In recognition of patients' rights, the controversial "Northampton consent decree" requires the state to develop community-based programs for people with mental illness.
A class-action lawsuit on behalf of patients at the Northampton State Hospital (a facility similar to Westborough State Hospital) was brought against the state in 1977 (Brewster v Dukakis). Through the resulting "Northampton consent decree," the state has a duty to create and maintain community-based programs to provide treatment in the "least restrictive setting" for people with mental illness, in effect establishing the state's first community mental health system. However, community-based services are not abundant. The decree is controversial because while many recognize the need for support outside of hospitals, they fear that community programs are underfunded and insufficient. Lacking sufficient community supports, some psychiatric patients end up facing homelessness and/or incarceration.
"Deinstitutionalization" nationwide began in the 1950s as society realized that some patients had the ability to thrive, if not entirely independently, outside of a hospital setting. Much has changed in the sociopolitical sphere since Westborough State Hospital and others like it first opened; treatment options such as psychotropic drugs are more readily available, and state and federal funding begin to favor outpatient care settings to cut healthcare costs. People believe that the state can direct funds it would have spent on institutionalized patients towards community-based programs for people with mental illness instead.
