ~îáçêK==
qÜáåâáåÖ= ãçêÉ= Äêç~ÇäóI= íïç= çíÜÉê= êÉä~íÉÇ= éçëëáÄáäáíáÉë= ÅçãÉ= íç= ãáåÇK= cáêëíI= íÜÉ= Öê~Çì~ä=
äÉÖ~äáò~íáçå=çê=ãÉÇáÅ~äáò~íáçå=çÑ=ã~êáàì~å~=áë=äáâÉäó=íç=Ü~îÉI=çê=ÉîÉåíì~ääó=ã~ó=Ü~îÉ=Çê~ã~íáÅ=ÉÑÑÉÅíë=
çå=êÉéçêíÉÇ=ÅêáãÉ=äÉîÉäë=ÄçíÜ=íÜêçìÖÜ=ÇÉÅêáãáå~äáò~íáçå=~åÇ=~äëç=Äó=Éäáãáå~íáåÖ=íÜÉ=ÇêìÖ=íê~ÇÉ=~åÇ=
áíë=~ííÉåÇ~åí=îáçäÉåÅÉK=qÜáë=áë=ÉëéÉÅá~ääó=íêìÉ=çå=íÜÉ=ÄçêÇÉê=~êÉ~=ïáíÜ=jÉñáÅç=ïÜÉêÉ=íÜÉ=ã~êáàì~å~=
ÇêìÖ= íê~ÇÉ= áë= ïêÉ~âáåÖ= Ü~îçÅK= fÑ= ã~êáàì~å~= ~åÇ= çíÜÉê= äÉëëÉê= ÅçåíêçääÉÇ= ëìÄëí~åÅÉë= ~êÉ= ÉîÉåíì~ääó=
äÉÖ~äáòÉÇI=íÜáë=ïçìäÇ=ëìêÉäó=Ü~îÉ=~=ëáÖåáÑáÅ~åí=ÉÑÑÉÅí=çå=êÉÇìÅáåÖ=íÜÉ=áåÅ~êÅÉê~íÉÇ=éçéìä~íáçåK=pÉÅçåÇI=
ÑìåÅíáçå~ä= ëìÄëíáíìíÉë= íç= áåÅ~êÅÉê~íáçåI= ëìÅÜ= ~ë= dmp= ãçåáíçêáåÖ= ~åÇ= çíÜÉê= Ñçêãë= çÑ= ÜçãÉ=
ëìêîÉáää~åÅÉ=~åÇ=ÇÉíÉåíáçåI=Å~å=ÄÉ=íÜçìÖÜí=çÑ=~ë=~å=~äíÉêå~íáîÉ=Ñçêã=çÑ=ãÉÇáÅ~äáò~íáçåÔ~ë=ëçãÉíÜáåÖ=
äáâÉ=éêÉëÅêáéíáçå=ÇêìÖë=íÜ~í=~Åíë=~ë=~å=~äíÉêå~íáîÉ=íç=áåÅ~êÅÉê~íáçåK=qÜÉëÉ=ÇÉîÉäçéãÉåíë=~ë=ïÉää=ëÜçìäÇ=
ÄÉ=ÅçåëáÇÉêÉÇ=~ë=ëìÄëíáíìíÉë=íç=íÜÉ=éêáëçåK==
^= ÖêÉ~í= Ç~åÖÉê= áå= íÜáë= ~ééêç~ÅÜ= áë= íÜÉ= éçíÉåíá~ä= ê~Åá~äáò~íáçå= çÑ= éëóÅÜçäçÖáÅ~ä= Çá~ÖåçëÉë= çÑ=
ÇÉîá~åÅÉÔ~= Ç~åÖÉê= ã~ÇÉ= îáîáÇ= Äó= çìê= é~ëí= ÉñéÉêáÉåÅÉ= ïáíÜ= ëÅÜáòçéÜêÉåá~I= ~ë= ÇÉãçåëíê~íÉÇ=
Äêáääá~åíäó= Äó= gçå~íÜ~å= jÉíòä= áå= Üáë= ÄççâI= qÜÉ= mêçíÉëí= mëóÅÜçëáëW= eçï= pÅÜáòçéÜêÉåá~= _ÉÅ~ãÉ= ~=
_ä~Åâ= aáëÉ~ëÉ= EOMNMFK= få= Üáë= êÉëÉ~êÅÜ= ~í= fçåá~= pí~íÉ= eçëéáí~ä= áå= jáÅÜáÖ~åI= jÉíòä= êÉÅçìåíë= íÜÉ=
ëÜçÅâáåÖ= ëíçêó= çÑ= Üçï= ëÅÜáòçéÜêÉåá~I= ~ë= ~= Çá~ÖåçëáëI= ÄÉÅ~ãÉ= çîÉêïÜÉäãáåÖäó= ~ééäáÉÇ= íç=
áåëíáíìíáçå~äáòÉÇ=^ÑêáÅ~åJ^ãÉêáÅ~åI=~åÇ=Üçï=íÜÉ=ÉñéÉêáÉåÅÉ=íÜÉêÉ=ãáêêçêÉÇ=íÜÉ=å~íáçå~ä=ÅçåîÉêë~íáçå=
íÜ~í= áåÅêÉ~ëáåÖäó= äáåâÉÇ= Ää~ÅâåÉëë= íç= ã~ÇåÉëëK= iáâÉ= íÜÉ= éêáëçå= áíëÉäÑÔ~ë= f= ÇáëÅìëë= ä~íÉêÔãÉåí~ä=
áääåÉëëI= ÉëéÉÅá~ääó= êÉä~íÉÇ= íç= îáçäÉåÅÉI= ÄÉÅ~ãÉ= áåÅêÉ~ëáåÖäó= ê~Åá~äáòÉÇ= ÇìêáåÖ= íÜÉ= ëÉÅçåÇ= Ü~äÑ= çÑ= íÜÉ=
íïÉåíáÉíÜ=ÅÉåíìêóI=~åÇ=íÜáë=ïçìäÇ=ÄÉ=ëçãÉíÜáåÖ=áãéçêí~åí=íç=Öì~êÇ=~Ö~áåëíK==
ÄK qÜÉ=dêÉ~í=oÉÅÉëëáçå=çÑ=OMMU=
qÜÉ=ëÉÅçåÇ=Ñ~Åíçê=íç=ÅçåëáÇÉê=áåîçäîÉë=ï~óë=çÑ=êÉëíêìÅíìêáåÖ=ÑÉÇÉê~ä=êÉáãÄìêëÉãÉåí=éêçÖê~ãë=
íç=ã~âÉ=áí=ãçêÉ=~ííê~ÅíáîÉ=íç=ëí~íÉë=íç=ÇÉÅ~êÅÉê~íÉI=ÉëéÉÅá~ääó=ÇìêáåÖ=íÜÉëÉ=íáãÉë=çÑ=ÉÅçåçãáÅ=ÅêáëÉëK=
tçìäÇ=áí=ÄÉ=éçëëáÄäÉ=íç=áã~ÖáåÉI=áå=çìê=Ü~êÇ=ÉÅçåçãáÅ=íáãÉëI=~=ÑÉÇÉê~ä=áåáíá~íáîÉ=~áãÉÇ=~í=ÇáîÉêíáåÖ=
ÑáëÅ~ä= êÉëçìêÅÉë= íçï~êÇ= éêçÖê~ãë= íÜ~í= éêçãçíÉ= ~äíÉêå~íáîÉë= íç= áåÅ~êÅÉê~íáçå\= fë= íÜÉêÉ= ~åóçåÉ= áå= ~=
éçëáíáçå= çÑ= äÉ~ÇÉêëÜáé= ~í= íÜÉ= ÑÉÇÉê~ä= äÉîÉä= ïÜç= ïçìäÇ= ÄÉ= ïáääáåÖ= íç= í~âÉ= çå= íÜáë= áëëìÉI= ~ë= mêÉëáÇÉåí=
hÉååÉÇó= ÇáÇ= áå= NVSP\= mêÉëáÇÉåí= _~ê~Åâ= lÄ~ã~= ÅÉêí~áåäó= ÉãÄê~ÅÉÇ= ÜÉ~äíÜ= Å~êÉ= ~ë= ~= ã~àçê= éçäáÅó=
êÉÑçêã=ÇìêáåÖ=Üáë=Ñáêëí=íïç=óÉ~êë=áå=çÑÑáÅÉI=ÇÉëéáíÉ=íÜÉ=dêÉ~í=oÉÅÉëëáçå=çÑ=OMMUX=~åÇ=ÜÉ=Ü~Ç=íç=ÇÉ~ä=
ïáíÜ=~=ã~ëëáîÉ=oÉéìÄäáÅ~å=Ä~Åâä~ëÜ=íç=Üáë=ÜÉ~äíÜ=Å~êÉ=êÉÑçêãë=ÇìêáåÖ=íÜÉ=åÉñí=íïç=óÉ~êëK=fë=áí=ÉîÉå=
ÅçåÅÉáî~ÄäÉ=íÜ~í=ã~ëë=áåÅ~êÅÉê~íáçå=ÅçìäÇ=ÄÉ=éä~ÅÉÇ=çå=mêÉëáÇÉåí=lÄ~ã~Ûë=~ÖÉåÇ~=çê=çå=íÜ~í=çÑ=~åó=
ÑìíìêÉ=mêÉëáÇÉåí\=fí=ã~ó=ÄÉ=ÇáÑÑáÅìäí=íç=áã~ÖáåÉI=f=ÅçåÑÉëëI=Äìí=~=éçëáíáîÉ=~åëïÉê=íç=íÜÉëÉ=èìÉëíáçåë=
ëÉÉãë=~äãçëí=ÉëëÉåíá~ä=íç=ã~âáåÖ=~åó=ÜÉ~Çï~ó=áå=êÉÇìÅáåÖ=ã~ëë=áåÅ~êÅÉê~íáçåK==

                                                            
104

Id.

21 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

få= Åçåíê~ëí= íç= éêÉëÅêáéíáçå= ÇêìÖëI= íÜÉêÉ= Ü~îÉ= ÄÉÉå= ëçãÉ= ïêáíáåÖë= çå= íÜÉ= áëëìÉ= çÑ= íÜÉ=
êÉä~íáçåëÜáé=ÄÉíïÉÉå=íÜÉ=OMMU=ÑáëÅ~ä=Åêáëáë=~åÇ=ã~ëë=áåÅ~êÅÉê~íáçåKNMR=pçãÉ=êÉëÉ~êÅÜÉêëI=ëìÅÜ=~ë=h~ê~=
dçíëÅÜ=çÑ=íÜÉ=pÉåíÉåÅáåÖ=mêçàÉÅíI=~êÖìÉ=íÜ~í=íÜÉ=Ñáå~åÅá~ä=Åêáëáë=Ü~ë=~äêÉ~Çó=íêáÖÖÉêÉÇ=~=åÉï=Åäáã~íÉ=
çÑ=Äáé~êíáë~åëÜáé=çå=éìåáëÜãÉåíKNMS=dçíëÅÜ=ëìÖÖÉëíë=íÜ~í=ïÉ=~êÉ=íçÇ~ó=áå=~=ìåáèìÉ=éçäáíáÅ~ä=Åäáã~íÉ=
EÉãÄçÇáÉÇI=Ñçê=áåëí~åÅÉI=Äó=íÜÉ=é~ëë~ÖÉ=çÑ=pÉÅçåÇ=`Ü~åÅÉ=^Åí=ìåÇÉê=mêÉëáÇÉåí=dÉçêÖÉ=tK=_ìëÜFI=~=
Åäáã~íÉ=ëìÄëí~åíá~ääó=ÇáÑÑÉêÉåí=Ñêçã=íÜÉ=Éê~=çÑ=mêÉëáÇÉåí=`äáåíçåÛë=lãåáÄìë=`êáãÉ=_áääK=lå=ÜÉê=îáÉïI=
íÜÉ= ÑáëÅ~ä= Åêáëáë= áë= ~äêÉ~Çó= äÉ~ÇáåÖ= íç= Äáé~êíáë~åëÜáé= ~êçìåÇ= ëÉåíÉåÅáåÖ= éçäáÅó= ~åÇ= éêáëçå= êÉÑçêãK=
oÉÅÉåí=éçäáÅó=êÉëÉ~êÅÜ=Ü~ë=äççâÉÇ=~í=íÜÉ=ÅÜ~åÖÉë=~í=íÜÉ=ëí~íÉ=äÉîÉä=áå=êÉëéçåëÉ=íç=íÜÉ=ÑáëÅ~ä=ÅêáëáëNMT=~åÇ=
íÜÉ= áãé~Åí= çÑ= Ñáå~åÅá~ä= Åêáëáë= çå= ÅçêêÉÅíáçåë= ëéÉåÇáåÖINMU= Äìí= íÜÉ= ÑáåÇáåÖë= ~êÉ= åçí= ÉëéÉÅá~ääó=
ÉåÅçìê~ÖáåÖK==
líÜÉêë= ÅçåíÉåÇ= íÜ~í= íÜÉ= ÅìêêÉåí= ÉÅçåçãáÅ= Åêáëáë= ~äçåÉ= ïáää= Ü~îÉ= äáííäÉ= ÉÑÑÉÅíK= få= ÜÉê= OMNM=

