Community Mental Health Act

Community Mental Health Act

Other short titles	Mental Retardation and Community Mental Health Centers Construction Act of 1963
Long title	An Act to provide assistance in combating mental retardation through grants for construction of research centers and grants for facilities for the mentally retarded and assistance in improving mental health through grants for construction of community mental health centers, and for other purposes.
Nicknames	Community Mental Health Act of 1963
Enacted by	the 88th United States Congress
Effective	October 31, 1963
Citations
Public law	88-164
Statutes at Large	77 Stat. 282
Codification
Titles amended	42 U.S.C.: Public Health and Social Welfare
U.S.C. sections created	42 U.S.C. ch. 33, subch. I §§ 2661-2666 42 U.S.C. ch. 33, subch. II §§ 2670-2677c 42 U.S.C. ch. 33, subch. IIA §§ 2678-2678d 42 U.S.C. ch. 33, subch. III §§ 2681-2688j-1, 2688j-2, 2688k-2688o, 2688p, 2688q-2688v, 2689-2689e, 2689f-2689h, 2689i-2689l, 2689m, 2689n-2689p, 2689q, 2689r-2689aa 42 U.S.C. ch. 33, subch. IV §§ 2691, 2692, 2693-2697b 42 U.S.C. ch. 33, subch. V §§ 2698-2698b
Legislative history
Introduced in the Senate as S. 1576 Passed the Senate on May 27, 1963 (72-1) Passed the House on September 10, 1963 (335-18) Reported by the joint conference committee on October 21, 1963; agreed to by the Senate on October 21, 1963 (agreed) and by the House on October 21, 1963 (299-13) Signed into law by President John F. Kennedy on October 31, 1963

The Community Mental Health Act of 1963 (CMHA) (also known as the Community Mental Health Centers Construction Act, Mental Retardation Facilities and Construction Act, Public Law 88-164, or the Mental Retardation and Community Mental Health Centers Construction Act of 1963) was an act to provide federal funding for community mental health centers in the United States. This legislation was passed as part of John F. Kennedy's New Frontier.^[1] It led to considerable deinstitutionalization.

In 1955, Congress passed the Mental Health Study Act, leading to the establishment of the Joint Commission on Mental Illness and Mental Health. That Commission issued a report in 1961,^[2] which would become the basis of the 1963 Act.^[3]

The CMHA provided grants to states for the establishment of local mental health centers, under the overview of the National Institute of Mental Health. The NIH also conducted a study involving adequacy in mental health issues. The purpose of the CMHA was to build mental health centers to provide for community-based care, as an alternative to institutionalization. At the centers, patients could be treated while working and living at home.

Only half of the proposed centers were ever built; none were fully funded, and the act didn’t provide money to operate them long-term. Some states saw an opportunity to close expensive state hospitals without spending some of the money on community-based care. Deinstitutionalization accelerated after the adoption of Medicaid in 1965. During the Reagan administration, the remaining funding for the act was converted into a mental-health block grant for states. Since the CMHA was enacted, 90 percent of beds have been cut at state hospitals.^[4]

The CMHA proved to be a mixed success. Many patients, formerly warehoused in institutions, were released into the community. However, not all communities had the facilities or expertise to deal with them.^[5] In many cases, patients wound up in adult homes or with their families, or homeless in large cities,^[6][7] but without the mental health care they needed.^[8]

See also

• Community mental health service
• Deinstitutionalisation
• Psychiatric hospital
• Psychiatric survivors movement
• Institutional syndrome
• Involuntary commitment
• Outpatient commitment
• Homeless dumping
• Self-help groups for mental health
• Treatment Advocacy Center
• Political abuse of psychiatry
• Global Mental Health
• Community health

Notes

1. "Remarks on signing mental retardation facilities and community health centers construction bill, 31 October 1963". Community Mental Health Act of 1963. John F. Kennedy Presidential Library and Museum.
2. National Mental Health Association (NMHA) History
3. THINK ABOUT THE NEXT 25 YEARS, (Archive.org Cache)
4. SMITH, MICHELLE R. (October 20, 2013). "50 years later, Kennedy’s vision for mental health not realized". The Associated Press.
5. The University of California, Berkeley and San Francisco, Center for Mental Health Services Research
6. Scanlon, John, "Homelessness: Describing the Symptoms, Prescribing a Cure", Heritage Foundation, Backgrounder #729, October 2, 1989
7. Rubin, Lillian, "Sand Castles and Snake Pits: Homelessness, Public Policy, and the Law of Unintended Consequences", Dissent journal, Fall 2007.
8. Friedman, Michael B., "Keeping The Promise of Community Mental Health", The Journal News, mirror retrieved August 8, 2003

Further reading

• Arce, A. Anthony, Vergare, Michael J., "Homelessness, the chronic mentally ill and community mental health centers", Community Mental Health Journal, Springer Netherlands, Volume 23, Number 4 / December, 1987.
• Institute of Medicine (U.S.) Committee on Health Care for Homeless People, Institute of Medicine (U.S.), "Homelessness, Health, and Human Needs: Health Care and Human Needs", National Academies Press, 1988, ISBN 0-309-03832-4. Cf. p. 97.
• Kramer, Morton, "Statistics of Mental Disorders in the United States: Current Status, Some Urgent Needs and Suggested Solutions", Journal of the Royal Statistical Society. Series A (General), Vol. 132, No. 3 (1969), pp. 353–407, Blackwell Publishing for the Royal Statistical Society
• Rochefort, David A., "From Poorhouses to Homelessness: Policy Analysis and Mental Health Care", Westport, CT: Auburn House, 1993
• Rudin, Edward, McInnes, Robert S., "Community Mental Health Services Act — Five Years of Operation Under the California Law", California Medicine, 1963 July; 99(1): 9–11.
• Sharfstein, Steven S., "Whatever Happened to Community Mental Health?", Psychiatric Services, 51:616-620, May 2000, American Psychiatric Association
• Stavis, Paul F., "Homeward Bound: The Developing Legal Right to a Home in the Community", Quality of Care Newsletter, Issue 48, April–May 1991, New York State Commission on Quality of Care and Advocacy for Persons with Disabilities.