The Community Mental Health Act Of 1963

This paper will give a description of the Disability Insurance Policy with a focus on the mentally disabled, giving rise to the Community Mental Health Act of 1963. It will describe the problems that made it necessary to create the CMHA policy, giving the pros and cons of deinstitutionalization. It will give a historical account of the policy and finally will give an analysis of the policy.

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.

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

Doyle, Jim, and Peter Fimrite. "Caring for Mentally Ill Criminals Outside of Prison Is Dangerous." America's Prisons. Ed. Clare Hanrahan. Detroit: Greenhaven Press, 2006. Opposing Viewpoints. Rpt. from "Criminally Insane Taking over State Hospitals." San Francisco Chronicle 22 July 2001. Opposing Viewpoints In Context. Web. 26 Feb. 2013.

The Mental Health Services Act is designed to accumulate and distribute funds to county mental health programs (upon program plan approval). There are five different areas that the act helps with funding in mental health. The first is Community Services & Support (CSS) which helps fund the pairing of mental health care with primary health care settings. CSS also provides mental health support services to people that aren’t able to receive the services elsewhere (Dchs.ca.gov 2015). CSS has some main objectives including reduction of homelessness, justice and child welfare system

During the 1800s, treating individuals with psychological issues was a problematic and disturbing issue. Society didn’t understand mental illness very well, so the mentally ill individuals were sent to asylums primarily to get them off the streets. Patients in asylums were usually subjected to conditions that today we would consider horrific and inhumane due to the lack of knowledge on mental illnesses.

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

In the course of proper identification, evaluation, and treatment, children and adolescents suffering with mental illness can conduct positive, normal lives. Nevertheless, the devastating majority of children with mental illnesses are unsuccessfully identified and the lack of treatment or support services have led to a subordinate worth of life and violence. The Mental Health Awareness and Improvement Act of 2013 (S. 689) is an inclusive bill proposed to address the extensive issue of mental health. By strongly considering the United States’ struggle against mental illness and school violence, as well as utilizing theoretical constructs to examine the Senate’s bill, a social worker can develop a more holistic perspective that can productively integrate practical insights reached from a variety of different points of view.

Policy analysis of mental health care under the ACA as well as description of how mental health care/service are organized under the ACA from federal to local levels.

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.

In today’s society there is a greater awareness of mental illnesses. With this greater awareness one might assume that there would be a substantial increase in government involvement or funding in the area of mental illness treatment. Unfortunately this isn’t the case in the U.S. today. There are hundreds of thousands of people with mental illness that go untreated. These potential patients go untreated for many reasons. These reasons are discussed in the Time article “Mental Health Reform: What Would it Really Take.

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

In America, one in five adults has a mental health condition, a staggering statistic. Appreciatively, recovery is the goal in the mental health centers of 2017. Nevertheless, in the 1950s, patients were provided with inhumane treatments such as lobotomies. Ken Kesey’s novel, One Flew Over the Cuckoo’s Nest, provides an accurate portrayal of a psychiatric ward in the 1950s. The antagonist, Nurse Ratched, hopes her patients will not recover and manipulates them to gain authority. In contrast with the past, Nurses of the present day treat individuals with respect. Conduct towards mentally ill patients has changed since the 1950s in ways such as public attitude, medication, and

In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.

Psychiatric communities can be seen in the psychiatric hospitals used to treat those with mental illness before the deinstitutionalization movement. This approach was unsuccessful and yet after taking away these facilities those with mental illnesses face even more problems. Through the examination of total institutions and the effects deinstitutionalization, it is apparent that those with mental illness would best benefit from community programs such as the Supported Housing project. I argue this because after the deinstitutionalization of treating those with mental illness there was not any programs in place in the community to help those leaving the facilities to re-enter society.