a~ÉÇ~äìë= ~êíáÅäÉ= “`Éää= _äçÅâë= C= oÉÇ= fåâIÒNMV=dçííëÅÜ~äâ= ~êÖìÉë= íÜ~í= ÉÅçåçãáÅ= íêçìÄäÉë= ~êÉ= åçí=
åÉÅÉëë~êáäó= ~= Å~í~äóëí= Ñçê= ÇÉÅ~êÅÉê~íáçåW= “jçìåíáåÖ= ÑáëÅ~ä= éêÉëëìêÉë= çå= íÜÉáê= çïå= ïáää= åçí= ëéìê=
ÅçããìåáíáÉëI=ëí~íÉëI=~åÇ=íÜÉ=ÑÉÇÉê~ä=ÖçîÉêåãÉåí=íç=Éãéíó=à~áäë=~åÇ=éêáëçåëXÒNNM=áå=Ñ~ÅíI=ëÜÉ=~êÖìÉëI=áí=
ã~ó=ÄÉ=íÜÉ=áåîÉêëÉK=“fÑ=Üáëíçêó=áë=~åó=ÖìáÇÉI=êáëáåÖ=éìÄäáÅ=~åñáÉíó=áå=íÜÉ=Ñ~ÅÉ=çÑ=éÉêëáëíÉåí=ÉÅçåçãáÅ=
ÇáëíêÉëë= ~åÇ= ÖêçïáåÖ= ÉÅçåçãáÅ= áåÉèì~äáíáÉë= ã~óI= áå= Ñ~ÅíI= áÖåáíÉ= ëìééçêí= Ñçê= ãçêÉ= éìåáíáîÉ= éÉå~ä=
éçäáÅáÉëKÒNNN=bÅçåçãáÅ=Ü~êÇ=íáãÉë=EÑçê=~=î~êáÉíó=çÑ=êÉ~ëçåëF=~êÉ=ãçêÉ=äáâÉäó=íç=ëíçâÉ=íÜÉ=ÑáêÉ=çÑ=éìÄäáÅ=
éìåáíáîÉåÉëëÔ~ë=ïÉ=ë~ï=~í=íÜÉ=íáãÉ=çÑ=íÜÉ=dêÉ~í=aÉéêÉëëáçå=~åÇ=íÜÉ=kÉï=aÉ~äKNNO=dçáåÖ=Ñçêï~êÇI=
dçííëÅÜ~äâ= ~êÖìÉëI= ~ÇîçÅ~íÉë= çÑ= ÇÉÅê~ÅÉê~íáçå= ïáää= åÉÉÇ= íç= ~îçáÇ= Ñê~ãáåÖ= íÜÉ= áëëìÉ= éêáã~êáäó= ~ë= ~å=
ÉÅçåçãáÅ=çåÉKNNP==
`Üêáë= _Éêâ= ~í= íÜÉ= råáîÉêëáíó= çÑ= `ÜáÅ~Öç= Ü~ë= ~= ïçêâáåÖJé~éÉê= íáíäÉÇ= “fåîÉëíãÉåí= q~äâW=
`çããÉåíë=çå=íÜÉ=rëÉ=çÑ=íÜÉ=i~åÖì~ÖÉ=çÑ=cáå~åÅÉ=áå=mêáëçå=oÉÑçêã=^ÇîçÅ~ÅóIÒ=ïÜáÅÜ=ÑçÅìëÉë=çå=
ïÜ~í= ÜÉ= Å~ääë= “~å= ÉãÉêÖáåÖ= ÇáëÅçìêëÉ= áå= éêáëçå= êÉÑçêã= ÅáêÅäÉëIÒ= çê= “áåîÉëíãÉåí= í~äâIÒ= íÜ~í= ìëÉë= íÜÉ=
ä~åÖì~ÖÉ= ~åÇ= ÅçåÅÉéíë= çÑ= áåîÉëíãÉåí= ~åÇ= Ñáå~åÅÉ= íç= ~êÖìÉ= Ñçê= ä~êÖÉJëÅ~äÉ= éêáëçå= êÉÑçêãK= _Éêâ= áë=
                                                            
105

Andrew Dilts is preparing a collection of essays on the topic of crisis and contemporary criminal justice to be
published in the Carceral Notebooks.
106
Kara Gotsch, “Bipartisan Justice.” The American Prospect (Dec. 2010): A22-23. Incidentally, that issue of The
American Prospect is entirely dedicated to mass incarceration and has a number of interesting contributions. See
http://www.prospect.org/cs/special_report
107
Nicole D. Porter, “The State of Sentencing 2009: Developments in Policy and Practice,” The Sentencing Project,
available here: http://sentencingproject.org/doc/publications/s_ssr2009Update.pdf
108
Christine S. Scott-Hayward, “The Fiscal Crisis in Corrections: Rethinking Policies and Practices, July 2009
(updated),
Vera
Institute
of
Justice,
available
here:
http://www.pewcenteronthestates.org/uploadedFiles/Vera_state_budgets.pdf?n=5515
109
Marie Gottschalk, “Cell Blocks & Red Ink: Mass Incarceration, The Great Recession & Penal Reform,”
Daedalus 139(3): 62-73 (2010). The original formulation of Gottschalk’s argument traces to her earlier book, where
she argued that financial crisis does not necessarily mean that Left and Right will end up reaching across the aisle or
that the results will be a reduction in punishment. See Marie Gottschalk, Marie, The Prison and the Gallows
(Cambridge: Cambridge University Press 2006): 240-245.
110
Gottschalk, “Cell blocks & red ink,” p. 62.
111
Id. at 63.
112
Id. at 64.
113
Id. at 70.

22 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ëâÉéíáÅ~ä=çÑ=íÜáë=åÉï=ÇáëÅçìêëÉ=~åÇ=ëìÖÖÉëíë=íÜ~í=áí=ã~ó=ìåÇÉêãáåÉ=éêáëçå=êÉÑçêã=~ÇîçÅ~Åó=ÄÉÅ~ìëÉI=
ÑáêëíI= áí= í~âÉë= íÜÉ= áåíÉêéêÉí~íáçå= çÑ= ëçÅá~ä= Åçëí= íç= ÄÉ= ÖáîÉåI= ê~íÜÉê= íÜ~å= éçäáíáÅ~ääó= ÅçåíÉëíÉÇI= ~åÇ=
ëÉÅçåÇI=áí=ÉãéçïÉêë=~=é~êíáÅìä~ê=ëÉí=çÑ=ÉñéÉêíë=~åÇ=âåçïäÉÇÖÉI=ÅçåëçäáÇ~íáåÖ=íÜÉ=äçÖáÅ=çÑ=“åÉçäáÄÉê~ä=
éÉå~äáíóKÒ=`çåëÉèìÉåíäóI=_Éêâ=~êÖìÉëI=áåîÉëíãÉåí=í~äâ=ÇçÉë=åçí=åÉÅÉëë~êáäó=áãéäóI=~ë=ëçãÉ=~ÇîçÅ~íÉë=
ëìÖÖÉëíI=ãçêÉ=äáãáíÉÇI=ÅçããìåáíóJÅçåíêçääÉÇ=éìåáëÜãÉåí=éê~ÅíáÅÉëK=
píáää= çíÜÉêëI= ëìÅÜ= ~ë= gçå~íÜ~å= páãçå= ~åÇ= ãóëÉäÑI= Ü~îÉ= Çê~ïå= é~ê~ääÉäë= ÄÉíïÉÉå= íÜÉ= éêáëçå=
Äççã=~åÇ=íÜÉ=ÜçìëáåÖ=ÄìÄÄäÉKNNQ=páãçå=~êÖìÉëI=áå=Üáë=a~ÉÇÉäìë=~êíáÅäÉ=“`äÉ~êáåÖ=íÜÉ=ÚíêçìÄäÉÇ=~ëëÉíëÛ=
NNR
çÑ= ^ãÉêáÅ~Ûë= éìåáëÜãÉåí= ÄìÄÄäÉIÒ = íÜ~í= íÜÉ= ã~ëë= áåÅ~êÅÉê~íáçå= Åêáëáë= Å~å= ÄÉ= ã~ééÉÇ= çåíç= íÜÉ=
ÜçìëáåÖ=ÅêáëáëI=ëìÖÖÉëíáåÖ=íÜ~í=íÜÉ=~å~äçÖó=íç=íÜÉ=ÜçìëáåÖ=ã~êâÉí=Å~å=êÉîÉ~ä=éçíÉåíá~ä=êÉãÉÇáÉë=íç=íÜÉ=
ÅìêêÉåí=ÅêáëáëK=“cçê=íÜÉ=éêáëçåë=íÜÉãëÉäîÉëIÒ=páãçå=ëìÖÖÉëíëI=“ïÉ=åÉÉÇ=~=ÅçåîÉêëáçå=éêçÖê~ã=ëáãáä~ê=
íç=íÜÉ=éä~å=ÇÉîÉäçéÉÇ=íç=Ü~åÇäÉ=ÑçêãÉê=ãáäáí~êó=áåëí~ää~íáçåë=ÅäçëÉÇ=Ççïå=~ë=~=êÉëìäí=çÑ=`çåÖêÉëëÛë=
NNS
Ä~ëÉJÅäçëáåÖ=Åçããáëëáçå=áå=íÜÉ=NVVMëKÒ =hÉ~ääó=jÅ_êáÇÉ=Ü~ë=~äëç=ÄÉÉå=ïêáíáåÖ=áå=íÜáë=îÉáå=çå=íÜÉ=
`~äáÑçêåá~=ÅêáëáëKNNT=få= qÜÉ=fääìëáçå=çÑ=cêÉÉ=j~êâÉíëI=f=ëìÖÖÉëí=íÜ~í=íÜÉ=ÖêçïíÜ=çÑ=éêáëçåë=Ü~ëI=áå=Ñ~ÅíI=
êÉëÉãÄäÉÇ= íÜÉ= “ÄìÄÄäÉ= ÉÅçåçãáÉëÒ= íÜ~í= ïÉ= ïáíåÉëëÉÇ= çîÉê= íÜÉ= é~ëí= ÑÉï= ÇÉÅ~ÇÉëÔíÜÉ= “ÇçíJÅçã=
ÄìÄÄäÉÒ=çÑ=íÜÉ=ä~íÉ=NVVMë=~åÇ=íÜÉ=“êÉ~ä=Éëí~íÉ=ÄìÄÄäÉÒ=çÑ=íÜÉ=ä~íÉ=OMMMëK=mêáëçå=ÄìáäÇáåÖ=E~=Ñçêã=çÑ=
êÉ~ä=Éëí~íÉI=ë~ÇäóF=ÉñéäçÇÉÇ=áå=íÜÉ=NVVMëI=ÖÉåÉê~íáåÖ=~=êÉã~êâ~ÄäÉ=çìíÄìêëí=çÑ=ÉñéÉåÇáíìêÉëI=àçÄëI=~åÇ=
ÇÉÄíK= fí= áë= éçëëáÄäÉ= íç= íÜáåâ= çÑ= íÜÉ= ÖêçïíÜ= çÑ= íÜÉ= éêáëçå= ëÉÅíçê= ~ë= êÉëÉãÄäáåÖI= áå= ã~åó= ï~óëI= íÜÉ=
ÖêçïíÜ=çÑ=íÜÉ=êÉ~ä=Éëí~íÉ=ëÉÅíçêW=ÑìÉäÉÇ=Äó=áêêÉëéçåëáÄäÉ=äÉåÇáåÖ=çê=ÄçêêçïáåÖI=ÖêçïáåÖ=ÄÉóçåÇ=ÑìíìêÉ=
Å~é~ÅáíóI=êÉëíáåÖ=çå=ëéÉÅìä~íáîÉ=éêáÅÉëK==
qÜÉ= dêÉ~í= oÉÅÉëëáçå= çÑ= OMMU= Ü~ë= ÅÉêí~áåäó= éìí= ëÉîÉêÉ= éêÉëëìêÉ= çå= íÜÉ= “éêáëçå= ÄìÄÄäÉÒÔáÑ=
íÜ~í=áë=~=Ñ~áê=íÉêãÔ~ë=ã~åó=ëí~íÉë=ÑáåÇ=íÜÉãëÉäîÉë=ìå~ÄäÉ=íç=ëÉêîáÅÉ=íÜÉ=ÇÉÄí=~ëëçÅá~íÉÇ=ïáíÜ=éêáëçå=
ÄìáäÇáåÖ= çê= Å~êêó= íÜÉ= ÉñéÉåëÉë= ~ëëçÅá~íÉÇ= ïáíÜ= ã~ëëáîÉ= éêáëçå= éçéìä~íáçåëK= qÜáë= Ü~ë= ÄÉÉå= åçïÜÉêÉ=
ãçêÉ= ÅäÉ~ê= íÜ~å= áå= ^êáòçå~= ïÜÉêÉI= áå= É~êäó= OMMVI= íÜÉ= ëí~íÉ= äÉÖáëä~íçêë= ÄÉÖ~å= ÇáëÅìëëáåÖ= íÜÉ= áÇÉ~= çÑ=
ÅçåîÉêíáåÖ=íÜÉ=ÉåíáêÉ=ëí~íÉJêìå=éêáëçå=ëóëíÉã=áåíç=~=éêáî~íÉäó=êìå=Åçêéçê~íáçå=íç=ÅçìåíÉê~Åí=íÜÉ=APKP=
Äáääáçå=êÉîÉåìÉ=ëÜçêíÑ~ää=ÉñéÉÅíÉÇ=íÜ~í=óÉ~êKNNU=pçãÉ=äÉÖáëä~íçêë=éêÉÇáÅíÉÇ=íÜ~í=íÜáë=ÅÜ~åÖÉ=ÅçìäÇ=ë~îÉ=
NNV
íÜÉ= ëí~íÉ= ~ééêçñáã~íÉäó= AQM= ãáääáçå= ~ååì~ääóI = ïÜÉêÉ~ë= çíÜÉêë= ÜçéÉÇ= íÜ~í= íÜáë= ÅçìäÇ= êÉÇìÅÉ= íÜÉ=
NOM
ÄìÇÖÉí=ëÜçêíÑ~ää=Äó=ANMM=ãáääáçåK =qÜÉ=éä~å=íç=éêáî~íáòÉ=íÜÉ=ïÜçäÉ=ëÉÅíçê=Ü~ë=ÖçåÉ=Ñçêï~êÇI=íÜçìÖÜ=
áí= ïçìäÇ= çåäó= ~ÇÇ= íç= ^êáòçå~Ûë= ~äêÉ~ÇóJëáÖåáÑáÅ~åí= êÉäá~åÅÉ= çå= éêáî~íÉ= éêáëçåëW= íç= Ç~íÉI= åÉ~êäó= PM=
éÉêÅÉåí=çÑ=íÜÉ=ëí~íÉÛë=éêáëçåÉêë=~êÉ=ÜÉäÇ=áå=éêáî~íÉäó=êìå=Ñ~ÅáäáíáÉëKNON=fí=áëI=çÑ=ÅçìêëÉI=ìåÅäÉ~ê=ïÜ~í=ïáää=
                                                            
114

Bernard E. Harcourt, The Illusion of Free Markets: Punishment and the Myth of Natural Order, at 238-239;
Jonathan Simon, “Clearing the 'troubled assets' of America's punishment bubble,” Daedalus 139(3): 91-101 (2010).
115
Daedalus, Summer 2010, p. 91-101. Simon has also blog posted on this topic here:
http://governingthroughcrime.blogspot.com/search?q=great+recession .
116
Simon, “Clearing,” 2010, at 97.
117
Need to get this from Keally.
118
Private Prisons Offer Potential for State Savings (May 25, 2009), available at
http://www.yumasun.com/opinion/state-50322-potential-balance.html.
119
Id.
120
Jennifer Steinhauer, Arizona May Put State Prisons in Private Hands (Oct. 23, 2009), available at
http://www.nytimes.com/2009/10/24/us/24prison.html.
121

Steinhauer, Arizona May Put State Prisons in Private Hands.

23 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ìäíáã~íÉäó= Ü~ééÉå= ïáíÜ= íÜÉ= éêáëçå= ëÉÅíçêI= ïÜÉíÜÉê= áí= ïçìäÇ= ÉîÉê= “éçéIÒ= ïÜÉíÜÉê= áí= ïáää= ÄÉ= Ñìääó=
éêáî~íáòÉÇI=~åÇ=ïÜÉíÜÉê=áí=ïáää=ëìÄëáÇÉK=
_ìí=áí=áë=ìåäáâÉäó=íÜ~í=íÜÉ=ÉÅçåçãáÅ=Åêáëáë=ïáää=Ü~îÉ=ãìÅÜ=çÑ=~å=ÉÑÑÉÅí=çå=éêáëçå=éçéìä~íáçåë=
ïáíÜçìí=ÑÉÇÉê~ä=äÉ~ÇÉêëÜáéK=qÜáë=áëI=f=ÄÉäáÉîÉI=~=äÉëëçå=Ñêçã=ÇÉáåëíáíìíáçå~äáò~íáçåI=~åÇI=áå=íÜáë=êÉÖ~êÇI=
f=~ÖêÉÉ=ïáíÜ=j~êáÉ=dçííëÅÜ~äâI=ïÜç=ïêáíÉëI=ÅçêêÉÅíäó=f=ÄÉäáÉîÉI=íÜ~í=“xízÜÉ=ÇÉáåëíáíìíáçå~äáò~íáçå=Å~ëÉ=
ÇÉãçåëíê~íÉë= íÜÉ= Éåçêãçìë= áãéçêí~åÅÉ= çÑ= íÜÉ= éçäáíáÅ~ä= ÅçåíÉñí= Ñçê= íÜÉ= ÇÉîÉäçéãÉåí= ~åÇ=
áãéäÉãÉåí~íáçå= çÑ= ëìÅÅÉëëÑìä= ÑÉÇÉê~ä= ~åÇ= ëí~íÉ= éçäáÅáÉë= íç= Çê~ëíáÅ~ääó= ëÜêáåâ= ëí~íÉ= áåëíáíìíáçåëÁK=
NOO
xizÉ~ÇÉêëÜáé=~í=íÜÉ=ÑÉÇÉê~ä=äÉîÉä=ï~ë=ÅêáíáÅ~ä=íç=Éå~ÅíáåÖ=ÅÜ~åÖÉKÒ qÜÉ=êÉ~ä=èìÉëíáçåI=íÜÉåI=áë=ïÜÉíÜÉê=
íÜÉêÉ= ÅçìäÇ= éçëëáÄäó= ÄÉ= ÑÉÇÉê~ä= ÑìåÇáåÖ= ãÉÅÜ~åáëãë= éìí= áå= éä~ÅÉ= íÜ~í= ÅçìäÇ= ãáÖê~íÉ= íÜÉ= Ñáå~åÅá~ä=
ÄìêÇÉå= çÑ= áåÅ~êÅÉê~íáçå= íç= íÜÉ= ÑÉÇÉê~ä= ÖçîÉêåãÉåí= áå= ëìÅÜ= ~= ï~ó= ~ë= íç= éêçãçíÉI= ìäíáã~íÉäóI=
~äíÉêå~íáîÉë= íç= áåÅ~êÅÉê~íáçå\= qÜáë= ï~ë= íÜÉ= ãçÇÉä= çÑ= NVSMë= ÇÉáåëíáíìíáçå~äáò~íáçåW= ëÜáÑíáåÖ= íÜÉ=
ÑìåÇáåÖ= ÄìêÇÉå=íç=íÜÉ=ÑÉÇÉê~ä=ÖçîÉêåãÉåí= ~ë= ~= ï~ó=íç= áåÅÉåíáîáòÉ= íÜÉ=ëí~íÉë= íç= ãçîÉ= é~íáÉåíë= áåíç=
çíÜÉê=Ñ~ÅáäáíáÉë=ÅäçëÉê=íç=íÜÉ=Åçããìåáíó=~åÇ=ÅäçëÉê=íç=ÜçãÉK=eçï=ÅçìäÇ=íÜáë=ÄÉ=ÉåÅçìê~ÖÉÇ=íçÇ~ó\=
pçãÉ=éçáåí=íç=íÜÉ=gìëíáÅÉ=oÉáåîÉëíãÉåí=ãçîÉãÉåí=~ë=ÄÉáåÖ=~=ï~ó=íç=~ÇÇêÉëë=íÜáë=èìÉëíáçåK=
“gìëíáÅÉ=oÉáåîÉëíãÉåíIÒ=~=éêçàÉÅí=çÑ=íÜÉ=`çìåÅáä=çÑ=pí~íÉ=dçîÉêåãÉåíë=gìëíáÅÉ=`ÉåíÉêI=áëI=áå=áíë=çïå=
ïçêÇëI=“~=Ç~í~JÇêáîÉå=~ééêç~ÅÜ=íç=êÉÇìÅÉ=ÅçêêÉÅíáçåë=ëéÉåÇáåÖ=~åÇ=êÉáåîÉëí=ë~îáåÖë=áå=ëíê~íÉÖáÉë=íÜ~í=
Å~å=ÇÉÅêÉ~ëÉ=ÅêáãÉ=~åÇ=ëíêÉåÖíÜÉå=åÉáÖÜÄçêÜççÇëKÒNOP=qÜÉ=éêçàÉÅí=áë=áåíÉåÇÉÇ=íç=ÄÉ=ÉîáÇÉåÅÉJÇêáîÉå=
~åÇ= íç= ÇáëÅçîÉê= ÅçëíJÉÑÑÉÅíáîÉ= ï~óë= çÑ= âÉÉéáåÖ= ëçÅáÉíó= ë~ÑÉK= qÜÉ= ã~åíê~= áë= ÉîáÇÉåÅÉI= ÅçëíJÉÑÑÉÅíáîÉ=
éçäáÅáÉëI=~åÇ=ãÉ~ëìêÉÇ=éÉêÑçêã~åÅÉÔ~ë=ÉîáÇÉåÅÉÇ=Äó=áíë=íÜêÉÉJéêçåÖ=~ééêç~ÅÜW=
NK ^å~äóòÉ=Ç~í~=~åÇ=ÇÉîÉäçé=éçäáÅó=çéíáçåëK=
gìëíáÅÉ= `ÉåíÉê= ÉñéÉêíë= ~å~äóòÉ= ÅêáãÉI= ~êêÉëíI= ÅçåîáÅíáçåI= à~áäI= éêáëçåI= ~åÇ= éêçÄ~íáçå=
~åÇ=é~êçäÉ=ëìéÉêîáëáçå=Ç~í~=éêçîáÇÉÇ=Äó=ëí~íÉ=~åÇ=äçÅ~ä=~ÖÉåÅáÉëX=ã~é=ëéÉÅáÑáÅ=åÉáÖÜÄçêÜççÇë=
ïÜÉêÉ=ä~êÖÉ=åìãÄÉêë=çÑ=éÉçéäÉ=ìåÇÉê=Åêáãáå~ä=àìëíáÅÉ=ëìéÉêîáëáçå=äáîÉ=~åÇ=ÅêçëëJêÉÑÉêÉåÅÉ=íÜáë=
áåÑçêã~íáçå= ïáíÜ= êÉéçêíë= çÑ= Åêáãáå~ä= ~Åíáîáíó= ~åÇ= íÜÉ= åÉÉÇ= Ñçê= î~êáçìë= ëÉêîáÅÉë= EáåÅäìÇáåÖ=
ëìÄëí~åÅÉ= ~ÄìëÉ= ~åÇ= ãÉåí~ä= ÜÉ~äíÜ= íêÉ~íãÉåí= éêçÖê~ãëF= ~åÇ= êÉëçìêÅÉë= EëìÅÜ= ~ë=
ìåÉãéäçóãÉåí= çê= ÑççÇ= ëí~ãé= ÄÉåÉÑáíëFX= ~åÇ= ~ëëÉëë= ~î~áä~ÄäÉ= ëÉêîáÅÉë= ÅêáíáÅ~ä= íç= êÉÇìÅáåÖ=
êÉÅáÇáîáëãK=rëáåÖ=íÜ~í=ëí~íÉJëéÉÅáÑáÅ=áåÑçêã~íáçåI=íÜÉ=gìëíáÅÉ=`ÉåíÉê=ÇÉîÉäçéë=éê~ÅíáÅ~äI=Ç~í~J
ÇêáîÉåI= ~åÇ= ÅçåëÉåëìëJÄ~ëÉÇ= éçäáÅáÉë= íÜ~í= êÉÇìÅÉ= ëéÉåÇáåÖ= çå= ÅçêêÉÅíáçåë= íç= êÉáåîÉëí= áå=
ëíê~íÉÖáÉë=íÜ~í=Å~å=áãéêçîÉ=éìÄäáÅ=ë~ÑÉíóK=
OK ^Ççéí=åÉï=éçäáÅáÉë=~åÇ=éìí=êÉáåîÉëíãÉåí=ëíê~íÉÖáÉë=áåíç=éä~ÅÉK=
låÅÉ= ÖçîÉêåãÉåí= çÑÑáÅá~äë= Éå~Åí= íÜÉ= éçäáÅó= çéíáçåëI= íÜÉó= ãìëí= í~âÉ= ëíÉéë= íç= îÉêáÑó=
íÜ~í= íÜÉ= éçäáÅáÉë= ~êÉ= ~ÇçéíÉÇ= ÉÑÑÉÅíáîÉäóK= qÜÉ= gìëíáÅÉ= `ÉåíÉê= ~ëëáëíë= àìêáëÇáÅíáçåë= ïáíÜ=
íê~åëä~íáåÖ= íÜÉ= åÉï= éçäáÅáÉë= áåíç= éê~ÅíáÅÉI= ~åÇ= ÉåëìêáåÖ= êÉä~íÉÇ= éêçÖê~ãë= ~åÇ= ëóëíÉã=
áåîÉëíãÉåíë=~ÅÜáÉîÉ=éêçàÉÅíÉÇ=çìíÅçãÉëK=qÜáë=~ëëáëí~åÅÉ=áåÅäìÇÉë=ÇÉîÉäçéáåÖ=áãéäÉãÉåí~íáçå=
                                                            
122
123

Gottschalk, “Cell Blocks & Red Ink,” 2010, p. 68.
See http://www.justicereinvestment.org/

24 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

éä~åë= ïáíÜ= ëí~íÉ= ~åÇ= äçÅ~ä= çÑÑáÅá~äë= ~åÇ= âÉÉéáåÖ= éçäáÅóã~âÉêë= ~ééêáëÉÇ= íÜêçìÖÜ= ÑêÉèìÉåí=
éêçÖêÉëë=êÉéçêíë=~åÇ=íÉëíáãçåó=íç=êÉäÉî~åí=äÉÖáëä~íáîÉ=ÅçããáííÉÉëK=
PK jÉ~ëìêÉ=éÉêÑçêã~åÅÉK=
cáå~ääóI= íÜÉ= gìëíáÅÉ= `ÉåíÉê= ÉåëìêÉë= íÜ~í= ÉäÉÅíÉÇ= çÑÑáÅá~äë= êÉÅÉáîÉ= ÄêáÉÑI= ìëÉêJÑêáÉåÇäóI=
~åÇ= ìéJíçJÇ~íÉ= áåÑçêã~íáçå= íÜ~í= Éñéä~áåë= íÜÉ= áãé~Åí= çÑ= Éå~ÅíÉÇ= éçäáÅáÉë= çå= à~áä= ~åÇ= éêáëçå=
éçéìä~íáçåëI=~åÇ=çå=ê~íÉë=çÑ=êÉáåÅ~êÅÉê~íáçå=~åÇ=Åêáãáå~ä=~ÅíáîáíóK=qóéáÅ~ääóI=íÜáë=áåÅäìÇÉë=~=
“Ç~ëÜÄç~êÇÒ= çÑ= ãìäíáéäÉ= áåÇáÅ~íçêë= íÜ~í= ã~âÉ= áí= É~ëó= Ñçê= éçäáÅóã~âÉêë= íç= íê~ÅâÔáå= êÉ~ä=
íáãÉÔíÜÉ=ÅÜ~åÖÉë=áå=î~êáçìë=ÅçãéçåÉåíë=çÑ=íÜÉ=Åêáãáå~ä=àìëíáÅÉ=ëóëíÉãK=
^ÅÅçêÇáåÖ= íç= íÜÉ= gìëíáÅÉ= oÉáåîÉëíãÉåí= éêçàÉÅíI= íÜáë= áë= éêÉÅáëÉäó= íÜÉ= ~ééêç~ÅÜ= íÜ~í= äÉÇI= Ñçê=
áåëí~åÅÉI=íç=íÜÉ=áåîÉëíãÉåí=çÑ=AOQN=ãáääáçå=Äó=íÜÉ=qÉñ~ë=äÉÖáëä~íìêÉ=áå=OMMT=“íç=Éñé~åÇ=íÜÉ=Å~é~Åáíó=
çÑ= ëìÄëí~åÅÉ= ~ÄìëÉ= ~åÇ= ãÉåí~ä= ÜÉ~äíÜ= íêÉ~íãÉåí= ~åÇ= ÇáîÉêëáçå= éêçÖê~ãëI= ~åÇ= íç= ÉåëìêÉ= íÜ~í= íÜÉ=
êÉäÉ~ëÉ= çÑ= äçïJêáëâ= áåÇáîáÇì~äë= áë= åçí= ÇÉä~óÉÇ= ÇìÉ= íç= ä~Åâ= çÑ= áåJéêáëçå= ~åÇ= ÅçããìåáíóJÄ~ëÉÇ=
íêÉ~íãÉåí= éêçÖê~ãëÒ= ~åÇ= íç= íÜÉ= áåîÉëíãÉåí= çÑ= ATKV= ãáääáçå= áå= h~åë~ë= “íç= Éñé~åÇ= íêÉ~íãÉåí=
éêçÖê~ãë=~åÇ=ëíêÉåÖíÜÉå=éêçÄ~íáçå=~åÇ=é~êçäÉKÒNOQ=
fí=ãáÖÜí=ÄÉ=éçëëáÄäÉ=íç=í~é=áåíç=íÜáë=ÅìêêÉåí=~åÇ=äçÖáÅ=íç=éêçãçíÉ=ÑÉÇÉê~ä=äÉ~ÇÉêëÜáé=~ë=~=ÅçëíJ
ÉÑÑÉÅíáîÉ= ï~ó=~êçìåÇ=ã~ëë=áåÅ~êÅÉê~íáçåK=lå= íÜÉ=çíÜÉê=Ü~åÇI=çÑ=ÅçìêëÉI=íÜáë=ÉåíáêÉ=~ééêç~ÅÜ=ÅçìäÇ=
ëáãéäó= ÄÉ= ~= äçí= çÑ= íÉÅÜåçÅê~íáÅ= åçåëÉåëÉÔ~= äçí= çÑ= éçäáíáÅë= ã~ëèìÉê~ÇáåÖ= ~ë= ÉÅçåçãáëíáÅI= ÅçëíJ
ÉÑÑáÅáÉåÅó=ä~åÖì~ÖÉK=^åÇ=íÜÉ=ÉåíáêÉ=Åçíí~ÖÉ=áåÇìëíêó=çÑ=êÉÉåíêó=~åÇ=ÇáîÉêëáçå~êó=éêçÖê~ãë=ã~ó=ïÉää=
ÄÉ= ~= Öê~åÇ= áääìëáçåI= çêI= áå= iç≥Å= t~Åèì~åíÛë= íÉêãëI= ~= äçí= çÑ= “ãóíÜ= ~åÇ= êáíì~äKÒNOR= qÜÉ= èìÉëíáçåI=
ìäíáã~íÉäóI=ã~ó=ÄÉ=ïÜÉíÜÉê=íÜÉ=éìÄäáÅ=ÉÅçåçãó=çÑ=êÉÉåíêó=áë=ãçêÉ=çê=äÉëë=Ñ~îçê~ÄäÉ=íÜ~å=íÜ~í=çÑ=ã~ëë=
áåÅ~êÅÉê~íáçåK= låÅÉ= ~Ö~áåI= íÜÉëÉ= ~îÉåìÉë= ã~ó= áåîçäîÉ= ~= ÇÉîáäÛë= é~ÅíK= tÜ~í= áë= ÅäÉ~êI= íÜçìÖÜI= áë= íÜ~í=
ÑÉÇÉê~ä=äÉ~ÇÉêëÜáé=ïáää=ÄÉ=åÉÅÉëë~êó=íç=ã~âÉ=íÜáë=é~Åí=ïçêâK==
=
ÅK qÜÉ=pçÅá~ä=`çåëíêìÅíáçå=çÑ=íÜÉ=`çåîáÅí=
qÜÉ=íÜáêÇ=èìÉëíáçå=áë=ïÜÉíÜÉê=ïÉ=ÅçìäÇ=áã~ÖáåÉI=~í=ëçãÉ=éçáåíI=íÜ~í=íÜÉ=éìÄäáÅ=áã~Öáå~íáçå=
çÑ=íÜÉ=“ÅçåîáÅíÒ=ïçìäÇ=ÉîÉê=ÄÉ=êÉëÜ~éÉÇ\=qÜáë=áë=åçí=ëáãéäó=~=ã~ííÉê=çÑ=ÅÜ~åÖáåÖ=ëçÅá~ä=ãÉ~åáåÖK=fí=
áåîçäîÉë=ÅçãéäáÅ~íÉÇ=éêçÅÉëëÉë=çÑ=áÇÉåíáÑáÅ~íáçåK=^äíÜçìÖÜ=ÉñÅÉÉÇáåÖäó=ÅçãéäÉñI=ÜÉêÉ=íçç=íÜÉêÉ=ã~ó=
ÄÉ= ëçãÉíÜáåÖ= ÑêìáíÑìäK= ^åÇ= íÜÉ= éä~ÅÉ= íç= äççâ= ã~ó= ÄÉ= íÜÉ= êÉÅÉåí= äáíáÖ~íáçå= çÑ= `~äáÑçêåá~= éêáëçå=
çîÉêÅêçïÇáåÖ= ~í= íÜÉ= råáíÉÇ= pí~íÉë= pìéêÉãÉ= `çìêíÔ~= ÜáÖÜJéêçÑáäÉ= ãÉÇá~= ~åÇ= Åìäíìê~ä= ÉîÉåí= íÜ~í=
ã~ó=ëáÖå~ä=ïáÇÉê=~ééêÉÅá~íáçå=Ñçê=íÜÉ=éêáëçå=ÅçåÇáíáçåë=Ñ~ÅáåÖ=ÅçåîáÅíÉÇ=áåã~íÉëK=^å=~å~äóëáë=çÑ=íÜÉ=
êÜÉíçêáÅ=~åÇ=ëìêêçìåÇáåÖ=ãÉÇá~=ÅçîÉê~ÖÉ=çÑ=íÜÉ=çê~ä=~êÖìãÉåí=ÄÉÑçêÉ=íÜÉ=pìéêÉãÉ=`çìêí=áåÇáÅ~íÉëI=
éçëëáÄäóI=~=ÖêçïáåÖ=~ï~êÉåÉëë=çÑ=çîÉêÅêçïÇáåÖ=áå=éêáëçåë=~åÇ=íÜÉ=êÉëìäíáåÖ=éççê=ÅçåÇáíáçåëK=qÜÉ=Å~ëÉ=
ã~ó= ëÉêîÉ= ~ë= ~å= áääìëíê~íáçå= çÑ= Üçï= íç= ãçÄáäáòÉ= ÖêÉ~íÉê= ~ííÉåíáçå= çå= íÜÉ= éêçÄäÉãë= ~ëëçÅá~íÉÇ= ïáíÜ=
ã~ëë=áåÅ~êÅÉê~íáçåK==
                                                            
