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July 30, 2026
Quarterly Article
Harold A. Pollack
Richard Frank
Sherry Glied
May 6, 2026
June 2026
March 2026
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Policy Points:
Context: Since the early 1960s, US policymakers have sought to assist persons living with intellectual and developmental disabilities (IDDs) and persons living with severe and persistent mental illness (SPMI) to live on a human scale with their clinical and service needs met in their communities.
Methods: We review this history, including the accomplishments and shortcomings of these efforts.
Findings: People with both sets of disabilities and their families have benefited from deinstitutionalization. Yet deinstitutionalization proved tangibly more successful in assisting people with IDDs and their families than have comparable efforts that sought to assist people with SPMI and their families.
Conclusions: These contrasting histories offer instructive lessons for state policymakers and others seeking to improve services for people living with SPMI.