Thursday, October 8, 2015

Mental health and the Man timeline

This summary is courtesy of the Hogg Foundation at the University of Texas at Austin:

1700 – A series of local mental health acts that created local responsibility for the mentally ill.

1800 — State policies began an era of rapid development of state hospitals, with 84 percent of the states following this trend. Between 1800-1850 over 300 state hospitals were constructed.

1853 — President Franklin Pierce vetoed a bill that would have involved the federal government in the provision of mental health care at the state level.

1930 – Federal statute creating a division of mental health within the Public Health Service. This division was the forerunner of the National Institute of Mental Health (NIMH).

1946 – Congress passed legislation (PL 79-487) creating NIMH and asked each state to designate a single state agency to be responsible for mental health care. This law was in response to the high proportion of males found mentally unfit to serve in WWII and to the number of psychiatric causalities.

1947 – The Supreme Court ruled that national health insurance was constitutional.

1955 – Congress passed legislation (PL 84-142) creating the President’s Commission on Mental Illness. The Commission identified 600,000 individuals in state hospitals in the United States in poor conditions in state hospitals. The report of the Commission (Action for Mental Health) became the basis for the eventual development of the community mental health movement and law.

1963 – Congress passed and President John F. Kennedy signed (PL 88-164), the community mental health centers construction act, providing federal money to construct mental health centers that provided the five essential services. The Act bypassed the states and gave money directly to non-profit groups to provide alternative services to the state mental hospitals.

1964 – Congress passed amendments to the Social Security Act creating Medicaid and Medicare that provided graduated federal payment to the states to provide medical and inpatient psychiatric care outside state hospitals for the poor and aged. This Act enabled private psychiatric hospitals and general hospitals with psychiatric units, but not community mental health centers, to be paid for the inpatient care that they provided to the mentally ill.

1973 – Congress passed legislation (PL 93-45) extending the 1963 legislation for an additional year. Community mental health legislation and funding were strongly opposed by President Nixon and efforts were made by his administration to eliminate this legislation.

1980 – Congress proposed new legislation (PL 96-398) called the community mental health systems act (crafted by Ted Kennedy), but the program was ended by newly-elected President Ronald Reagan. This action ended the federal community mental health centers program and its funding.

1980 – Congress passed legislation (PL 96-416) tile Civil Rights of Institutionalized Persons Act (CRIPA) allowing the Justice Department to sue state governments if they violate the civil rights of the mentally ill or mentally retarded in their state hospitals (the Act was focused originally on prisons).

1981 – Congress passed legislation (PL 97-35) sought by Reagan, titled the Omnibus Reconciliation Act of 1981 that shifted funds to the states vial block grants. States had the option of using their funds to continue to support mental health centers.

1987 – Congress passed new legislation (PL 99-319) developing rules for the protection and advocacy for the mentally ill and offered dollars to the states to set up human rights agencies and regulations to insure rights of the mentally disabled.

1987 – Congress passed new legislation (PL 99-660) requiring that for states to receive block grant monies for mental health and substance abuse, the states had to develop plans for how they would care for the mentally ill who were released from state hospitals and the staff who needed to be retrained.

1987 – Congress passed new legislation (PL 100-77) called the Stewart B. McKinney Homeless Assistance Act, to assist the states in providing housing for the homeless who are mentally ill.

1989 – Congress passed legislation (PL 100-336) titled the Americans with Disabilities Act, designed to prohibit discrimination against individuals with physical or mental disabilities.

1990 – Newly elected President Clinton proposes a national health reform act that will provide mental health and substance abuse services in the coverage (Hillary Rodham-Clinton was chairperson).

1992 – A newly elected Republican congress endorses managed care as the policy for controlling costs and services in health care in the United States.

Currently LA County jail has the largest mental health facility in the US.

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