124
125

See Justice Reinvestment Overview pdf document downloadable at http://www.justicereinvestment.org/
See new paper by Loïc Wacquant on reentry programs.

25 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

qÜÉ=`~äáÑçêåá~=éêáëçå=çîÉêÅêçïÇáåÖ=Å~ëÉI= pÅÜï~êòÉåÉÖÖÉê=îK=mä~í~= çê=åçï= _êçïå=îK=mä~í~NOS=
ï~ë=~êÖìÉÇ=~í=íÜÉ=rKpK=pìéêÉãÉ=`çìêí=çå=kçîÉãÄÉê=PMI=OMNMI=çå=íÜÉ=èìÉëíáçå=çÑ=íÜÉ=~ìíÜçêáíó=çÑ=
íÜÉ=ÑÉÇÉê~ä=Åçìêíë=íç=áëëìÉ=~åÇ=Ñ~ëÜáçå=êÉãÉÇáÉë=íç=êÉÅíáÑó=ìåÅçåëíáíìíáçå~ääó=éççê=ÅçåÇáíáçåë=ïáíÜáå=
éêáëçåëI=éìêëì~åí=íç=íÜÉ=mêáëçå=iáíáÖ~íáçå=oÉÑçêã=^ÅíI=NU=rKpK`K=¬=PSOS=E“mio^ÒFK= qÜÉ=pìéêÉãÉ=
`çìêí= äáíáÖ~íáçå= ~êçëÉ= çìí= çÑ= íïç= ëÉé~ê~íÉ= Åä~ëë= ~Åíáçå= ä~ïëìáíëI= mä~í~= îK= pÅÜï~êòÉåÉÖÖÉêNOT= ~åÇ=
`çäÉã~å=îK=pÅÜï~êòÉåÉÖÖÉêINOU=ÑáäÉÇ=çå=ÄÉÜ~äÑ=çÑ=éêáëçåÉêë=áåÅ~êÅÉê~íÉÇ=áå=`~äáÑçêåá~=pí~íÉ=éêáëçåëK=
få=ÄçíÜ=Å~ëÉëI=íÜÉ=éêáëçåÉêë=ëìÅÅÉëëÑìääó=Åä~áãÉÇ=íÜ~í=éççê=ãÉÇáÅ~ä=~åÇ=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉ=éêçîáÇÉÇ=
Äó= íÜÉ= `~äáÑçêåá~= aÉé~êíãÉåí= çÑ= `çêêÉÅíáçåë= ~åÇ= oÉÜ~Äáäáí~íáçå= E“`a`oÒF= îáçä~íÉÇ= íÜÉáê=
Åçåëíáíìíáçå~ä= êáÖÜíëKNOV= ^í= áëëìÉ= ~í= íÜÉ= pìéêÉãÉ= `çìêí= ï~ë= íÜÉ= êÉãÉÇó= Ñ~ëÜáçåÉÇ= Äó= íÜÉ= Åçìêíë= íç=
ÅçêêÉÅí=íÜÉ=Åçåëíáíìíáçå~ä=îáçä~íáçåK=jçêÉ=ëéÉÅáÑáÅ~ääóI=~=íÜêÉÉJàìÇÖÉ=é~åÉä=áå=íÜÉ=ÅçåëçäáÇ~íÉÇ=Å~ëÉë=
Ü~Ç=çêÇÉêÉÇ=íÜ~í=`~äáÑçêåá~=ÅêÉ~íÉ=~åÇ=ÑáäÉ=“~=éçéìä~íáçå=êÉÇìÅíáçå=éä~å=íÜ~í=ïáää=áå=åç=ãçêÉ=íÜ~å=
íïç= óÉ~êë= êÉÇìÅÉ= íÜÉ= éçéìä~íáçå= çÑ= íÜÉ= `a`oÛë= ~Çìäí= áåëíáíìíáçåë= íç= NPTKRB= çÑ= íÜÉáê= ÅçãÄáåÉÇ=
ÇÉëáÖå=Å~é~ÅáíóKÒ=qÜÉ=~ééÉ~ä=íç=íÜÉ=pìéêÉãÉ=`çìêí=ÅçåÅÉêåÉÇ=íÜÉ=ëÅçéÉ=çÑ=íÜáë=êÉãÉÇá~ä=çêÇÉêK==
qÜÉ=Å~ëÉë=Ü~îÉ=~=ÅçãéäáÅ~íÉÇ=éêçÅÉÇìê~ä=Üáëíçêó=íÜ~í=Ü~Ç=ÄÉÉå=ïáåÇáåÖ=áíë=ï~ó=íÜêçìÖÜ=íÜÉ=
NPM
ÑÉÇÉê~ä=Åçìêíë=ëáåÅÉ=íÜÉ=É~êäó=NVVMëK=qÜÉ=Ñáêëí=Å~ëÉI=íÜÉ=`çäÉã~å =Å~ëÉ=áåáíá~íÉÇ=áå=NVVMI=ï~ë=~=Åä~ëëJ
~Åíáçå= ä~ïëìáí= ÑáäÉÇ= çå= ÄÉÜ~äÑ= çÑ= `~äáÑçêåá~= áåã~íÉë= ïáíÜ= ëÉêáçìë= ãÉåí~ä= ÇáëçêÇÉêëK= qÜÉ= `çäÉã~å=
éä~áåíáÑÑë=ê~áëÉÇ=Åä~áãë=Ä~ëÉÇ=çå=áå~ÇÉèì~íÉ=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉ=éêçîáÇÉÇ=íç=`~äáÑçêåá~=éêáëçåÉêëK=få=
NVVRI=ÑçääçïáåÖ=~=Ñìää=íêá~ä=áå=Ñêçåí=çÑ=~=j~Öáëíê~íÉ=gìÇÖÉI=íÜÉ=aáëíêáÅí=`çìêí=ÑçìåÇ=íÜ~í=íÜÉ=ãÉåí~ä=
ÜÉ~äíÜ=Å~êÉ=éêçîáÇÉÇ=íç=`~äáÑçêåá~Ûë=áåã~íÉë=ï~ë=Åçåëíáíìíáçå~ääó=áå~ÇÉèì~íÉI=~åÇ=íÜ~í=íÜÉ=pí~íÉ=ÇáÇ=
åçí= éêçîáÇÉ= “Ä~ëáÅI= ÉëëÉåíá~ääó= Åçããçå= ëÉåëÉI= ÅçãéçåÉåíë= çÑ= ~= ãáåáã~ääó= ~ÇÉèì~íÉ= éêáëçå= ãÉåí~ä=
NPN
ÜÉ~äíÜ= Å~êÉ= ÇÉäáîÉêó= ëóëíÉãKÒ = _~ëÉÇ= çå= íÜÉëÉ= ÑáåÇáåÖëI= íÜÉ= `çäÉã~å= Åçìêí= ÉåíÉêÉÇ= ~å= çêÇÉê=
êÉèìáêáåÖ=ÇÉÑÉåÇ~åíë=íç=ÇÉîÉäçé=éä~åë=íç=êÉãÉÇó=íÜÉ=Åçåëíáíìíáçå~ä=îáçä~íáçåë=ìåÇÉê=íÜÉ=ëìéÉêîáëáçå=
çÑ=~=ëéÉÅá~ä=ã~ëíÉêK=qÜÉ=péÉÅá~ä=j~ëíÉê=ëìéÉêîáëÉÇ=çîÉê=~=ÇÉÅ~ÇÉ=çÑ=êÉãÉÇá~ä=ÉÑÑçêíëK=_ó=OMMSI=ïÜÉå=
íÜÉ=aáëíêáÅí=`çìêí=àìÇÖÉ=Öê~åíÉÇ=íÜÉ=`çäÉã~å=éä~áåíáÑÑëÛ=ãçíáçå=Ñçê=~=ÜÉ~êáåÖ=ÄÉÑçêÉ=~=íÜêÉÉJàìÇÖÉ=
é~åÉäI=íÜÉ=Åçìêí=Ü~Ç=áëëìÉÇ=çîÉê=TM=çêÇÉêë=áå=íÜÉ=`çäÉã~å=Å~ëÉK=

mä~í~=îK=pÅÜï~êòÉåÉÖÖÉêNPOI=ÑáäÉÇ=áå=OMMNI=ï~ë=~=Åä~ëë=~Åíáçå=ä~ïëìáí=Åä~áãáåÖ=íÜ~í=íÜÉ=ÇÉäáîÉêó=
çÑ=ãÉÇáÅ~ä=Å~êÉ=áå=íÜÉ=`~äáÑçêåá~=pí~íÉ=éÉå~ä=ëóëíÉã=ï~ë=Åçåëíáíìíáçå~ääó=áå~ÇÉèì~íÉK=qÜÉ=é~êíáÉë=áå=
mä~í~= EïÜç= Ü~Ç= ÄÉÉå= áåÑçêã~ääó= åÉÖçíá~íáåÖ= ëáåÅÉ= NVVVFNPP= åÉÖçíá~íÉÇ= ~= ëíáéìä~íáçå= Ñçê= áåàìåÅíáîÉ=
êÉäáÉÑ= áå= OMMOKNPQ= ^ÑíÉê= íÜêÉÉ= óÉ~êë= çÑ= êÉéçêíë= çÑ= íÜÉ= pí~íÉÛë= åçåÅçãéäá~åÅÉ= ïáíÜ= íÜÉ= ~ÖêÉÉãÉåí=
ElÅíçÄÉê= OMMRFI= íÜÉ= mä~í~= Åçìêí= ~ééçáåíÉÇ= ~= êÉÅÉáîÉê= íç= çîÉêëÉÉ= íÜÉ= `a`o= ~åÇ= ÄêáåÖ= áíë=
                                                            
126

The case has since been recaptioned to Brown et al. v. Plata et al., Supreme Court Docket No. 09-1233.
Plata v. Schwarzenegger, 3:01-cv-01351-TEH (N.D. Cal. 2001).
128
Coleman v. Schwarzenegger, 2:90-cv-00520-LKK-JFM (E.D. Cal. 1990)
129
Coleman specifically addresses the lack of mental healthcare facilities; while Plata addresses medical facilities
generally.
130
Coleman v. Schwarzenegger, 2:90-cv-00520-LKK-JFM (E.D. Cal. 1990)
131
Specific deficiencies cited by the court included delays in treatment, which worsened and exacerbated illness,
improper screening, improper medication management, poor record keeping and chronic understaffing.
132
Plata v. Schwarzenegger, 3:01-cv-01351-TEH (N.D. Cal. 2001).
133
Order and Opinion, 2009 WL 24308420, *3 (N.D. Cal., E.D. Cal. 2009).
134
Id.
127

