The period stretching from World War II to the dawn of the twenty-first century was a time of tremendous ferment, conflict, and flux in the history of mental health policy and practice. In the 1950s governments began closing down mental hospitals by the droves, releasing countless patients into the community. Fifty years later the quest for mental health had come full circle, only this time the asylum was a casualty of history, not its savior.

On other fronts, lawmakers pledged unprecedented resources for mental health research, programs, and services. Researchers discovered remarkable new medications for psychosis and mood disorders, reached innovative insights into brain chemistry, and made impressive strides in evolutionary neuro-biology. New technologies of neuro-imaging enabled scientists to scan the brain and view anatomical and physiological phenomena never before seen.

Over the same period the population was aging steadily and a consumer revolt in medicine fundamentally altered the relationship between doctors and patients. The pharmaceutical industry spent millions trying to convince physicians, the public, government bureaucrats, and health insurance companies that their products were safe and effective, a campaign that helped send rates of prescription drug use soaring. Illegal drug use also spread, making addiction a central concern in the mental health field. The definition of psychiatric disease itself succumbed to inflationary pressures as more and more mental and behavioral states were labeled medical disorders. Never before in history were more people diagnosed as depressed, deluded, anxious, addicted, or addled.