The Community Mental Health Centers Act Of 1963 Closed State Psychiatric Hospitals

In an effort to transform the public mental health system, in 1963, President Kennedy proposed the Community Mental Health Act. It was the first among several federal initiatives to create a community mental health care system. Once the act was ratified, there was an intense deterioration in institutionalization, otherwise known as “deinstitutionalization”, and by 1980 there was a 75% declined of the inpatient population at many public psychiatric hospitals. In 2000, there was less than 10% of the public institutionalized just fifty years earlier. In 2009, there was even a more dramatic shift among children and adolescence whereby there was a 98% decline in

With states closing many of its mental facilities in the communities, there were a lot of people in need of outpatient care who fell through the cracks of the system and ended up in prison. Prison is where many of them died from inadequate treatment. Prisons were suddenly receiving inmates with the following types of mental illnesses: Schizophrenia, bipolar, and deep depressions. These prisons just did not provide these inmates with any medication during their incarceration. Because the community based health services is lacking, and patients aren’t receiving sufficient outpatient care, it makes the effectiveness of deinstitutionalization a serious problem. Without the availability of 24/7 psychiatric services that are well structured, I believe that deinstitutionalization is what is accounting for the increase of the mentally ill inmates in the correctional facility.

The community-based mental health programs are not only inadequate in relation to numbers, but also underfunded (Unite for Sight.org, 2013). According to Martin (1995), we live in a society that is increasingly becoming conscious of an excessive tax burden. Tax burden, on the other hand, provides for the realization of just how deinstitutionalization is directly related to politics and public policy. The pubic in America who account for the electorate, have a significant say in how policy is affected. To this extent the assumption in relation to deinstitutionalization is that due to increased public outcry in regards to taxation, the both federal and state governments have over the years been forced to cut down spending on some items in the recurring budget in order to free up additional funds. According to Treatment Advocacy Center (2011), the federal government in 1965 surgically excluded the payment of Medicaid for patients institutionalized in state psychiatric and other mental disorders institutions. The goals of this action, according to Treatment Advocacy Center (2011) was to foster deinstitutionalization, and the wading of care costs to sates, viewing them as largely responsible for mental care.

Deinstitutionalization further exacerbated the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill, and this situation continues up to the present.

Overcrowding became a major problem during the 1940s. Public pressure to reduce the lengthy waiting lists for admission to state hospitals and to remove mentally ill individuals from local jails increased occupancy in already overcrowded hospitals. In 1943, the legislature converted the Confederate Home for Men into a hospital for mentally ill male geriatric patients in order to provide beds in the larger hospitals. In 100 years, the state system for caring for the mentally ill grew to nine state hospitals scattered about the state. Their population had, however, begun to decline as a result of new treatment techniques and changing social ideas about the role of state psychiatric hospitals in caring for afflicted individuals (Creson).

Today, it seems almost incomprehensible that so many people with serious mental illnesses reside in prisons instead of receiving treatment. Over a century and a half ago, reform advocates like Dorothea Dix campaigned for prison reform, urging lawmakers to house the mentally ill in hospitals rather than in prisons. The efforts undertaken by Dix and other like-minded reformers were successful: from around 1870 to 1970, most of the United States’ mentally ill population was housed in hospitals rather than in prisons. Considering reformers made great strides in improving this situation over a century and a half ago. Granted, mental hospitals in the late 19th and early 20th century were often badly run and critically flawed, but rather than pushing for reform of these hospitals, many politicians lobbied for them to close their doors, switching instead to a community-based system for treating the mentally ill. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people. Nevertheless, there are things that can be done to lower the rate mentally ill persons are being incarcerated. Such

The conditions of psychiatric hospitals were poorly maintained yet again. From the late 1800s until the mid-1900s, the conditions of these institutions were hit or miss. Despite the rising population of those in need of mental health treatment, conditions were deteriorating across the board. This pushed in the deinstitutionalization movement (Nevid, Rathus, & Green, 2014). This was a push to remove patients from state-run hospitals into a more community-based treatment center. In most cases today, there are treatment plans in place depending upon the severity of the disorder an individual may be suffering from. It’s more about treating an individual with any variety of modern techniques or therapies and trying to reintegrate them into society rather than a lifelong stay in an institution. Deinstitutionalization didn’t work the way it was intended. After it was put into place there was a rise in the homeless population and different programs that were supposed to be put into place didn’t live up to

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

This was the first effective antipsychotic medication. Most of those who were deinstitutionalized were severely mentally ill. Between 50 and 60 percent of them were diagnosed with schizophrenia. Another 10 to 15 percent were diagnosed with manic-depressive illness and severe depression and an additional 10 to 15 percent were diagnosed with organic brain diseases, such as epilepsy, strokes, and Alzheimer's disease. Deinstitutionalization further worsened the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill. This situation continues up to the present. As a result, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment. Patients were kicked out with no choice. Many untreated mentally ill patients were incarcerated instead of being placed in asylums. The goal of deinstitutionalizing was that these patients should be treated in the least restrictive settings. But the settings ended up being on the streets or behind

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and

The homeless- found on city park benches, street corners, and subway grates. Where did all of these people come from? One third, to one half of the homeless suffer from a mental illness. A lot is said about the homeless-mentally ill, but what their plight says about us may be more significant. We still have not found a place for those who are both poor and insane. Once there was a place for them; the asylum fulfilled the basic needs of thousands for decades, but now these institutions lay empty and in ruin. Has the hope to heal the mentally ill also been abandoned? Is there once again a need for the asylum? The disbandment of the asylum was the first step in ending segregation for those

Imagine living in a place where you were sent to be aided on a disability and it turns out to be a nightmare. A nightmare where you are living in poor conditions, abused by a corrupt staff, and performed dangerous operations on without your permission. Even though many of us don 't experience this, this is a cold hearted reality for the mentally ill. Not only were the mentally ill treated horrible in these “institutions” back then, but outside they weren 't treated any better. In this research paper I am going to look into the treatment of the mentally ill in the mid-1800s to mid-1900s.

In the 1800s, people with mental disorders were simply deemed as “crazy”. They were usually believed to be possessed by evil spirits, or even the devil himself. Practices such as exorcism were not uncommon among this group of people, along with lobotomies, skull drilling, and even cruel isolation. “Many of the drastic procedures that have been put in place to relieve a person of mental illness are only successful in creating ‘vegetables’ out of patients, not curing their illness but making them ghosts of their previous selves.” (Stanley, 2016) Dorothea Dix changed how society viewed mentally disabled individuals. She was a “humanitarian, reformer, educator and crusader.” (Reddi, n.d.) Dorothea Dix was a woman who loved to stand up for what she believed, and made a difference in the world. She protected those who needed protection, loved those who needed love, and understood the misunderstood. Without the dedication she gave, the treatment of mental sickness and female criminals would be far from what it is today. She decided to stand up for the minorities that she connected with and changed how society viewed them. She was able to see first hand what mental illness was like, and struggled with it herself.