26 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ã~å~ÖÉãÉåí=çÑ=áåã~íÉ=ÜÉ~äíÜÅ~êÉ=áåíç=Åçåëíáíìíáçå~ä=Åçãéäá~åÅÉKNPR=qÜÉ=êÉÅÉáîÉê=ï~ë=Öê~åíÉÇ=Äêç~Ç=
~ìíÜçêáíó= íç= ÇÉîÉäçé= ~åÇ= áãéäÉãÉåí= ~= ëóëíÉã= çÑ= ãÉÇáÅ~ä= Å~êÉ= ÇÉäáîÉêó= íÜ~í= ãÉí= Åçåëíáíìíáçå~ä=
ëí~åÇ~êÇë=“~ë=ëççå=~ë=éê~ÅíáÅ~ÄäÉKÒNPS==
få=íÜÉ=ãÉ~å=íáãÉI=çå=lÅíçÄÉê=NQI=OMMSI=íÜÉåJÖçîÉêåçê=pÅÜï~êòÉåÉÖÖÉê=ÇÉÅä~êÉÇ=~=ëí~íÉ=çÑ=
ÉãÉêÖÉåÅóI=ëí~íáåÖ=íÜ~í=íÜÉ=çîÉêÅêçïÇáåÖ=áå=éêáëçåë=éçëÉÇ=~=ëìÄëí~åíá~ä=êáëâ=íç=íÜÉ=ÜÉ~äíÜ=~åÇ=ë~ÑÉíó=
çÑ= ïçêâÉêë= ~åÇ= áåã~íÉë= áå= `~äáÑçêåá~= éêáëçåëI= ~åÇ= íÜ~í= áããÉÇá~íÉ= ~Åíáçå= ï~ë= êÉèìáêÉÇ= íç= éêÉîÉåí=
ÇÉ~íÜ=~åÇ=Ü~êã=Å~ìëÉÇ=Äó=ëÉîÉêÉ=çîÉêÅêçïÇáåÖK=cçääçïáåÖ=íÜÉ=ÖçîÉêåçêÛë=ÇÉÅä~ê~íáçå=çÑ=íÜÉ=ëí~íÉ=çÑ=
ÉãÉêÖÉåÅóI=ÄçíÜ=íÜÉ=éä~áåíáÑÑë=áå=íÜÉ=mä~í~=~åÇ=`çäÉã~å=Å~ëÉë=ÑáäÉÇ=ãçíáçåë=íç=ÅçåîÉåÉ=~=íÜêÉÉJàìÇÖÉ=
é~åÉä= ìåÇÉê= mio^= íç= ÅçåëáÇÉê= ïÜÉíÜÉê= ~= mêáëçå= oÉäÉ~ëÉ= lêÇÉê= ëÜçìäÇ= ÄÉ= ÅçåëáÇÉêÉÇI= ~åÇ= íÜÉ=
ãçíáçåë=ïÉêÉ=Öê~åíÉÇK=qÜÉ=Å~ëÉë=ïÉêÉ=ÅçåëçäáÇ~íÉÇI=~åÇ=ÜÉ~êÇ=ÄÉÑçêÉ=~=íÜêÉÉJàìÇÖÉ=é~åÉä=íç=~ëëÉëë=
ïÜÉíÜÉê=~=mêáëçå=oÉäÉ~ëÉ=lêÇÉê=ï~ë=~å=~ééêçéêá~íÉ=êÉãÉÇó=ìåÇÉê=íÜÉ=mio^K=cçääçïáåÖ=~å=ÉñíÉåëáîÉ=
ÉîáÇÉåíá~êó=ÜÉ~êáåÖI=íÜÉ=é~åÉä=ÇÉíÉêãáåÉÇ=íÜ~í=çîÉêÅêçïÇáåÖ=áå=ëí~íÉ=éÉå~ä=Ñ~ÅáäáíáÉë=ï~ë=íÜÉ=éêáã~êó=
Å~ìëÉ= çÑ= íÜÉ= Åçåëíáíìíáçå~ääó= áå~ÇÉèì~íÉ= éêçîáëáçå= çÑ= ãÉÇáÅ~ä= ~åÇ= ãÉåí~ä= ÜÉ~äíÜ= Å~êÉK= qÜÉ= é~åÉä=
çêÇÉêÉÇ= `~äáÑçêåá~= íç= ÅêÉ~íÉ= ~åÇ= ÑáäÉ= “~= éçéìä~íáçå= êÉÇìÅíáçå= éä~å= íÜ~í= ïáää= áå= åç= ãçêÉ= íÜ~å= íïç=
óÉ~êë=êÉÇìÅÉ=íÜÉ=éçéìä~íáçå=çÑ=íÜÉ=`a`oÛë=~Çìäí=áåëíáíìíáçåë=íç=NPTKRB=çÑ=íÜÉáê=ÅçãÄáåÉÇ=ÇÉëáÖå=
Å~é~ÅáíóKÒNPT==
få=íÜÉ=~ééÉ~ä=ÄÉÑçêÉ=íÜÉ=pìéêÉãÉ=`çìêíI=íÜÉ=pí~íÉ=çÑ=`~äáÑçêåá~=ÅÜ~ääÉåÖÉÇ=íÜÉ=íÜêÉÉJàìÇÖÉ=
çêÇÉê= ã~åÇ~íáåÖ= íÜ~í= íÜÉ= pí~íÉ= êÉÇìÅÉ= íÜÉ= éçéìä~íáçå= çÑ= íÜÉ= éêáëçåë= íç= NPTKRB= çÑ= íÜÉáê= ÇÉëáÖåÉÇ=
Å~é~Åáíó= ïáíÜáå= íïç= óÉ~êëKNPU= qÜÉ= íÜêÉÉ= àìÇÖÉ= é~åÉä= ÅÜçëÉ= íÜáë= Å~é= Ä~ëÉÇ= çå= ÉñéÉêí= íÉëíáãçåó= ~åÇ=
ÉîáÇÉåÅÉ=éêÉëÉåíÉÇ=ÇìêáåÖ=íÜÉ=ÜÉ~êáåÖK=qÜÉ=éä~áåíáÑÑë=Ü~Ç=êÉèìÉëíÉÇ=~=NPMB=ÇÉëáÖå=Å~é~Åáíó=Å~éI=~åÇ=
ëìééçêíÉÇ=íÜÉ=êÉèìÉëí=ïáíÜ=ÉñéÉêí=íÉëíáãçåóI=ïÜáÅÜ=áåÅäìÇÉÇ=êÉéçêíë=Ñêçã=íÜÉ=dìÄÉêå~íçêá~ä=píêáâÉ=
qÉ~ã= í~ëâÉÇ= ïáíÜ= ~ÇÇêÉëëáåÖ= íÜÉ= mêáëçå= lîÉêÅêçïÇáåÖ= pí~íÉ= çÑ= bãÉêÖÉåÅó= ~åÇ= íÜÉ= _ìêÉ~ì= çÑ=
mêáëçåëK=_çíÜ=êÉéçêíë=ëÉí=éçéìä~íáçå=ã~å~ÖÉãÉåí=Öç~äë=íç=Å~é=áåã~íÉ=éçéìä~íáçåë=~í=NPMB=ÇÉëáÖå=
Å~é~ÅáíóK= qÜÉ= pí~íÉ= ~êÖìÉÇ= íÜ~í= íÜÉëÉ= éçéìä~íáçå= Öç~äë= ïÉêÉ= “ÇÉëáê~ÄäÉIÒ= Äìí= åçí= Åçåëíáíìíáçå~ääó=
êÉèìáêÉÇK= líÜÉê= ÉñéÉêí= íÉëíáãçåóI= áåÅäìÇáåÖ= ~= OMMQ= `çêêÉÅíáçåë= fåÇÉéÉåÇÉåí= oÉîáÉï= m~åÉä=
EéêÉé~êÉÇ=Äó=~=Öêçìé=çÑ=ÉñéÉêáÉåÅÉÇ=`~äáÑçêåá~=éêáëçå=ï~êÇÉåëF=ëìÖÖÉëíÉÇ=íÜ~í=“~=ëóëíÉã=çéÉê~íáåÖ=~í=
NPV
NQRB= ÇÉëáÖå= Å~é~Åáíó= ÅçìäÇ= ëìééçêí= Ñìää= áåã~íÉ= éêçÖê~ããáåÖ= áå= ~= ë~ÑÉI= ëÉÅìêÉ= ÉåîáêçåãÉåíKÒ =
eçïÉîÉêI=íÉëíáãçåó=êÉÖ~êÇáåÖ=íÜáë=êÉéçêí=ëÜçïÉÇ=íÜ~í=~ÇÉèì~íÉ=ãÉÇáÅ~ä=~åÇ=ãÉåí~ä=ÜÉ~äíÜ=Ñ~ÅáäáíáÉë=
ïÉêÉ= åçí= ~ÅÅçìåíÉÇ= Ñçê= áå= éêÉé~êáåÖ= íÜÉ= êÉéçêíX= íÜÉ= Åçìêí= íÜÉêÉÑçêÉ= êÉ~ëçåÉÇ= íÜ~í= Å~ééáåÖ= íÜÉ=
éçéìä~íáçå=~í=NQRB=Å~é~Åáíó=ïçìäÇ=åçí=ÄÉ=ÉåçìÖÜ=íç=éêçîáÇÉ=~ÇÉèì~íÉ=Å~êÉK=qÜìë=íÜÉ=àìÇáÅá~ä=é~åÉä=
                                                            
135

Id. at *10. The Plata court considered the appointment of a Receiver “a drastic measure” but blamed “the State’s
abdication of responsibility,” and stating that the court had “no choice but to step in to fill the void.” Id.
136
Id. at *11.
137
Order and Opinion, 2009 WL 24308420, *82 (N.D. Cal., E.D. Cal. 2009).
138
The challenge rests in part on the language of the PLRA, which states that a court cannot issue a prisoner release
order unless “( i) a court has previously entered an order for less intrusive relief that has failed to remedy the
deprivation....; and (ii) the defendant has had a reasonable amount of time to comply with the previous court orders.”
18. U.S.C. 3226 (a) (3) (A). California argues in part that t has not had a reasonable amount of time to remedy the
violations.
139
The Judicial Panel notes, with some frustration, that the State did not propose an alternative population cap that
would fix the Constitutional violation. Id.

