Law That Changed Mental Health Care Celebrates 50th Anniversary Today

Fifty years ago today, President John F. Kennedy signed  a law that became a major milestone on the long road to improving the state of mental health care in the U.S. The primary goal of the Community Mental Health Act of 1963, signed just three weeks before Kennedy was assassinated, was to greatly reduce the number of patients with serious mental illness who were routinely treated in huge state hospitals and ensure instead that they would receive treatment in their communities. He envisioned that 1,500 community mental health centers (CMHCs) would be built under funding provided through the act, which would result in a cut of 50% in the 500,000 or so patients who were in state psychiatric hospitals in 1963. The act also signaled a shift to giving the federal government a greatly expanded role in mental health care.

Part of the act's promise was fulfilled in that deinstitutionalization did, in fact, occur on a massive scale, but an adequate number of community-treatment alternatives did not follow. Only half of the proposed CMHCs were built, and none received the full amount of funding indicated in the act or funds to function over the long term. In addition, many CMHCs did not want to treat patients with severe illnesses. During the Reagan administration, the funding was converted into mental health block grants that went to the states to distribute.

To read more about the legacy of the 1963 mental health act, see the essay "The Next 50 Years: A New Vision of 'Community Mental Health' ” by former member of Congress Patrick Kennedy and psychiatrists John Greden, M.D, and Michelle Riba, M.D., in the October American Journal of Psychiatry.