III. Organizational analysis of deinstitutionalization in a psychiatric hospital

Background: Few studies have been conducted of the organizational aspects t hat impact on the course of psychiatric deinstitutionalization. Method: A case study was undertaken of 10 years of deinstitutionalization i n a Montreal psychiatric hospital. Results: Deinstitutionalization has forged ahead in the hospital over the p ast few years, although the course it has taken is not the one initially pl otted by its promoters. Care management of deinstitutionalized patients rem ains under the control of the psychiatric hospital and its physicians. Howe ver, the patients' well-being has remained a focus of concern and does not seem to have been detrimentally affected by this development. Conclusion: Deinstitutionalization is both a solution to the criticisms lev elled at the hospital-psychiatric approach of managing persons with severe and persistent mental disorders and an extremely useful tool in the power s truggle among the various stakeholders in mental health services reform. De institutionalization has become