27 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ÅêÉÇáíÉÇ=íÜÉ=ÉîáÇÉåÅÉ=ëìééçêíáåÖ=íÜÉ=NQRB=Éëíáã~íÉ=“íç=íÜÉ=ÉñíÉåí=íÜ~í=áí=ëìÖÖÉëíë=íÜ~í=íÜÉ=äáãáí=çå=
`~äáÑçêåá~Ûë= éêáëçå= éçéìä~íáçå= ëÜçìäÇ= ÄÉ= ëçãÉïÜ~í= ÜáÖÜÉê= íÜ~å= NPMB= Äìí= äçïÉê= íÜ~å= NQRBKÒNQM=
dáîÉå= ÅçåÑäáÅíáåÖ= ÉîáÇÉåÅÉI= íÜÉ= é~åÉä= çêÇÉêÉÇ= ~= éçéìä~íáçå= Å~é= çÑ= NPTKRB= ÇÉëáÖå= Å~é~ÅáíóI= “~=
éçéìä~íáçå=êÉÇìÅíáçå=Ü~äÑï~ó=ÄÉíïÉÉå=íÜÉ=Å~é=êÉèìÉëíÉÇ=Äó=éä~áåíáÑÑë=~åÇ=íÜÉ=ï~êÇÉåëÛ=Éëíáã~íÉ=çÑ=
íÜÉ= `~äáÑçêåá~= éêáëçå= ëóëíÉãÛë= ã~ñáãìã= çéÉê~ÄäÉ= Å~é~Åáíó= ~ÄëÉåí= ÅçåëáÇÉê~íáçå= çÑ= íÜÉ= åÉÉÇ= Ñçê=
ãÉÇáÅ~ä=~åÇ=ãÉåí~ä=ÜÉ~äíÜ=Å~êÉKÒNQN=
f=êÉ~äáòÉ=íÜÉëÉ=~êÉ=~=äçí=çÑ=ÇÉí~áäëI=Äìí=íÜáë=äáíáÖ~íáçå=~í=íÜÉ=pìéêÉãÉ=`çìêí=~åÇ=íÜÉ=ëíêìÖÖäÉ=
çîÉê=NPMI=NPTKR=çê=NQR=éÉêÅÉåí=çîÉêéçéìä~íáçåë=~êÉ=îÉêó=ëáÖåáÑáÅ~åí=ÄÉÅ~ìëÉ=íçÖÉíÜÉêI=íÜÉó=ëáÖå~ä=~=
ÖêÉ~íÉê=~ï~êÉåÉëë=çÑ=íÜÉ=éäáÖÜí=çÑ=éêáëçåÉêë=~åÇ=çÑ=íÜÉáê=ÅçåÇáíáçåë=çÑ=áåÅ~êÅÉê~íáçåK=qÜÉ=êÜÉíçêáÅ=~í=
íÜÉ=çê~ä=~êÖìãÉåí=~åÇ=íÜÉ=ãÉÇá~=ÅçîÉê~ÖÉ=çÑ=íÜÉ=pìéêÉãÉ=`çìêí=Å~ëÉ=ëÉÉã=íç=áåÇáÅ~íÉ=~=ÖêçïáåÖ=~åÇ=
ïáÇÉê=~ï~êÉåÉëë=çÑ=çîÉêÅêçïÇáåÖ=áå=éêáëçåë=~åÇ=íÜÉ=êÉëìäíáåÖ=éççê=ÅçåÇáíáçåëI=~ë=ïÉää=~ë=~=ÖêçïáåÖ=
ÅçåÅÉêå= Ñçê= íÜÉ= ÄÉëí= ï~ó= íç= ~ääçÅ~íÉ= éìÄäáÅ= êÉëçìêÅÉë= íç= ~ÇÇêÉëë= íÜÉëÉ= éêçÄäÉãëK= `çåÅÉêå= Ñçê= íÜÉ=
ïÉäÑ~êÉ=çÑ=éêáëçåÉêë=ï~ë=ÉîáÇÉåí=áå=ëÉîÉê~ä=èìÉëíáçåë=~ëâÉÇ=Äó=íÜÉ=àìëíáÅÉëK=gìëíáÅÉ=pçåá~=pçíçã~óçê=
çéÉåäó=~ëâÉÇ=íÜÉ=pí~íÉ=íç=~ÇÇêÉëë=íÜÉ=Üìã~å=Åçëíë=çÑ=çîÉêÅêçïÇáåÖW=“tÜÉå=~êÉ=óçì=ÖçáåÖ=íç=~îçáÇ=
íÜÉ= åÉÉÇäÉëë=ÇÉ~íÜë=íÜ~í=ïÉêÉ=êÉéçêíÉÇ=áå=íÜáë=êÉÅçêÇ\=tÜÉå=~êÉ=óçì=ÖçáåÖ=íç=~îçáÇ=çê=ÖÉí=~êçìåÇ=
éÉçéäÉ=ëáííáåÖ=áå=íÜÉáê=ÑÉÅÉë=Ñçê=Ç~óë=áå=~=Ç~òÉÇ=ëí~íÉ\=tÜÉå=~êÉ=óçì=ÖçáåÖ=íç=ÖÉí=íç=~=éçáåí=ïÜÉêÉ=
óçìDêÉ= ÖçáåÖ= íç= ÇÉäáîÉê= Å~êÉ= íÜ~í= áë= ÖçáåÖ= íç= ÄÉ= ~ÇÉèì~íÉ\ÒNQO= gìëíáÅÉ= píÉéÜÉå= _êÉóÉê= ~äëç= Å~ääÉÇ=
~ííÉåíáçå= íç= íÜÉ= éççê= ÅçåÇáíáçåëÔïÜáÅÜ= ÜÉ= ä~íÉê= Å~ääÉÇ= “~= ÄáÖ= Üìã~å= êáÖÜíë= éêçÄäÉãÒNQPÔëí~íáåÖ=
íÜ~í= “fíÛë= çÄîáçìëÁ= óçì= Å~ååçí= Ü~îÉ= ãÉåí~ä= ÜÉ~äíÜ= Ñ~ÅáäáíáÉë= íÜ~í= ïáää= ëíçé= éÉçéäÉ= Ñêçã= âáääáåÖ=
íÜÉãëÉäîÉë= ~åÇ= óçì= Å~ååçí= Ü~îÉ= ãÉÇáÅ~ä= Ñ~ÅáäáíáÉë= íÜ~í= ïáää= ëíçé= ëí~éÜ= ~åÇ= íìÄÉêÅìä~ê= áåÑÉÅíáçå= áå=
NQQ
ÅçåÇáíáçåë=äáâÉ=íÜáëKÒ ==
líÜÉê= èìÉëíáçåë= áåÇáÅ~íÉÇ= ~= ÑÉ~ê= çÑ= íÜÉ= ÅçåëÉèìÉåÅÉë= çÑ= íÜÉ= éçéìä~íáçå= Å~éI= êÉÑäÉÅíáåÖ= íÜÉ=
ÇÉÄ~íÉë= çîÉê= íÜÉ= éêçéÉê= íêÉ~íãÉåí= çÑ= íÜÉ= ãÉåí~ääó= áää= Eáëçä~íÉÇ= áå= ~ëóäìãë= çê= áåíÉÖê~íÉÇ= áåíç=
ÅçããìåáíáÉëFK= _ìí= ìåäáâÉ= íÜÉ= ãÉåí~ä= ÜÉ~äíÜ= ÇÉÄ~íÉëI= áå= íÜÉ= éêáëçå= ÅçåíÉñí= ÅçåÑáåÉãÉåí= áíëÉäÑ= áë= ~=
é~êí=çÑ=éìåáëÜãÉåíI=~åÇ=ëìééçëÉÇäó=~å=áããÉÇá~íÉ=ÇÉíÉêêÉåí=íç=ÑìêíÜÉê=ÅêáãÉK=qÜáë=ÅçåëÉèìÉåíá~äáëí=
~êÖìãÉåí= ï~ë= êÉÑäÉÅíÉÇ= áå= èìÉëíáçåë= Äó= gìëíáÅÉ= p~ãìÉä= ^äáíç= E“xfzÑ= f= ïÉêÉ= ~= ÅáíáòÉå= çÑ= `~äáÑçêåá~I= f=
NQR
ïçìäÇ=ÄÉ=ÅçåÅÉêåÉÇ=~Äçìí=íÜÉ=êÉäÉ~ëÉ=çÑ=QMIMMM=éêáëçåÉêëÒF =~åÇ=`ÜáÉÑ=gìëíáÅÉ=gçÜå=oçÄÉêíëI=ïÜçëÉ=
NQS
èìÉëíáçåë= ÉãéÜ~ëáòÉÇ= íÜÉ= ÜáÖÜ= êÉÅáÇáîáëã= ê~íÉ= çÑ= é~êçäÉÉë I= ïÜÉå= ~ÇÇêÉëëáåÖ= ïÜÉíÜÉê= íÜÉ= íÜêÉÉJ
àìÇÖÉ=é~åÉäÛë=çêÇÉê=Ö~îÉ=~ééêçéêá~íÉ=ÅçåëáÇÉê~íáçå=íç=Åçããìåáíó=ë~ÑÉíóI=áå=~ÇÜÉêÉåÅÉ=ïáíÜ=mio^K=
qÜÉ= çê~ä= ~êÖìãÉåíë= ~äëç= áåÇáÅ~íÉÇ= ~= ÖêçïáåÖ= Ñêìëíê~íáçå= ~åÇ= ÉñÜ~ìëíáçå= ïáíÜ= íÜÉ= éìÄäáÅ=
ÅçåëÉèìÉåÅÉë= çÑ= ~= ä~êÖÉ= éêáëçå= éçéìä~íáçåK= gìëíáÅÉ= ^äáíç= èìÉëíáçåÉÇ= íÜÉ= ~ééêçéêá~íÉåÉëë= çÑ= ~=
ã~åÇ~íÉÇ= éêáëçå= Å~éI= Äìí= gìëíáÅÉë= _êÉóÉêI= dáåëÄìêÖ= ~åÇ= hÉååÉÇó= É~ÅÜ= ÉãéÜ~ëáòÉÇ= íÜÉ= Ñ~áäìêÉ= çÑ=
                                                            
140

Additionally, the Panel found the evidence supporting the adequacy of care at 145% capacity to be “far less
persuasive.” Id. at *83.
141
Id.
142
Transcript of Oral Argument at 15, Schwarzenegger v. Plata, No. 09-1233 (November 30, 2010).
143
Id. at 27.
144
Id. at 20.
145
Id. at 48.
146
Id. at 67.

28 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

éêÉîáçìë= ~ííÉãéíë= íç= áãéêçîÉ= ÅçåÇáíáçåëK= qÜêçìÖÜçìí= íÜÉ= ~êÖìãÉåíI= êÉÑÉêÉåÅÉë= ïÉêÉ= ã~ÇÉ= íç= íÜÉ=
Ñ~áäìêÉ=íç=ëÉÅìêÉ=ÑìåÇáåÖ=íç=áãéêçîÉ=éêáëçå=ÅçåÇáíáçåë=íç=~=Åçåëíáíìíáçå~ääó=~ÇÉèì~íÉ=ëí~íÉK=
jÉÇá~= ÅçîÉê~ÖÉ= çÑ= íÜÉ= Å~ëÉ= ëÉÉãë= íç= áåÇáÅ~íÉ= ~= ÖêçïáåÖ= éìÄäáÅ= ëÉåíáãÉåí= ~Ö~áåëí= ã~ëë=
áåÅ~êÅÉê~íáçåKNQT=j~åó=ÉÇáíçêá~äëI=ïáíÜ=íáíäÉë=ëìÅÜ=~ë=íÜÉ=“`êáãÉ=çÑ=mìåáëÜãÉåíÒ=~åÇ=“lîÉêÅêçïÇáåÖ=
áå= mêáëçåë= mìí= rë= ^ää= ^í= oáëâIÒ= ëìééçêíÉÇ= ìéÜçäÇáåÖ= íÜÉ= íÜêÉÉJàìÇÖÉ= é~åÉäÛë= ÇÉÅáëáçå= Å~ééáåÖ= íÜÉ=
éêáëçå= éçéìä~íáçåK= bîÉå= ~êíáÅäÉë= íÜ~í= ÑçÅìëÉÇ= ãçêÉ= çå= íÜÉ= çê~ä= ~êÖìãÉåí= E~åÇ= äÉëë= çå= ~ÇîçÅ~ÅóF=
ëÉÉãÉÇ=íç=åçíÉ=íÜÉ=ëâÉéíáÅáëã=ãÉãÄÉêë=çÑ=íÜÉ=`çìêí=ëÜçïÉÇ=Ñçê=íÜÉ=pí~íÉÛë=~êÖìãÉåíëKNQU==
qÜáë=âáåÇ=çÑ=ÜáÖÜJéêçÑáäÉ=äáíáÖ~íáçå=ã~ó=ïÉää=ÜÉäé=íç=ëÜáÑí=éçéìä~ê=îáÉïë=~Äçìí=éêáëçåë=~åÇ=
éêáëçå= ÅçåÇáíáçåëK= ^äçåÖ= ïáíÜ= ÇçÅìãÉåí~êó= Ñáäãë= áå= íÜÉ= îÉáå= çÑ= qáíáÅìí= cçääáÉëI= áí= áë= éçëëáÄäÉ= íç=
áã~ÖáåÉ= íÜÉëÉ= äÉÖ~ä= ~åÇ= Åìäíìê~ä= áåíÉêîÉåíáçåë= Ü~îáåÖ= ~å= ÉÑÑÉÅí= çå= éìÄäáÅ= éÉêÅÉéíáçå= íÜ~í= ÅçìäÇ=
ìäíáã~íÉäó=êÉÇìÅÉ=éêáëçå=éçéìä~íáçåëK=fíÛë=íêìÉ=íÜ~íI=ïÜáäÉ=éìÄäáÅ=ëÉåíáãÉåí=ã~ó=ÄÉ=ãçêÉ=ëóãé~íÜÉíáÅ=
íç=íÜÉ=ãçêÉ=ÉÖêÉÖáçìë=Éñ~ãéäÉë=çÑ=ÜçêêáÑáÅ=ÅçåÇáíáçåë=áå=éêáëçåëI=áí=ëÉÉãë=ìåäáâÉäó=íÜ~í=éêáëçåÉêë=ïáää=
ÉîÉê= ÄÉ= ~ÄäÉ= íç= ÉîçâÉ= íÜÉ= ë~ãÉ= ~ãçìåí= çÑ= ëóãé~íÜó= ~ë= íÜÉ= ãÉåí~ääó= áääK= få= Åçåíê~ëí= íç= ãÉåí~ä=
é~íáÉåíëI= éêáëçåÉêë= íÉåÇ= íç= ÄÉ= îáÉïÉÇ= ~ë= ÇÉëÉêîáåÖ= çÑ= íÜÉáê= éìåáëÜãÉåíK= qÜÉ= èìÉëíáçåI= íÜçìÖÜI= áë=
ïÜÉíÜÉê=íÜÉó=ïáää=ÅçåíáåìÉ=íç=ÄÉ=îáÉïÉÇ=~ë=ÇÉëÉêîáåÖ=çÑ=íÜÉ=ÉñÅÉëëáîÉ=Ñçêãë=çÑ=éìåáëÜãÉåí=~ëëçÅá~íÉÇ=
ïáíÜ=íÜÉëÉ=çîÉêÅêçïÇÉÇ=~åÇ=ìåë~åáí~êó=éêáëçåë=~åÇ=à~áäëK=
fffK qÜÉ=máíÑ~ääë=çÑ=aÉáåëíáíìíáçå~äáò~íáçåW=tÜ~í=íç=^îçáÇ\=
^= ëÉÅçåÇ= ä~êÖÉ= ~êÉ~= íç= ÅçåëáÇÉê= áë= ïÜÉíÜÉê= íÜÉêÉ= ~êÉ= Öä~êáåÖ= éáíÑ~ääë= íç= ~îçáÇ= Ñêçã= íÜÉ=
ÉñéÉêáÉåÅÉ=ïáíÜ=ÇÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMëK=qÜÉ=Ç~åÖÉêë=ÜÉêÉ=~êÉ=ÉîÉå=ãçêÉ=ëíê~áÖÜíÑçêï~êÇK=
qïç= äÉ~é= íç= ãáåÇW= íÜÉ= áåÅêÉ~ëÉÇ= ê~Åá~äáò~íáçå= çÑ= íÜÉ= áåëíáíìíáçåë= ~ë= íÜÉó= ïÉêÉ= ÇÉáåëíáíìíáçå~äáòÉÇI=
~åÇI=ëÉÅçåÇI=íÜÉ=íê~åëáåëíáíìíáçå~äáò~íáçå=íÜ~í=çÅÅìêêÉÇ=áå=íÜÉ=ï~âÉ=çÑ=ÇÉáåëíáíìíáçå~äáò~íáçåK==
^K o~Åá~äáò~íáçå=çÑ=íÜÉ=eçëéáí~ä=mçéìä~íáçå=
                                                            
147

See, e.g., The Crime of Punishment:[Editorial], New York Times. (Late Edition (east Coast)). New York, N.Y.:
Dec 6, 2010. p. A.26; David Fathi , Bulging Prisons Put Us At Risk, Contra Costa Times, Walnut Creek, Calif.: Dec
4, 2010. p. A.8; Justices Debate Prison Lawsuit: Justices question if rights of inmates outweigh state's interest in
managing own penal system, Contra Costa Times, Walnut Creek, Calif.: Dec 1, 2010. p. A.11; Adam Liptak,
Justices Hear Arguments on California Prison Crowding, New York Times. (Late Edition (east Coast)). New York,
N.Y.: Dec 1, 2010. p. A.16; Jimmy Bierman and Jaime Dorenbaum, “’Three strikes’ law is a human travesty,” The
Sacramento Bee, Sacramento, Calif., Dec 17, 2010, p. A.19; Michael Doyle , Calif. prison ruling expected to be split
Supreme Court divided on how to fix crowding, The Fresno Bee. Fresno, Calif.: Dec 1, 2010. p. A.1; Robert Barnes,
High court hears California prisons case, The Washington Post. Washington, D.C.: Dec 1, 2010. p. A.2; High Court
to look at Calif. prison crowding, The Associated Press, Charleston Daily Mail. Charleston, W.V.: Nov 30, 2010. p.
A.10; Warren Richey, California, at Supreme Court, fights judicial order on prison overcrowding, The Christian
Science Monitor. Boston, Mass.: Nov 30, 2010; Prison Ruling Stirs Up California, Wall Street Journal (Online),
New York, N.Y.: Nov 29, 2010; Joanna Chung and Bobby White, Court to Hear Prison-Crowding Case, Wall Street
Journal (Eastern Edition), New York, N.Y.: Nov 29, 2010. p. A.4.
148
David G. Savage, “State prison case falls on dubious ears; High court appears likely to back ruling ordering
California to free 40,000 inmates,” Los Angeles Times. Los Angeles, Calif., Dec 1, 2010. p. AA.1; Bob Egelko,
“State arguments draw skepticism from high court,” San Francisco Chronicle, San Francisco, Calif., Dec 1, 2010. p.
C.1.

