Individualizations vs Deinstitutionalization

Deinstitutionalization: A Satirical Guide to Failure ​

This thought-provoking essay by John O’Brien, originally penned in 1977 and republished in 2011, offers a satirical take on the systemic barriers to deinstitutionalization for people with disabilities. Using humor and irony, O’Brien critiques the bureaucratic inertia, fear-based rhetoric, and deliberate mismanagement that have historically hindered efforts to transition from institutional care to community-based services. ​

The essay is structured as a tongue-in-cheek “planner’s guide” to ensuring failure in deinstitutionalization, outlining strategies at three levels: Primary Prevention, which relies on government inefficiency; Secondary Prevention, which demoralizes advocates through stereotypes and dismissive attitudes; and Tertiary Prevention, which sabotages community services through confusion, neglect, and profit-driven funding structures.