Landscapes of Despair: From Deinstitutionalization to Homelessness

by Michael J. Dear, Jennifer R. Wolch

Overview

Michael Dear and Jennifer Wolch examine the emergence of urban ghettos of the socially dependent—an unforeseen "solution" to the problem of developing community-based care for a variety of service-dependent groups, including the mentally and physically disabled, ex-offenders, and addicts. Based on detailed case studies drawn from several cities in Canada and the United States, Landscapes of Despair is a comprehensive analysis of these ghettos.

Originally published in 1987.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

Product Details

ISBN-13:	9780691631110
Publisher:	Princeton University Press
Publication date:	04/19/2016
Series:	Princeton Legacy Library , #823
Pages:	322
Product dimensions:	7.10(w) x 10.10(h) x 1.00(d)

Read an Excerpt

Landscapes of Despair

From Deinstitutionalization to Homelessness

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By Michael J. Dear, Jennifer R. Wolch

PRINCETON UNIVERSITY PRESS

Copyright © 1987 Michael J. Dear and Jennifer R. Wolch
All rights reserved.
ISBN: 978-0-691-07754-3

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CHAPTER 1

Service-dependent populations in the city

In the 1960s and 1970s, the deinstitutionalization movement was translated from philosophy into a tangible social program. It represented a well-intentioned effort to remove the mentally disabled, physically handicapped, mentally retarded, prisoners and other dependent groups from asylums and similar places of incarceration, in order to place them in community settings. For most groups, this policy represented a fundamental change in practices that had been in place since the early nineteenth century.

It is a major part of our purpose to explain why things went wrong with deinstitutionalization. It is not our intention to argue against deinstitutionalization, or for reinstitutionalization; we believe that the discharge of the dependent from large-scale institutions has been a necessary and humane stage in the evolution of our service system. But today as we survey some of the human and social costs of the movement, we feel an urgent need to tell the full story so that some overdue policy initiatives may be developed and implemented rapidly.

This is, therefore, a book with a very particular purpose and viewpoint. It is written by two social scientists closely involved with the organization and planning of human-service systems. We are not directly involved in providing services, so we have some degree of detachment from the problem of front-line caring. This perspective, has, we believe, allowed us to provide some fresh insight into the problems of deinstitutionalization and of providing for society's dependent persons.

What we would like to achieve here is to remove the sense of shock and unpleasant discovery which seems to accompany each new phase in the deinstitutionalization history. In retrospect, we should not have been surprised that the deinstitutionalized should have become 'ghettoized' in our inner cities. Similarly, it should not now be surprising that the atrophying service system should be accompanied by a massive surge in homelessness amongst service-dependent populations. Nor is it unexpected that many groups are being misassigned to inappropriate social settings and reinstitutionalized (for instance, in prisons) because they lack other shelter options. The historical wheel has turned full circle. Current newspaper accounts of prison officials' attempts to separate the mentally disabled from the regular inmate population in many jails echo similar efforts of wardens in the seventeenth century – efforts that eventually culminated in the birth of the asylum during the late seventeenth and early eighteenth centuries.

One of the most fascinating aspects of the contemporary crisis in human services is its focus in the city. As institutions have been closed, discharged populations have gravitated toward specific zones in our urban areas. These have typically been core areas of the inner city, where the service-dependent have found helping agencies and housing opportunities. As dependent persons migrated to those urban locations (often from considerable distances outside the city), they attracted more services which themselves acted as a magnet for yet more needy persons. A self-reinforcing cycle of ghettoization was thus begun.

This specific urban manifestation of the deinstitutionalization process is, we believe, the key to understanding the history and possible future of our current social welfare dilemmas. We have previously referred to this phenomenon as the growth of the 'public city'. Other commentators have drawn attention to the deep-rooted social changes currently affecting modern cities. Manuel Castells, for example, has referred to the essentially anarchistic process of contemporary urbanization in what he calls the 'wild city' (Castells, 1976). Stanley Cohen (somewhat more sinisterly) views the development of community-based care as an exercise in the dispersal of social control – in what he calls the 'punitive city' (Cohen, 1979).

Our narrative is therefore an explanation of a social process (deinstitutionalization) and its particular urban manifestation (the ghetto). In attempting to unfold the logic of this historical process and to avoid any unpleasant future surprises, we have drawn extensively on experiences in the US and Canada, and especially the State of California and the Province of Ontario. In no sense do we provide a complete picture of either experience. However, the cumulative comparative analyses based on these examples build a compelling explanation of the current crisis of deinstitutionalization in the North American city.

A NOTE ON METHODS OF ANALYSIS

In preparing this narrative, we have drawn extensively on conventional historical, social-theoretic, geographical and policy-analytic methods. First, we sythesize the major events marking the history of deinstitutionalization in North America – particularly in the State of California and the Province of Ontario. Our research relies on both primary and secondary historical sources to arrive at an understanding of the evolution of service-dependency and social welfare practices. In recounting this history, we have considered both the longue durée and durée, to portray both the structural continuity of historical experience in urban social welfare and the important role of changing social practices that shape the more immediate context of service provision.