29 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

aÉáåëíáíìíáçå~äáò~íáçå=áå=íÜÉ=NVSMë~åÇ=NVTMë=ÇêÉï=ÜÉ~îáäó=çå=éêÉÇáÅíáçåë=çÑ=Ç~åÖÉêçìëåÉëëK=
qÜÉ= íêçìÄäÉ= áë= íÜ~í= íÜÉ= ìëÉ= çÑ= êáëâ= ~ëëÉëëãÉåí= íççäë= íóéáÅ~ääó= Ü~ë= íÜÉ= ÉÑÑÉÅí= çÑ= ëçêíáåÖ= çå= ê~ÅÉ= ~åÇ=
áåÅêÉ~ëáåÖ=íÜÉ=ê~Åá~ä=Çáëéêçéçêíáçå=ïáíÜáå=çìê=“Ç~åÖÉêçìëÒ=éçéìä~íáçåëK=qÜáë=ï~ë=ÅÉêí~áåäó=íÜÉ=Å~ëÉ=
ïáíÜ=êÉÖ~êÇ=íç=ãÉåí~ä=Üçëéáí~äëK=fí=áë=~äëç=äáâÉäó=íç=Ü~ééÉå=ïáíÜ=éêáëçåë=áÑ=ïÉ=êÉäó=íçç=ÜÉ~îáäó=çå=êáëâ=
~ëëÉëëãÉåíK==
qÜÉ= íìêå= íç= Ç~åÖÉêçìëåÉëë= Ü~Ç= ~= ÇáëíáåÅíäó= Çáëéêçéçêíáçå~íÉ= ÉÑÑÉÅí= çå= ^ÑêáÅ~åJ^ãÉêáÅ~å=
éçéìä~íáçåëW= íÜÉ= éêçéçêíáçå= çÑ= ãáåçêáíáÉë= áå= ãÉåí~ä= Üçëéáí~äë= áåÅêÉ~ëÉÇ= ëáÖåáÑáÅ~åíäó= ÇìêáåÖ= íÜÉ=
éêçÅÉëë= çÑ= ÇÉáåëíáíìíáçå~äáò~íáçåK= cêçã= NVSU= íç= NVTUI= Ñçê= áåëí~åÅÉI= íÜÉêÉ= ï~ë= ~= ëáÖåáÑáÅ~åí=
ÇÉãçÖê~éÜáÅ= ëÜáÑí= ~ãçåÖ= ãÉåí~ä= Üçëéáí~ä= ~ÇãáííÉÉëK= få= ~= NVUQ= ëíìÇóI= eÉåêó= píÉ~Çã~åI= gçÜå=
jçå~Ü~åI=~åÇ=íÜÉáê=ÅçääÉ~ÖìÉë=íÉëíÉÇ=íÜÉ=ÇÉÖêÉÉ=çÑ=êÉÅáéêçÅáíó=ÄÉíïÉÉå=íÜÉ=ãÉåí~ä=ÜÉ~äíÜ=~åÇ=éêáëçå=
ëóëíÉãë=áå=íÜÉ=ï~âÉ=çÑ=ëí~íÉ=ãÉåí~ä=Üçëéáí~ä=ÇÉáåëíáíìíáçå~äáò~íáçåI=ìëáåÖ=~=ê~åÇçãäó=ëÉäÉÅíÉÇ=ë~ãéäÉ=
çÑ=PIUVT=ã~äÉ=éêáëçåÉêë=~åÇ=OIPTS=~Çìäí=ã~äÉ=~ÇãáííÉÉë=íç=ëí~íÉ=ãÉåí~ä=Üçëéáí~äë=Ñêçã=ëáñ=ÇáÑÑÉêÉåí=
ëí~íÉëKNQV= tÜ~í= íÜÉáê= êÉëÉ~êÅÜ= êÉîÉ~äÉÇ= áë= íÜ~í= íÜÉ= éêçéçêíáçå= çÑ= åçåJïÜáíÉë= ~ÇãáííÉÇ= íç= ãÉåí~ä=
Ñ~ÅáäáíáÉë= áåÅêÉ~ëÉÇ= Ñêçã= NUKPB= áå= NVSU= íç= PNKTB= áå= NVTUW= “^Åêçëë= íÜÉ= ëáñ= ëí~íÉë= ëíìÇáÉÇI= íÜÉ= Á=
éÉêÅÉåí~ÖÉ= çÑ= ïÜáíÉë= ~ãçåÖ= ~ÇãáííÉÇ= é~íáÉåíë= ~äëç= ÇÉÅêÉ~ëÉÇI= Ñêçã= UNKTB= áå= NVSU= íç= SUKPB= áå=
NVTUKÒNRM==
qÜáë= áë= ÇÉãçåëíê~íÉÇ= áå= íÜÉ= ÑçääçïáåÖ= Öê~éÜ= ïÜáÅÜ= ÅÜ~êíë= íÜÉ= ëÜáÑí= ÇçÅìãÉåíÉÇ= Äó=
píÉ~Çã~åI=jçåçÜ~å=~åÇ=íÜÉáê=ÅçääÉ~ÖìÉëW=
=
=
=
=
=
=
=
=
=
cáÖìêÉ=RW=^Çãáëëáçåë=íç=ãÉåí~ä=Ñ~ÅáäáíáÉë=Äó=o~ÅÉ=
                                                            
149

Henry J. Steadman et al., “The Impact of State Mental Hospital Deinstitutionalization on United States Prison
Populations, 1968–1978,” 75 J. Crim. L. & Criminology 474, 478 (1984).
150. Steadman et al. 1984:479. Note that there was a similar, though less stark shift in prison admissions: “Across
the six states, the … percentage of whites among prison admittees was also relatively stable, decreasing only from
57.6% in 1968 to 52.3% in 1978.” Id.

30 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

qÜÉ= íê~Åâ= êÉÅçêÇ= áë= Ç~ãåáåÖW= ãÉåí~ä= Üçëéáí~äë= ïÉêÉ= ÇÉáåëíáíìíáçå~äáòÉÇ= Äó= ÑçÅìëáåÖ= çå=
Ç~åÖÉêçìëåÉëë=~åÇ=íÜÉ=êÉëìäí=ï~ë=~=ëÜ~êé=áåÅêÉ~ëÉ=áå=íÜÉ=Ää~Åâ=êÉéêÉëÉåí~íáçå=áå=~ëóäìãë=~åÇ=ãÉåí~ä=
áåëíáíìíáçåëK= f= Ü~îÉ= ïêáííÉå= ~í= ÖêÉ~íÉê= äÉåÖíÜ= ~Äçìí= íÜáë= áå= ~å= Éëë~óI= “oáëâ= ~ë= ~= mêçñó= Ñçê= o~ÅÉIÒ=
ÑçêíÜÅçãáåÖ= áå= `êáãáåçäçÖó= ~åÇ= mìÄäáÅ= mçäáÅóX= ~åÇ= jáÅÜÉääÉ= ^äÉñ~åÇÉê= Ü~ë= ÑçêÅÉÑìääó= Çê~ïå= íÜÉ=
ÇÉî~ëí~íáåÖ=ÅçåëÉèìÉåÅÉë=Ñçê=ÅçããìåáíáÉë=~åÇ=^ãÉêáÅ~å=éçäáíáÅë=áå=ÜÉê=Äççâ= qÜÉ=kÉï=gáã=`êçïW=
j~ëë=fåÅ~êÅÉê~íáçå=áå=íÜÉ=^ÖÉ=çÑ=`çäçêÄäáåÇåÉëë=EOMNMF=~åÇ=áå=ÜÉê=ÅçåíêáÄìíáçå=íç=íÜáë=ëóãéçëáìãK=
fí=áë=~ÄëçäìíÉäó=ÅêìÅá~ä=íÜ~í=áå=~åó=ÉÑÑçêí=íç=êÉÇìÅÉ=ã~ëë=áåÅ~êÅÉê~íáçåI=íÜáë=éáíÑ~ää=ÄÉ=~îçáÇÉÇK==
_K qê~åëáåëíáíìíáçå~äáò~íáçå=
qÜÉ= çíÜÉê= Ç~åÖÉê= íç= ~îçáÇ= áë= íê~åëáåëíáíìíáçå~äáò~íáçåK= qÜáë= ìåèìÉëíáçå~Ääó= Ü~ééÉåÉÇ= ïáíÜ=
íÜÉ=ãÉåí~ääó=áääI=~ë=íÜÉó=ïÉêÉ=åçí=çåäó=íê~åëÑÉêêÉÇ=íç=åìêëáåÖ=ÜçãÉëI=Äìí=ÉîÉåíì~ääó=ÄÉÅ~ãÉ=~=ãìÅÜ=
ä~êÖÉê= ëÉÖãÉåí= çÑ= íÜÉ= éêáëçå= éçéìä~íáçåK= táääá~ã= dêçåÑÉáå= Ü~ë= ÇçÅìãÉåíÉÇ= íÜÉ=
íê~åëáåëíáíìíáçå~äáò~íáçå= çÑ= çäÇÉê= ãÉåí~ä= é~íáÉåíë= Ñêçã= Üçëéáí~äë= íç= åìêëáåÖ= ÜçãÉë= áå= íÜÉ= NVTMëK=
dêçåÑÉáå=ÉãéÜ~ëáòÉë=íÜ~í=íÜÉ=çîÉê~ää=áåëíáíìíáçå~äáòÉÇ=éçéìä~íáçå=ÇáÇ=åçí=ÇÉÅêÉ~ëÉ=çîÉê=íÜÉ=NVSMëI=áå=
Ñ~Åí= êáëáåÖ= ëäáÖÜíäó= Ñêçã= NIMPR= éÉê= NMMIMMM= ÖÉåÉê~ä= éçéìä~íáçå= áå= NVSM= íç= NIMQS= éÉê= NMMIMMM= áå=
NVTMK=vÉíI=ÇìêáåÖ=íÜáë=éÉêáçÇI=íÜÉ=éêçéçêíáçå=çÑ=íÜÉ=áåëíáíìíáçå~äáòÉÇ=éçéìä~íáçå=áå=åìêëáåÖ=~åÇ=çäÇ=
~ÖÉ=ÜçãÉë=áåÅêÉ~ëÉÇ=Ñêçã=NVB=áå=NVRM=íç=ORB=áå=NVSMI=~åÇ=êÉ~ÅÜÉÇ=QQB=Äó=NVTMKNRN=“qÜÉ=íçí~ä=
åìãÄÉê=çÑ=åìêëáåÖ=Å~êÉ=~åÇ=êÉä~íÉÇ=ÜçãÉë=êçëÉ=Ñêçã=NSITMN=áå=NVSP=íç=OOIRRU=áå=NVTNI=~å=áåÅêÉ~ëÉ=
çÑ=PRKNBI=ïÜáäÉ=íÜÉ=åìãÄÉê=çÑ=ÄÉÇë=~î~áä~ÄäÉ= áå=ëìÅÜ=ÜçãÉë=êçëÉ=Ñêçã=RSUIRSM=íç=NIOPRIQMRI=~å=
áåÅêÉ~ëÉ=çÑ=NNTKPBKÒNRO=få=dêçåÑÉáåÛë=îáÉïI=íÜáë=ï~ë=íÜÉ=éêçÇìÅí=çÑ=jÉÇáÅ~êÉ=~åÇ=jÉÇáÅ~áÇI=ïÜáÅÜ=
ÉåÅçìê~ÖÉÇ=íÜÉ=ëìÄëíáíìíáçå=çÑ=çåÉ=áåëíáíìíáçå=EåìêëáåÖ=Å~êÉF=Ñçê=~åçíÜÉê=EãÉåí~ä=Üçëéáí~äëFK==
få=~ÇÇáíáçåI=ïÉ=Ü~îÉ=~ää=ïáíåÉëëÉÇ=íÜÉ=íê~åëáåíáíìíáçå~äáò~íáçå=çÑ=ãÉåí~ä=ÜÉ~äíÜ=é~íáÉåíë=áåíç=
éêáëçåë=~åÇ=à~áäëK=få=Üáë=é~éÉêI=qÜÉ=aÉáåëíáíìíáçå~äáò~íáçå=çÑ=íÜÉ=jÉåí~ääó=fää=~åÇ=dêçïíÜ=áå=íÜÉ=rKpK=
mêáëçå= mçéìä~íáçåëW= NVTN= íç= NVVSINRP= píÉîÉå= o~éÜ~Éä= ÉñéäçêÉë= íÜÉ= êÉä~íáçåëÜáé= ÄÉíïÉÉå= ãÉåí~ä=
Üçëéáí~äáò~íáçå=~åÇ=éêáëçå=éçéìä~íáçåë=ìëáåÖ=ëí~íÉJäÉîÉä=Ç~í~=Ñçê=íÜÉ=éÉêáçÇ=NVTN=íç=NVVSI=~åÇ=ÑáåÇë=
íÜ~í= ÇÉáåëíáíìíáçå~äáò~íáçå= Ñêçã= NVTN= íç= NVVS= éêçÄ~Ääó= êÉëìäíÉÇ= áå= ÄÉíïÉÉå= QUIMMM= ~åÇ= NQUIMMM=
~ÇÇáíáçå~ä=ëí~íÉ=éêáëçåÉêë=áå=NVVSI=ïÜáÅÜI=~ÅÅçêÇáåÖ=íç=o~éÜ~ÉäI=“~ÅÅçìåíë=Ñçê=QKR=íç=NQ=éÉêÅÉåí=çÑ=
íÜÉ=íçí~ä=éêáëçå=éçéìä~íáçå=Ñçê=íÜáë=óÉ~ê=~åÇ=Ñçê=êçìÖÜäó=OU=íç=US=éÉêÅÉåí=çÑ=éêáëçå=áåã~íÉë=ëìÑÑÉêáåÖ=
NRQ
Ñêçã=ãÉåí~ä=áääåÉëëKÒ =tÜ~í=ïÉ=~äëç=âåçï=áë=íÜ~íI=~í=íÜÉ=ÅäçëÉ=çÑ=íÜÉ=íïÉåíáÉíÜ=ÅÉåíìêóI=íÜÉêÉ=ï~ë=~=

                                                            
151

Gronfein, “Incentives and Intentions,” 1985, p. 200.
Id.
153
Steven Raphael, “The Deinstitutionalization of the Mentally Ill and Growth in the U.S. Prison Populations: 1971
to
1996”
(Sept.
2000)
(unpublished
manuscript),
available
at
http://istsocrates.berkeley.edu/~raphael/raphael2000.pdf (finding that mental hospitalization rates have significant negative
effects on prison incarceration rates).
152

154

Id. at 12.

