Individualism and its Discontents: The Response to the Seriously Mentally Ill in Late Twentieth Century America

Abstract

The rise of individualism -a set of socio-cultural arrangements that encourage and legitimate the autonomy, dignity and equality of individuals-is one of the master trends of social organization over the past two centuries. In this paper we relate this trend to recent changes in the social control of the seriously mentally ill, in particular, the change from long-term involuntary stays in isolated institutions to short-term voluntary stays in community-oriented, decentralized programs. Our analysis focuses on three aspects of individualism:1 .) the loss of moral sovereignty of family units and the corresponding increase in protection given to the autonomy of individuals; 2.) the increasing fluidity of family relationships that makes it easier both for members to leave their families and for families to expel their deviant members and 3.) the decreasing ability of communitiesto strictly uphold the moral order of public places. Finding ways to strike the appropriate balance between protecting families and communities and respecting individual autonomy may be the most essential question social groups will face as they respond to the seriously mentally ill in the future.