The Community Mental Health Centers Act of 1963
In October 1963, President Kennedy signed into law the Community Mental Health Centers Act (PL 88-164), which authorized federal grants for the construction of public or nonprofit community mental health centers to provide inpatient, outpatient, partial hospitalization, emergency care, and consultation and education services. Grants were awarded to the states, with the stipulation that funds could not be used for existing state mental institutions. The program was administered by the NIMH, signaling the greater involvement of the federal government in determining mental health policy and the delivery of mental health services.
In creating a new type of mental health treatment facility, the landmark Act fueled the community mental health movement with its emphasis on prevention and early treatment (Caplan, 1964). Scant attention was paid to the fate of the severely mentally ill, however, who were discharged from state mental asylums in increasingly greater numbers throughout the 1960s and 1970s. