“Deinstitutionalisation” has become one of the stated aims of modern, establishment psychiatry. Somewhat like motherhood and apple pie, it seems to have become a concept that is nearly impossible to criticise. Whether institutionalisation was ever exactly like its critics described it is a moot point; another is whether what we have seen since the move to community psychiatry is really “transinstitutionalisation”—with those patients who formerly would have been in asylums now in prison or homeless—rather than deinstitutionalisation. Goffman’s Asylums, a key text in the development of deinstitutionalisation, anticipated and indeed predicted some of these …