is an oversimplification which does not take into account the other policy changes which occurred during the same time. reinstitutionalisation some mental health academics and campaigners have argued that deinstitutionalisation was well-intentioned for trying to make patients less dependent on psychiatric care, but in practice patients were still left being dependent on the support of a mental healthcare system, a phenomenon known as "reinstitutionalisation" or "transinstitutionalisation". the argument is that community services can leave the mentally ill in a state of social isolation (even if it is not physical isolation), frequently meeting other service users but having little contact with the rest of the public community. fakhoury and priebe said that instead of "community psychiatry", reforms established a "psychiatric community". julie racino argues that having a closed social circle like this can limit opportunities for mentally ill people to integrate with the wider society, such as personal assistance services. other criticisms criticism of deinstitutionalisation takes on a number of forms. some, like e. fuller torrey, defend the use of psychiatric institutions and conclude that deinstitutionalisation was a move in the wrong direction entirely. torrey has opposed deinstitutionalisation in principle, arguing that people with mental illness will be resistant to medical help due to the nature of their conditions. these views have made him a controversial figure in psychiatry. he believes that reducing psychiatrists' powers to use involuntary commitment led to many patients losing out on treatment, and that many who would have previously lived in institutions are now homeless or in prison. another form of critique argues that while deinstitutionalization was a move in the right direction and had laudable goals, many shortcomings in the execution stage have made it unsuccessful thus far. new community services developed as alternatives to institutionalization leave patients dependent still on the support of mental healthcare without clear evidence of providing adequate treatment and support. multiple for-profit businesses, non-profit organizations and multiple levels of government involved have been criticized as being uncoordinated, underfunded and unable to meet complex needs. in a 1998 study of the effects of deinstitutionalisation in the united kingdom, means and smith argue that the program had some successes, such as increasing the participation of volunteers in mental healthcare, but that it was underfunded and let down by a lack of coordination between the health service and social services. thomas szasz, a longtime opponent of involuntary psychiatric treatment, argued that the reforms never addressed the aspects of psychiatry that he objected to, particularly his belief that mental illnesses are not true illnesses but medicalized social and personal problems. worldwide hong kong in hong kong, a number of residential care services such as halfway houses, long-stay care homes, supported hostels are provided for the discharged patients. in addition, community support services such as rehabilitation day services and mental health care have been launched to facilitate the patients' re-integration into the community. japan unlike most developed countries, japan has not followed a program of deinstitutionalisation. the number of hospital beds has risen steadily over the last few decades. physical restraints are used far more often. in 2014, more than 10,000 people were restrained–the highest ever recorded, and more than double the number a decade earlier. in 2018, the japanese ministry of health introduced revised guidelines that placed more restrictions against the use of restraints. africa uganda has one psychiatric hospital. there are only 40 psychiatrists in uganda. the world health organisation estimates that 90% of mentally ill people here never get treatment. new zealand new zealand established a reconciliation initiative in 2005 to address the ongoing compensation payouts to ex-patients of state-run mental institutions in the 1970s to 1990s. a number of grievances were heard, including: poor reasons for admissions; unsanitary and overcrowded conditions; lack of communication to patients and family members; physical violence and sexual misconduct and abuse; inadequate mechanisms for dealing with complaints; pressures and difficulties for staff, within an authoritarian hierarchy based on containment; fear and humiliation in the misuse of seclusion; over-use and abuse of ect, psychiatric medications, and other treatments as punishments, including group therapy, with continued adverse effects; lack of support on discharge; interrupted lives and lost potential; and continued stigma, prejudice, and emotional distress and trauma. there were some references to instances of helpful aspects or kindnesses despite the system. participants were offered counselling to help them deal with their experiences, along with advice on their rights, including access to records and legal redress. republic of ireland