Before America began creating a federally based welfare state in the 1930s, most publicly funded responses to social problems had an institutional bias. The ways in which the welfare programs initiated 50 years ago have helped to influence institutional trends, and are likely to continue doing so in the future, constitute the major focus of this analysis. Four special problem groups are assessed from a historical perspective: (1) the dependent aged and the movement from local almshouses and state insane asylums to nursing homes; (2) the mentally ill and the movement from state hospitals to a variety of local medical and nonmedical residences; (3) the developmentally disabled—formerly the mentally retarded—and the movement from state schools to private community residential facilities; and (4) the dependent/neglected and delinquent youth and the movement away from orphan asylums and training schools to group homes, treatment centers, adolescent psychiatric units, halfway houses, and outdoor camps. Recent trends and projections, as well as present and future policy issues, are assessed.
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