Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reformReportar como inadecuado




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International Journal of Mental Health Systems

, 8:47

First Online: 22 November 2014Received: 30 July 2014Accepted: 11 November 2014

Abstract

BackgroundPolicies generate accountability in that they offer a standard against which government performance can be assessed. A central question of this study is whether ideological imprint left by policy is realized in the time following its adoption. National mental health policy expressly promotes the notion of deinstitutionalization, which mandates that individuals be cared for in the community rather than in institutional environments.

MethodsWe investigate whether mental health policy adoption induced a transformation in the structure of mental health systems, namely psychiatric beds, using panel data on 193 countries between 2001 and 2011.

ResultsOur striking regression results demonstrate that late-adopters of mental health policy are more likely to reduce psychiatric beds in mental hospitals and other biomedical settings than innovators, whereas they are less likely than non-adopters to reduce psychiatric beds in general hospitals.

ConclusionsIt can be inferred late adopters are motivated to implement deinstitutionalization for technical efficiency rather than social legitimacy reasons.

KeywordsDiffusion of innovation Institutional theory Governance Mental health policy Electronic supplementary materialThe online version of this article doi:10.1186-1752-4458-8-47 contains supplementary material, which is available to authorized users.

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Autor: Gordon C Shen - Lonnie R Snowden

Fuente: https://link.springer.com/







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