Psychiatric Deinstitutionalization and Prison Population Growth

• Author: Dae-Young Kim
• Published date: 01 February 2016
• Date: 01 February 2016
• DOI: 10.1177/0887403414547043
• Subject Matter: Articles

Criminal Justice Policy Review

2016, Vol. 27(1) 3 –21

© 2014 SAGE Publications

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DOI: 10.1177/0887403414547043

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Article

Psychiatric

Deinstitutionalization and

Prison Population Growth: A

Critical Literature Review and

Its Implications

Dae-Young Kim1

Abstract

A substantial amount of research has been devoted to explaining the reasons behind

the unprecedented explosion of U.S. prison populations. While the majority of prior

studies related imprisonment to four factors—specifically crimes, changes in the

labor markets, politics, and demographic changes—other relevant factors have not

received as much attention. In the historical context of decreases in mental hospital

populations resulting from psychiatric deinstitutionalization, imprisonment rates have

skyrocketed nationwide since the late 1970s. This inverse relationship between both

trends has called for prior research that empirically examines the impact of mental

hospitalization on imprisonment, especially through the criminalization of mental

illness. However, empirical findings are equivocal in general at the aggregate level.

This article conducts a comprehensive and critical literature review, discusses the

important conceptual and methodological limitations of the existing literature, and

finally provides guidance for future research.

Keywords

jail/prison, mental hospital, psychiatric deinstitutionalization, trans-institutionalization,

social control

Introduction

Over the past three decades, there has been a large and growing amount of scholarly

attention devoted toward explaining the reasons behind the unprecedented growth of

1State University of New York-Buffalo State, USA

Corresponding Author:

Dae-Young Kim, Assistant Professor, Criminal Justice Department, State University of New York-Buffalo

State, 1300 Elmwood Ave., Buffalo, NY 14222, USA.

Email: kimd@buffalostate.edu

547043CJPXXX10.1177/0887403414547043Criminal Justice Policy ReviewKim

research-article2014

4 Criminal Justice Policy Review 27(1)

U.S. prison populations.1 There are many potential sources of the growth, and corre-

sponding explanations were used to understand it, such as crimes, demographic

changes (age and race distributions), changes in the labor market and economic condi-

tions (Rusche & Kirchheimer, 1939/2003), politics (Foucault, 1977/1995; Garland,

2001; Tonry, 2006), collective consciousness (Durkheim, 1984), culture (Garland,

1990), and psychiatric deinstitutionalization (Scull, 1984). While the majority of prior

empirical studies related imprisonment to the first four factors, other relevant factors

have not received much of the attention (Pfaff, 2008).

There has been scholarly attention given to whether and/or how much psychiatric

deinstitutionalization contributes to the explosive increase of U.S. imprisonment.

Given that relatively little aggregate-level empirical research is available and its find-

ings are inconsistent, there is a continuing need for more research using a wide range

of research designs. This article conducts a comprehensive and critical review of the

historical and empirical literature and provides guidance for future research.

Specifically, this article is composed of three sections. First, it discusses historical and

theoretical foundations for understanding the deinstitutionalization–imprisonment

relationship. Second, it provides a literature review of prior empirical studies and

delineates what we know (and don’t know) about the relationship under consideration.

Third, it identifies key conceptual and methodological limitations in the existing lit-

erature and offers research implications for more accurate and stable findings.

Historical and Theoretical Foundations

Historical Perspectives on Confinement: Origin and Evolution

Several theorists have established historical and theoretical frameworks for under-

standing the history of prisons and asylums in the United States (Grob, 1973, 1983,

1991, 1994; Rothman, 1971, 2002; Scull, 1977, 1984). With shifts in the specific

social, political, and intellectual contexts of which it was part, confinement emerged

and evolved to meet the demands of society. During a time of growth and instability

during the Jacksonian Era (approximately 1820-1840), custodial institutions (prisons,

asylums, and almshouses) emerged and grew together as part of a response to the

social problems (crime, insanity, and poverty) brought by industrialization and urban-

ization (Grob, 1973, 1994; Rothman, 1971; Scull, 1977, 1984). As social geographic

mobility became intensive and general, Americans worried about the erosion of local

norms and cohesion, which was based on strong kinship and mutual discipline among

families and neighbors. There was also the unprecedented distance and distrust

between social classes. The institutional solution played an important role in restoring

social norms and cohesion by casting out marginalized groups and confirming the

goodness of the mainstream society. In addition, greater sensitivity to physical pain

under the influence of Enlightenment facilitated the shift from corporal punishment

and toward the use of incarceration as a primary punishment.

Although they share the same origin, the subsequent use of prisons and asylums has

remarkably differed over time in the United States. In the Progressive Era (approxi-

mately 1890s-1920s), insane asylums expanded more rapidly and substantially than