'Death by a thousand cuts': perspectives on deinsitutionalisation

This paper discusses findings from an Australian study that looks at housing and support for people who have had long stays in psychiatric institutions. Using qualitative methods, the study was designed to offer multiple perspectives on client outcomes and on the process of implementation. The study demonstrates the advantages of methods that look at program implementation from multiple perspectives. In situations where policy directions are contested, as has been the case with deinstitutionalization in South Australia, multiple perspectives are particularly instructive. Here they show how programs designed to facilitate deinstitutionalization, if implemented without an explicit policy context and a publicized commitment to ongoing funding, can be experienced by those involved in their implementation as ‘death by a thousand cuts’.