Re-institutionalizing America: The Politics of Mental Health and Incarceration, 1945-1985

This dissertation tracks a peculiar “re-institutionalization” between 1945 and 1990, showing how involuntary confinement in psychiatric hospitals and prisons transformed in both significance and scope. The project focuses on these changes in Pennsylvania and argues that during the post-war era, the public sector relied primarily on custodial psychiatric hospitals rather than prisons to handle social problems. In subsequent decades, the state government increasingly sought rehabilitative alternatives to custodial institutions such as community mental health centers and work-release prison programs. This anti-institutionalism came to a halt in the 1970s as conservative politicians rejected alternatives to prisons and transferred supervision of people in the mental health system to the criminal system. Highlighting this previously unstudied process, the dissertation argues that policymakers replaced involuntary confinement in mental health institutions with imprisonment. In this way, it recasts the rise of mass incarceration as part of a larger history of confinement in the U.S. rather than the sudden product of the late twentieth century. This re-institutionalization challenges the narrative of the rise of conservatism as primarily a rejection of state welfare responsibilities. Instead, new conservative policies shifted priorities away from welfare and medical authority and towards security and punishment, dramatically altering the state’s relationships to its citizens in ways determined by notions of race, gender and class. Drawing on disability history and public history, the dissertation employs research focused on local people, places and communities and collections on mental health and corrections in Pennsylvania previously unused by historians. The research has uncovered how many former mental hospitals converted into prisons in the 1980s, a national phenomenon the project identifies through local examples. The dissertation challenges the narrative of deinstitutionalization as a largely federal development and instead focuses on the changes at the state and local levels, where the politics of mental health and imprisonment most often intersected.