Having exposed the evils of institutional care, Deutsch pressed for reform, but he conceded that the system needed to be dismantled. By the end of his life it had become apparent that economics, psychopharmacology, and public opinion had given rise to a rights-oriented approach to mental health. Addressing the Senate on the status of the mentally ill shortly before his death, he began, "I share with many of my fellow citizens a deep sense of gratification that this splendid subcommittee is now turning a powerful search-light on one of the darkest and most shameful areas of public neglect. As historian, journalist, and citizen, I have been actively interested in the plight of the institutionalized mentally sick for a quarter century. With many others, I have been picking at the public conscience in their behalf, relying mainly on medical, economic, moral, and humanitarian persuasion. Now…[a] more effective instrument of reform comes to hand—the demand for constitutional protection, for basic justice guaranteed to every American citizen not as a matter of mere charity or sympathy, but of inalienable right" (5).