31 

DRAFT: January 21, 2011 

 

Harcourt:  Lessons from Deinstitutionalization 

 

ÜáÖÜ= äÉîÉä= çÑ= ãÉåí~ääó= áää= çÑÑÉåÇÉêë= áå= éêáëçåë= ~åÇ= à~áäë= áå= íÜÉ= råáíÉÇ= pí~íÉëÔOUPIUMM= áå= NVVUÔ
êÉéêÉëÉåíáåÖ=NSB=çÑ=à~áä=~åÇ=ëí~íÉ=éêáëçå=áåã~íÉëKNRR=
fÑ= íÜÉêÉ= áë= íç= ÄÉ= ÇÉÅ~êÅÉê~íáçåI= íÜÉêÉ= áë= ~= ëáÖåáÑáÅ~åí= êáëâ= íÜ~í= áí= ïáää= ëáãéäó= éêçÇìÅÉ= åÉï=
éçéìä~íáçåë=Ñçê=çíÜÉê=áåëíáíìíáçåëI=ïÜÉíÜÉê=ÜçãÉäÉëë=ëÜÉäíÉêëI=áåé~íáÉåí=íêÉ~íãÉåí=Ñ~ÅáäáíáÉëI=çê=çíÜÉê=
äçÅâÉÇJÇçïå=Ñ~ÅáäáíáÉëK=qÜáë=áëI=áåÇÉÉÇI=ïÜ~í=Ü~ééÉåÉÇ=ä~ëí=íáãÉK=qÜÉ=èìÉëíáçå=ïçìäÇ=ÄÉI=Å~å=áí=ÄÉ=
~îçáÇÉÇ=íÜáë=íáãÉ\=
fsK `çåÅäìëáçå=
tçìäÇ=áí=ÉîÉê=ÄÉ=éçëëáÄäÉ=íç=ÜÉ~ê=~=mêÉëáÇÉåí=çÑ=íÜÉ=råáíÉÇ=pí~íÉë=ÇÉÅä~êÉ=íç=`çåÖêÉëëW=
fÑ=ïÉ=ä~ìåÅÜ=~=Äêç~Ç=åÉï=éêçÖê~ã=åçïI=áí=ïáää=ÄÉ=éçëëáÄäÉ=ïáíÜáå=~=ÇÉÅ~ÇÉ=çê=íïç=íç=
êÉÇìÅÉ=íÜÉ=åìãÄÉê=çÑ=éêáëçåÉêë=åçï=ìåÇÉê=ÅìëíçÇá~ä=Å~êÉ=Äó=RM=éÉêÅÉåí=çê=ãçêÉK=j~åó=ãçêÉ=
áåã~íÉë= Å~å= ÄÉ= ÜÉäéÉÇ= íç= êÉã~áå= áå= íÜÉáê= ÜçãÉë= ïáíÜçìí= Ü~êÇëÜáé= íç= íÜÉãëÉäîÉë= çê= íÜÉáê=
Ñ~ãáäáÉëK= qÜçëÉ= ïÜç= ~êÉ= áåÅ~êÅÉê~íÉÇ= Å~å= ÄÉ= ÜÉäéÉÇ= íç= êÉíìêå= íç= íÜÉáê= çïå= ÅçããìåáíáÉëKKK=
`Éåíê~ä=íç=~=åÉï=éêçÖê~ã=áë=ÅçãéêÉÜÉåëáîÉ=Åçããìåáíó=Å~êÉK=jÉêÉäó=éçìêáåÖ=cÉÇÉê~ä=ÑìåÇë=
áåíç= ~= Åçåíáåì~íáçå= çÑ= íÜÉ= çìíãçÇÉÇ= íóéÉ= çÑ= áåëíáíìíáçå~ä= Å~êÉ= ïÜáÅÜ= åçï= éêÉî~áäë= ïçìäÇ=
NRS
ã~âÉ=äáííäÉ=ÇáÑÑÉêÉåÅÉK =
=
f= Çç= åçí= âåçï= íÜÉ= ~åëïÉê= íç= íÜáë= èìÉëíáçåI= ~åÇ= ãó= í~ëâ= Ü~ë= åçí= ÄÉÉå= íç= éêÉÇáÅí= çê= íç=
ëéÉÅìä~íÉI= Äìí= ê~íÜÉê= íç= ëâÉíÅÜI= éêÉäáãáå~êáäóI= ëçãÉ= äÉëëçåë= Ñêçã= çìê= é~ëí= ÉñéÉêáÉåÅÉ= çÑ=
ÇÉáåëíáíìíáçå~äáò~íáçåK=tÜÉíÜÉê=fI=éÉêëçå~ääóI=~ã=çéíáãáëíáÅ=çê=éÉëëáãáëíáÅ=ëÜçìäÇ=ÄÉ=çÑ=åç=ÅçåÅÉêå=
íç= óçìK= çåÉ= çÑ= íÜÉ= ãçëí= áãéçêí~åí= äÉëëçåë= Ñêçã= ~ää= íÜáëI= íÜçìÖÜI= áë= íÜ~í= áí= ã~ó= åçí= ÄÉ= éçëëáÄäÉ= íç=
ã~âÉ= ãìÅÜ= ÜÉ~Çï~ó= áå= êÉÇìÅáåÖ= ã~ëë= áåÅ~êÅÉê~íáçå= ïáíÜçìí= íÜÉ= âáåÇ= çÑ= éçäáíáÅ~ä= áåîÉëíãÉåíI=
ÅçåíÉñíI=~åÇ=ïáää=íÜ~í=mêÉëáÇÉåí=gçÜå=cK=hÉååÉÇó=ÉñéêÉëëÉÇ=áå=NVSPK=fÑ=ïÉ=~êÉ=áåÇÉÉÇ=íç=ïçêâ=íçï~êÇ=
ÇÉÅêÉ~ëÉÇ=éêáëçå=éçéìä~íáçåëI=íÜÉ=í~ëâ=~ÜÉ~Ç=ïáää=ÄÉ=íç=ã~ñáãáòÉ=ëçãÉ=çÑ=íÜÉ=ëáäîÉê=äáåáåÖë=çÑ=NVSMë=
ÇÉáåëíáíìíáçå~äáò~íáçå= ïÜáäÉ= ~îçáÇáåÖ= íÜÉ= Öä~êáåÖ= éáíÑ~ääëÔçê= ~í= äÉ~ëíI= íç= ÑìêíÜÉê= ëíìÇó= íÜÉëÉ= äÉëëçåë=
Ñêçã=ÇÉáåëíáíìíáçå~äáò~íáçåK==
=

                                                            
155

Paula M. Ditton, Bureau of Justice Statistics, U.S. Dep’t of Justice, Special Report: Mental Health and the
Treatment of Inmates and Probationers 3 (1999), available at http://www.ojp.usdoj.gov/bjs/pub/pdf/mhtip.pdf.

156

President Kennedy’s statement to Congress, slightly modified, quoted in Gronfein, “Incentives and Intentions,”
1985, at p. 196.

32 

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
Readers with comments should address them to:
Professor Bernard E. Harcourt
University of Chicago Law School
1111 East 60th Street
Chicago, IL 60637
harcourt@uchicago.edu

 

Chicago Working Papers in Law and Economics
(Second Series)
For a listing of papers 1–475 please go to Working Papers at
http://www.law.uchicago.edu/Lawecon/index.html
476.
477.
478.
479.
480.
481.
482.
483.
484.
485.
486.
487.
488.
489.
490.
491.
492.
493.
494.
495.
496.
497.
498.
499.
500.
501.
502.
503.
504.
505.
506.
507.
508.
509.

M. Todd Henderson, Credit Derivatives Are Not “Insurance” (July 2009)
Lee Anne Fennell and Julie Roin, Controlling Residential Stakes (July 2009)
Douglas G. Baird, The Holmesian Bad Man’s First Critic (August 2009)
Douglas G. Baird, The Bankruptcy Exchange (August 2009)
Jonathan Masur and Eric A. Posner, Against Feasibility Analysis (August 2009)
Lee Anne Fennell, The Unbounded Home, Property Values beyond Property Lines (August 2009)
Bernard E. Harcourt, Henry Louis Gates and Racial Profiling: What’s the Problem? (September
2009)
Stephen J. Choi, Mitu Gulati, Mirya Holman, and Eric A. Posner, Judging Women (September
2009)
Omri Ben-Shahar, One-Way Contracts: Consumer Protection without Law (October 2009)
Ariel Porat, Expanding Liability for Negligence Per Se (October 2009)
Ariel Porat and Alex Stein, Liability for Future Harm (October 2009)
Anup Malani and Ramanan Laxminrayan, Incentives for Surveillance of Infectious Disease
Outbreaks (October 2009)
Anup Malani, Oliver Bembom and Mark van der Laan, Accounting for Differences among
Patients in the FDA Approval Process (October 2009)
David Gilo and Ariel Porat, Viewing Unconsconability through a Market Lens (October 2009)
David Weisbach, Instrument Choice Is Instrument Design (October 2009)
M. Todd Henderson, Justifying Jones (November 2009)
Eric A. Posner, ProCD v. Zeidenberg and Cognitive Overload in Contractual Bargaining
(November 2009)
Randal C. Picker, Antitrust and Innovation: Framing Baselines in the Google Book Search
Settlement (November 2009)
Richard A. Epstein, Against Permititis: Why Volunteer Organizations Should Regulate the Use of
Cancer Drugs (November 2009)
Richard A. Epstein, Heller’s Gridlock Economy in Perspective: Why There Is Too Little, Not Too
Much, Private Property (November 2009)
Richard A. Epstein, NRA v. City of Chicago: Does the Second Amendment Bind Frank
Easterbrook? (November 2009)
Randal C. Picker, Easterbrook on Copyright (November 2009)
Omri Ben-Shahar, Pre-Closing Liability (November 2009)
Randal C. Picker, Assessing Competition Issues in the Amended Google Book Search Settlement
(November 2009)
Saul Levmore, Ambigious Statutes (November 2009)
Saul Levmore, Interest Groups and the Problem with Incrementalism (November 2009)
Tom Ginsburg, The Arbitrator as Agent: Why Deferential Review Is Not Always Pro-Arbitration
(December 2009)
Nuno Garoupa and Tom Ginsburg, Reputation, Information and the Organization of the Judiciary
(December 2009)
Eric A. Posner and Alan O. Sykes, Economic Foundations of the Law of the Sea (December 2009)
Jacob E. Gersen and Anne Joseph O’Connell, Hiding in Plain Sight? Timing and Transparency in
the Administrative State (December 2009)
Richard A. Epstein, Impermissible Ratemaking in Health-Insurance Reform: Why the Reid Bill is
Unconstitutional (December 2009)
Tom Ginsburg and Eric A. Posner, Subconstitutionalism (January 2010)
Stephen J. Choi, Mitu Gulati, and Eric A. Posner, What Do Federal District Judges Want? An
Analysis of Publications, Citations, and Reversals (January 2010)
Joseph Isenbergh, The Future of Taxation (January 2010)

 

510.
511.
512.
513.
514.
515.
516.
517.
518.
519.
520.
521.
522.
523.
524.
525.
526.
527.
528.
529.
530.
531.
532.
533.
534.
535.
536.
537.
538.
539.
540.
541.

542.

=

Lee Epstein, William M. Landes, and Richard A. Posner, Why (and When) Judges Dissent: A
Theoretical and Empirical Analysis (January 2010)
Tom Ginsburg, James Melton, and Zachary Elkiins, The Endurance of National Constitutions
(February 2010)
Omri Ben-Shahar and Anu Bradford, The Economics of Climate Enforcement (February 2010)
Neta-li E. Gottlieb, Free to Air? Legal Protection for TV Program Formats (February 2010)
Omri Ben-Shahar and Eric A. Posner, The Right to Withdraw in Contract Law (March 2010)
Richard A. Epstein, Inside the Coasean Firm: Competence as a Random Variable (March 2010)
Omri Ben-Shahar and Carl E. Schneider, The Failure of Mandated Disclosure (March 2010)
Kenneth W. Dam, The Subprime Crisis and Financial Regulation: International and Comparative
Perspectives (March 2010)
Lee Anne Fennell, Unbundling Risk (April 2010)
Stephen J. Choi, Mitu Gulati, and Eric A. Posner, Judicial Ability and Securities Class Actions
(April 2010)
Jonathan S. Masur and Jonathan Remy Nash, The Institutional Dynamics of Transition Relief
(April 2010)
M. Todd Henderson, Implicit Compensation, May 2010
Lee Anne Fennell, Possession Puzzles, June 2010
Randal C. Picker, Organizing Competition and Cooperation after American Needle, June 2010
Richard A. Epstein, What Is So Special about Intangible Property? The Case for intelligent
Carryovers, August 2010
Jonathan S. Masur and Eric A. Posner, Climate Regulation and the Limits of Cost-Benefit
Analysis, August 2010
Richard A. Epstein, Carbon Dioxide: Our Newest Pollutant, August 2010
Richard A. Epstein and F. Scott Kieff, Questioning the Frequency and Wisdom of Compulsory
Licensing for Pharmaceutical Patents, August 2010
Richard A. Epstein, One Bridge Too Far: Why the Employee Free Choice Act Has, and Should,
Fail, August 2010
Jonathan Masur, Patent Inflation, August 2010
Bernard E. Harcourt and Tracey L. Meares, Randomization and the Fourth Amendment, August
2010
Ariel Porat and Avraham Tabbach, Risk of Death, August 2010
Randal C. Picker, The Razors-and-Blades Myth(s), September 2010
Lior J. Strahilevitz, Pseudonymous Litigation, September 2010
Omri Ben Shahar, Damanged for Unlicensed Use, September 2010
Bermard E. Harcourt, Risk As a Proxy for Race, September 2010
Christopher R. Berry and Jacob E. Gersen, Voters, Non-Voters, and the Implications of Election
Timing for Public Policy, September 2010
Eric A. Posner, Human Rights, the Laws of War, and Reciprocity, September 2010
Lee Anne Fennell, Willpower Taxes, October 2010
Christopher R. Berry and Jacob E. Gersen, Agency Design and Distributive Politics, October 2010
Eric A. Posner, The Constitution of the Roman Republic: A Political Economy Perspective,
November 2010
Stephen J. Choi, Mitu Gulati, and Eric A. Posner, Pricing Terms in Sovereign Debt Contracts: A
Greek Case Study with Implications for the European Crisis Resolution Mechanism, Novemer
2010
Bernard E. Harcourt, Reducint Mass Incarceration: Lessons from the Deinstitutionalization of
Mental Hospitals in the 1960s, January 2011

 

 

The Habeas Citebook Ineffective Counsel Side
CLN Subscribe Now Ad
Prison Phone Justice Campaign