The 2015 Sidney Ball Memorial Lecture, Anti-Deinstitutionalization and Anti-Institutionalization for Persons with Severe Mental Illnesses: Finding Common Ground, delivered by Dr Phyllis Solomon, University of Pennsylvania. In the U.S. and the U.K., there are currently two diametrically opposed policy positions being promoted for the care and treatment of persons with severe mental illness, anti-deinstitutionalization and anti-institutionalization. Both share the same goal of ensuring the best quality of life for those with severe psychiatric disorders, but the pathways to achieving this goal are very different and have resulted in much contention. Each espouses a different belief system regarding this population and their presumed capabilities, and varying emphasis on maximizing protection of the community versus protection of individual rights, resulting in contrasting mental health policies and practice orientations. The presentation will delineate the history from which these positions evolved, consequent views, and policies and practices that emerged from the differing attitudes, culminating in a proposed practice approach that when supported by appropriate policy offers a more balanced approach to serving adults with mental illness–navigating risk management that preserves freedom and opportunities of risk while affording mutually satisfactory “risk control”.