In the past families would look after their own disabled members. Of course this is easier in large non-nuclear families. But maybe something like more like community centers in every town rather than imposing "Insane Asylums" run by scary officials would help?
To be clear, by institutions I don't mean monolithic asylums. I mean institutions in a broad sense. The way the fire department is an institution. I mean something much more akin to networks of social and the community centers you mention.
In the past families would look after their own disabled members. Of course this is easier in large non-nuclear families. But maybe something like more like community centers in every town rather than imposing "Insane Asylums" run by scary officials would help?