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.
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 and research facilities 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.[2] That Commission issued a report in 1961,[3] which would become the basis of the 1963 Act.[2]
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 was fully funded, and the act didn't provide money to operate them long-term. Some states closed expensive state hospitals, but never spent money to establish 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 grants for states. Since the CMHA was enacted, 90 percent of beds have been cut at state hospitals, but they have not been replaced by community resources.[4]
The CMHA proved to be a mixed success. Many patients, formerly warehoused in institutions, were released into the community. However, not all communities have 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] and without the mental health care they needed.[8] Without community support, mentally ill have more trouble getting treatment, maintaining medication regimens, and supporting themselves. They make up a large proportion of the homeless and an increasing proportion of people in jail.
Arce, A. Anthony; Vergare, Michael J. (December 1987). "Homelessness, the chronic mentally ill and community mental health centers". Community Mental Health Journal. Netherlands: Springer. 23 (4): 242–249. doi:10.1007/bf00769836. PMID3440376.
Kramer, Morton (1969). "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). Blackwell Publishing for the Royal Statistical Society. 132 (3): 353–407. doi:10.2307/2344118. JSTOR2344118.
Rochefort, David A. (1993). From Poorhouses to Homelessness: Policy Analysis and Mental Health Care. Westport, CT: Auburn House. OCLC27768141.
Involuntary commitment, civil commitment, or involuntary hospitalization/hospitalisation is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily. This treatment may involve the administration of psychoactive drugs, including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as outpatient commitment and shares legal processes with commitment.
Psychiatric hospitals, also known as mental health hospitals or behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative identity disorder, major depressive disorder and many others. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short-term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent containment of patients who need routine assistance, treatment, or a specialized and controlled environment due to a psychiatric disorder. Patients often choose voluntary commitment, but those whom psychiatrists believe to pose significant danger to themselves or others may be subject to involuntary commitment and involuntary treatment. Psychiatric hospitals may also be called psychiatric wards/units when they are a subunit of a regular hospital.
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, trauma, and self-actualization of one's intellectual and emotional potential, among others. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite and thinking of harming yourself or others.
In November 2004, voters in the U.S. state of California passed Proposition 63, the Mental Health Services Act (MHSA), which has been designed to expand and transform California's county mental health service systems. The MHSA is funded by imposing an additional one percent tax on individual, but not corporate, taxable income in excess of one million dollars. In becoming law in January 2005, the MHSA represents the latest in a Californian legislative movement, begun in the 1990s, to provide better coordinated and more comprehensive care to those with serious mental illness, particularly in underserved populations. Its claim of successes thus far, such as with the development of innovative and integrated Full Service Partnerships (FSPs), are not without detractors who highlight many problems but especially a lack of oversight, large amount of unspent funds, poor transparency, lack of engagement in some communities, and a lack of adherence to required reporting as challenges MHSA implementation must overcome to fulfill the law's widely touted potential.
Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.
Emergency psychiatry is the clinical application of psychiatry in emergency settings. Conditions requiring psychiatric interventions may include attempted suicide, substance abuse, depression, psychosis, violence or other rapid changes in behavior. Psychiatric emergency services are rendered by professionals in the fields of medicine, nursing, psychology and social work. The demand for emergency psychiatric services has rapidly increased throughout the world since the 1960s, especially in urban areas. Care for patients in situations involving emergency psychiatry is complex.
Deinstitutionalisation is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the late 20th century, it led to the closure of many psychiatric hospitals, as patients were increasingly cared for at home, in halfway houses and clinics, in regular hospitals, or not at all.
The Broadview Developmental Center was a psychiatric hospital built in 1939 near Broadview Heights, Ohio, United States. Constructed under the Works Progress Administration as part of President Franklin Roosevelt's New Deal, it functioned as a Veterans Administration Hospital until 1966 when it was sold to the state of Ohio. The Broadview Developmental Center was then converted into a psychiatric hospital, and remained open until 1993 when the prevailing opinion on mental health shifted from institutional care to community-based care, and the hospital lost its funding. The building was demolished in 2006, except for its newest portion, which was kept as the city of Broadview Heights' city hall and recreation centre.
