Online ordering is currently unavailable due to technical issues. We apologise for any delays responding to customers while we resolve this. For further updates please visit our website https://www.cambridge.org/news-and-insights/technical-incident
This chapter provides an overview of the history of mental health policy in the United States divided into three periods: (1) the development and establishment of the state asylum as the primary mode of mental health treatment; (2) deinstitutionalization and the move to community-based care; and (3) recovery as the guiding vision of mental health care. Federal involvement is a relatively new development in mental health policy, a fact that has lead to significant fragmentation in the mental health care system. While a number of policies since the 1950s have sought to increase social inclusion and the ability for people with mental illness to control their own lives, lack of support for these policies has resulted in relatively slow actual change. However, recent national reforms have potential to make lasting and substantial change. Watson and colleagues describe these reforms and how they may lead to implementation of recovery-oriented principles by improving mental health care access and service quality. They close with a discussion of potential areas for sociological mental health research related to contemporary health policy. What are the gaps in current mental health policy? How can mental health policy promote recovery for people living with mental health problems?
Introduction
Historically, there has been a lack of strong federal involvement in US mental health policy making. The result has been a highly fragmented mental health system with significant differences at the state and local levels of government. In this chapter, we provide an overview of the history of US mental health policy from the seventeenth century to the present, with a particular focus on polices affecting people living with serious and persistent mental illness (SPMI). We have divided the chapter into three broad periods of reform. The first period, the late 1700s through the 1940s, was a time marked by increasing social control over the lives of people with mental illness as states started to assume more responsibility for their care. This period culminated with the state psychiatric hospital (also known as the asylum) as the primary locus of mental health treatment. The 1950s–1980s was a time of advocacy leading to the movement of patients from state mental hospitals and into the community. This period was also marked by increased recognition of the rights of people living with mental illness, albeit with relatively few polices or resources to support them.
Review the options below to login to check your access.
Log in with your Cambridge Higher Education account to check access.
If you believe you should have access to this content, please contact your institutional librarian or consult our FAQ page for further information about accessing our content.