Since the advent of institutional care in the nineteenth century, there has been extensive discussion concerning the relative merits and constraints inherent in such service provision. In the twentieth century, the trend toward institutionalization began to be reversed. Patients or clients were released or returned to communities and community care through increasingly available medical and social resources. The impetus toward the use of alternatives to institutionalization has come from federal legislation and from a continuing loss of institutionalized clientele since the 1950's. These occurrences have caused a great deal of discussion and prompted an examination of the present-day patient or client population's use of state and public institutions and community support services. Possible sources of documented information are presented. (KA)