Patient dumping or homeless dumping is the practice of hospitals and emergency services inappropriately releasing homeless or indigent patients to public hospitals or on the streets instead of placing them with a homeless shelter or retaining them, especially when they may require expensive medical care with minimal government reimbursement from Medicaid or Medicare. The term homeless dumping has been used since the late 19th century and resurfaced throughout the 20th century alongside legislation and policy changes aimed at addressing the issue. Studies of the issue have indicated mixed results from the United States' policy interventions and have proposed varying ideas to remedy the problem.
The Canadian Mental Health Association (CMHA) is a Canadian non-profit mental health organization that focusing on resources, programs and advocacy. It was founded on April 22, 1918, by Dr. Clarence M. Hincks and Clifford W. Beers. Originally named the Canadian National Committee for Mental Hygiene, it is one of the largest and oldest voluntary health organizations operating in Canada.
Cherry Hospital is an inpatient regional referral psychiatric hospital located in Goldsboro, North Carolina, United States. As one of three psychiatric hospitals operated by the North Carolina Department of Health and Human Services, it provides services to 38 counties in the eastern region of North Carolina. It is part of the Division of State Operated Healthcare Facilities within the Department of Health and Human Services, which oversees and manages 14 state-operated healthcare facilities that treat adults and children with mental illness, developmental disabilities, and substance use disorders. The Division's psychiatric hospitals provide comprehensive inpatient mental health services to people with psychiatric illness who cannot be safely treated at a lower level of care.
A Crisis Intervention Team (CIT) is a police mental health collaborative program found in North America. The term "CIT" is often used to describe both a program and a training in law enforcement to help guide interactions between law enforcement and those living with a mental illness.
Community mental health services (CMHS), also known as community mental health teams (CMHT) in the United Kingdom, support or treat people with mental disorders in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided. It refers to a system of care in which the patient's community, not a specific facility such as a hospital, is the primary provider of care for people with a mental illness. The goal of community mental health services often includes much more than simply providing outpatient psychiatric treatment.
Services for mental health disorders provide treatment, support, or advocacy to people who have psychiatric illnesses. These may include medical, behavioral, social, and legal services.
The lunatic asylum or insane asylum was an early precursor of the modern psychiatric hospital.
The Department of Mental Hygiene (DMH) is a component of the New York state government composed of three autonomous offices:
In a study in Western societies, homeless people have a higher prevalence of mental illness when compared to the general population. They also are more likely to suffer from alcoholism and drug dependency. It is estimated that 20–25% of homeless people, compared with 6% of the non-homeless, have severe mental illness. Others estimate that up to one-third of the homeless have a mental illness. In January 2015, the most extensive survey ever undertaken found 564,708 people were homeless on a given night in the United States. Depending on the age group in question and how homelessness is defined, the consensus estimate as of 2014 was that, at minimum, 25% of the American homeless—140,000 individuals—were seriously mentally ill at any given point in time. 45% percent of the homeless—250,000 individuals—had any mental illness. More would be labeled homeless if these were annual counts rather than point-in-time counts. Being chronically homeless also means that people with mental illnesses are more likely to experience catastrophic health crises requiring medical intervention or resulting in institutionalization within the criminal justice system. Majority of the homeless population do not have a mental illness. Although there is no correlation between homelessness and mental health, those who are dealing with homelessness are struggling with psychological and emotional distress. The Substance Abuse and Mental Health Services Administration conducted a study and found that in 2010, 26.2 percent of sheltered homeless people had a severe mental illness.
Involuntary commitment or civil commitment is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily.
Mentally ill people are overrepresented in jail and prison populations in the United States relative to the general population. There are three times more seriously mentally ill people in jails and prisons than in hospitals in the United States. Scholars discuss many different causes of this overrepresentation, including the deinstitutionalization of mentally ill individuals in the mid-twentieth century, inadequate community mental health treatment resources, and the criminalization of mental illness itself. The majority of prisons in the United States employ a psychiatrist and a psychologist. There is a consensus that mentally ill offenders have comparable rates of recidivism to non-mentally ill offenders. Mentally ill people experience solitary confinement at disproportionate rates and are more vulnerable to its adverse psychological effects. Twenty-five states have laws addressing the emergency detention of the mentally ill within jails, and the United States Supreme Court has upheld the right of inmates to mental health treatment.
The United States has experienced two waves of deinstitutionalization, the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability.
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