Secondly, the research approach is shaped strongly by a conceptual framework based on contemporary social theory (Giddens, 1984; Gregory and Urry, 1985; Thrift, 1983; Dear and Scott, 1981). In particular, we have drawn on theories of the duality of structure and agency in social life and the role of political economic factors in social change, in order to interpret the historical experience of social welfare provision. This implies a multilevel analysis that accounts for the interaction of macrolevel political economic structures and constraints; the role of institutions such as the state in translating those structures into policies and programs; and the activities of knowledgeable and capable human agents involved in the social welfare system.

Third, our narrative is clearly geographical and place-specific. Rather than providing an aspatial analysis that discounts the time–space contingency of social welfare practice, we emphasize the geographic dimensions of service provision. Hence we have chosen to focus on particular locales that constitute the settings in which structural forces, institutional practices and everyday routines of agents interact to produce a concrete manifestation of deinstitutionalization outcomes. We have not attempted to provide complete accounts of the experiences in the locales that we consider; instead, we have woven together cross-cultural and intertemporal analyses in a way which allows us to move between study areas, to preserve a consistent narrative and a chronological integrity and yet to provide generalized conclusions relevant to other geographical areas.

Lastly, and perhaps most distinctively, we have wedded a critical perspective on social welfare in the city with pragmatic tools of public policy analysis. This may seem unconventional and is certainly problematic; however, as planners we feel compelled to move from interpretation to praxis. Designing an adequate human-services delivery system for cities is in part a technical planning problem involving the assignment of service-dependent clients to community-based service settings. Such an exercise calls for normative rules, decision criteria, operating principles and institutional means for conflict resolution and program implementation. Thus our recommendations for praxis, while remaining fully informed by a critical interpretation of deinstitutionalization, also use the technical language of planning to provide practical guidance to policymakers attempting to ameliorate the everyday crises of community-based human services.

ORGANIZATION OF THE BOOK

The ten chapters examine three broad themes. The first theme (chapters 1–3) explores the nature of the ghettoization problem, its historical background and our theoretical approach. The second theme (chapters 4–7) examines the rise and fall of the service-dependent ghetto and the growth of misassignment and homelessness. Finally (in chapters 8–10), we synthesize the implications of our analysis and explore the public policy dilemmas surrounding community-based care for the dependent.

To aid understanding of our extended (and at times complex) account, we present in the remainder of chapter 1 an abbreviated account of the arguments presented in the book. Chapter 2 addresses the central question about the ghetto: what set of social forces could have produced this particular urban form? The answers are sought in the processes of urbanization and of the restructuring of the Welfare State. These structural (or contextual) features have intersected decisively with the actions of import human agents to give rise – inevitably, predictably – to the ghetto of the service-dependent. The ghetto has, however, a very long history. In chapter 3, a general survey of the social history of 'dependency' during the nineteenth and twentieth centuries explains the evolution of the ghetto landscape.

Against the theoretical and historical backdrop provided in the first two chapters, Part II of the book begins a careful unravelling of the place-specific nature of the ghetto. The long narrative begins (in chapter 4) by explaining how general philosophies of treatment and care in Ontario became manifest as a specifically urban phenomenon in one locale (downtown Toronto). In chapter 5, a detailed analysis of the anatomy of the service-dependent ghetto in one city (Hamilton) shows how the deinstitutionalization movement affected many diverse populations which all gravitated to the downtown 'host' community. Here they congregated with the helping facilities designed to serve them.

In order to advance the narrative beyond the initial creation and consolidation of the ghetto, we shift the locus of our analysis in later chapters to California. In chapter 6, the systematic destruction of the service-dependent ghetto in San Jose is described as a consequence of public and private actions. Then in chapter 7, the present episode of the deinstitutionalization saga is unfolded. Here, we document the crises of misassignment and homelessness and the looming threat of reinstitutionalization.

In Part III we examine the normative implications of our analysis. Chapter 8 argues that deinstitutionalization remains a worthy policy objective for assisting dependent populations and that the current service interventions are pathological and iatrogenic. Two levels of intervention are subsequently identified: first, the need to adjust the mechanisms of community-based service planning; secondly, the need for a renewed political commitment to the development of a community-based alternative. Hence, in chapter 9, we explore the rights and obligations of communities and the need for planners to take into consideration community self-interest as well as client rights in devising service solutions. Finally, in chapter 10, we argue for a rebirth of the commitment to deinstitutionalization in order to relieve the homelessness crisis and to provide for successful social welfare in the city.

CHAPTER 2

The social construction of the service-dependent ghetto

The patterns of everyday life sometimes appear to be deceptively simple. The impetus for this book, for example, derives from the now-familiar observation of the ghettoization of ex-psychiatric patients in the inner city. Yet a knowledgeable observer might quickly surmise that ghettoization is a complex phenomenon - the result of a wide range of forces, including aspects of supply and demand for housing. For instance, on the supply side, in the inner city there are large properties available for conversion to group homes; an established supply of transient rental accommodations like single-room occupancy hotels; and established support networks (both of service facilities such as missions and of personal ties to other community residents). Demand for housing and jobs by ex-psychiatric patients has led to an informal spatial filtering of patients to the core area; a significant amount of interregional migration (from rural areas to core areas of cities with major psychiatric hospitals); and the formal referral of ex-patients to core-area housing alternatives. These 'market' forces encouraging ghettoization have been reinforced by two other factors: an apparently extensive community opposition, which has effectively excluded ex-patients from most suburban residential neighborhoods; and the development of planning strategies that attempt to avoid community conflict over locational decisions by seeking out uncontested sites for neighborhood mental health facilities.

Curious observers may, however, be tempted to look beyond this appealing overview. They will quickly learn that the mentally ill have been joined in the ghetto by a host of other deinstitutionalized populations, including the dependent elderly, the mentally retarded, the physically disabled, ex-prisoners and substance abusers. The past decade has witnessed the unprecedented growth of a 'public city' – the spatial concentration of service-dependent populations and the agencies and facilities designated to serve them. As an urban phenomenon, the public city represents a significant change in the form of cities. As a social welfare phenomenon, it acts as a reservoir of potential clients and as a primary reception area for the deinstitutionalized. As more people arrive in the ghetto, so more services are needed to care for them; the new services themselves act as a catalyst in attracting further clients and so a self-reinforcing cycle is intensified.

What set of social forces could have produced this particular urban form? How did deinstitutionalization give rise unexpectedly to the ghetto? And what will now happen to the ghetto as social welfare policies are restructured? To begin to answer these questions, we first establish in this chapter some general theoretical arguments about the relationship between social forces (deinstitutionalization) and spatial form (the urban ghetto). The precise nature of our concept of the relationship between society and space is explored in the next section. This is followed by consideration of the two longer-term, macroscale trends that have provided a necessary context for ghettoization: the process of suburbanization and the policies of an evolving Welfare State. Exactly how these contextual factors give rise to a particular spatial form is explored by looking at the short-term, microscale practices of the relevant 'actors' or agents in the deinstitutionalization process. Here, the daily activities of professional, client and community will be seen to create the service-dependent ghetto as a common element in city form.

SOCIETY, SPACE AND THE GENESIS OF THE GHETTO

There has been much debate about the precise relationship between societal processes and spatial form. We take the view that the geographical configuration of the landscape (including cities and regions) is a concrete reflection of underlying social processes. However, this translation from the social to the spatial is neither a simple nor a well-ordered sequence; neither is space simply the passive stage on which social events are played out. As Giddens (1984, p. 368) has observed: 'Space is not an empty dimension along which social groupings become structured, but has to be considered in terms of its involvement in the constitution of systems of interaction.'

The wider logic of the social construction of the service-dependent ghetto lies in the dual notions of society and space and structure and agency. The service-dependent ghetto has been created by skilled and knowledgeable actors (or agents) operating within a social context (or structure), which both limits and enables their actions. It is impossible to predict the exact geographical outcome of the interaction between structure and agency. The reason for this is that while individual activities are framed within a particular structural context, they can also transform the context itself. Any narrative about landscapes, regions, or locales is necessarily an account of the reciprocal relationship between relatively long-term structural forces and the shorter-term routine practices of individual human agents. Economic, political and social history is therefore time-specific, in the sense that these relationships evolve at different temporal rates; it is also place-specific, in that these relationships unfold in recognizable 'locales' according to some precise logic of spatial diffusion. So geographical patterns, such as the ghetto, are evolving manifestations of a complex social process. As society evolves, so does its spatial expression; but by the same token, the geographical form will have repercussions on the social forces themselves.

(Continues...)

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Excerpted from Landscapes of Despair by Michael J. Dear, Jennifer R. Wolch. Copyright © 1987 Michael J. Dear and Jennifer R. Wolch. Excerpted by permission of PRINCETON UNIVERSITY PRESS.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

• FrontMatter, pg. i
• Contents, pg. v
• List of tables, pg. viii
• List of maps and figures, pg. ix
• Preface, pg. xi
• Acknowledgements, pg. xiii
• PART I: INTRODUCTION, pg. 1
• PART II: THE RISE AND FALL OF THE SERVICE DEPENDENT GHETTO, pg. 69
• PART III: PUBLIC POLICY FOR THE CITY, pg. 193
• Notes, pg. 267
• References, pg. 274
• Index of subjects, pg. 295
• Index of works cited, pg. 302

Editorial Reviews

"This is an easy book to praise and one that will repay close study.... A scrupulous and wise discussion, balancing equity and therapeutics, and one with immediate relevance to current problems."—-Kim Hopper, Access

"This book could offer a whole new meaning to the concept of 'geography awareness' that has been so enthusiastically embraced in recent years."—-Christopher J. Smith, Economic Geography

"A major contribution to the theoretical development of the literature on homelessness, especially as this literature explores the relationships of service dependency and the central city.... [It] pushes the current parameters of American planning for the service-dependent."—-Robert W. Collin, Journal of the American Planning Association

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