One thing institutions had going for them is that they were large buildings with many employees, and thus had political weight. Spending the same money on comm

One thing institutions had going for them is that they were large buildings with many employees, and thus had political weight. Spending the same money on community care might be more efficient, but doesn't have this weight. So if you trim the budget 20% this year in some crisis, 20% another year, you never have to officially claim to be giving up. Which if I understand right is basically what happened. I don't claim that proponents of deinstitutionalization had this in mind, I think they were well-intentioned. But it does seem like a factor worth bearing in mind. It's a bit like the trams vs busses debate -- the more flexible system is vulnerable to getting squeezed, the less flexible one is more permanent.