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This is something I always think about ... After the advent of Thorazine in the '50s, when hundreds of thousands of beds in state run institutions were closed, the number of homeless people in the US rose dramatically (and currently, the percentage of homeless people with severe mental illness is very high compared to the general population). There is something that seems great about the idea of medication allowing severely "mentally ill" populations to assimilate into society ... But these medication only work if administered regularly, and sometimes they work in limited ways. The idea of an institution, particularly a permanent or semi-permanent period on institutionalization, has become an anathema to us. But is that segregation necessarily the worst possibility? Or, from another standpoint, if we agree as a society that institutionalization (quite possibly unwilling) is *not* an appropriate choice, have we created any real, sustainable, preferable alternatives yet?