When you are navigating the mental health system, have you felt:
To say that the United States does not have a well-thought-out mental health system is a great understatement. Here’s a brief review of how we got here:
In the 1700s, mental health treatment began to move from the horrific asylums to hospitalization. By the first half of the 20th century, mentally ill people were usually either at home or in institutions.
The year 1954 introduced the first antipsychotic drugs, which improved functioning for many people. So many thought that people with mental illness could live outside of hospitals.
In the early 1960s, the Kennedy administration introduced a plan for more humane mental illness treatment. In 1963, President John F. Kennedy signed the Community Mental Health Centers Act. The program proposed closing the hospitals and replacing them with community mental health centers, where the mentally ill could be treated in homelike settings. This included strict standards so only individuals “who posed an imminent danger to themselves or someone else” could be committed to a state psychiatric hospital.
Mental hospitals began to close in the mid-1960s. But Congress never approved the funds needed to open the equivalent number of community mental health centers.
President Jimmy Carter’s Mental Health Systems Act of 1980 was passed to continue federal funding for mental health programs. In 1981, President Ronald Reagan, in The Omnibus Budget Reconciliation Act , repealed that act, eliminating the money needed for these centers.
In 1955, 558,239 severely mentally ill patients were institutionalized at public hospitals (Torrey, 1997). By 1994, by percentage of the population, we have 92% fewer hospitalized individuals (Torrey, 1997).
Today, community mental health centers do provide mental health services. But many people released under deinstitutionalization became their families’ responsibilities.
They also became homeless (26% of homeless have mental illness, according to HUD). Many of them are in prison. People with mental illnesses are overrepresented in prison. It’s estimated that 55 percent of male inmates and 75 percent of female inmates have mental illnesses. Meantime, the CDC says there are 5.7 million emergency department visits with mental illness as the diagnosis annually.