The movement toward treating those with mental illness
in less restrictive environments gained momentum
in 1963 with the enactment of the Community
Mental Health Centers Act. Deinstitutionalization,
a deliberate shift from institutional care in state hospitals
to community facilities, began. Community mental
health centers served smaller geographic catchment
(service) areas that provided less restrictive
treatment located closer to the person’s home, family,
and friends. These centers provided emergency care,
inpatient care, outpatient services, partial hospitalization,
screening services, and education. Therefore,
deinsitutionalization had three components: release
of individuals from state institutions, diversion from
hospitalization, and development of alternative community
services (Lamb & Bachrach, 2001).
In addition to deinstitutionalization, federal legislation
was passed to provide an income for disabled
persons: Supplemental Security Income (SSI) and
Social Security Disability Income (SSDI). This allowed
people with severe and persistent mental illnesses
to be more independent financially and not have to
rely on family for money. States were able to spend
less money on care of the mentally ill than they had
in state hospitals, because these programs were federally
funded. Also commitment laws changed in the
early 1970s, making it more difficult to commit people
for mental health treatment against their will. This
further decreased the state hospital populations and,
consequently, the money that states spent on them
(Torrey, 1997).
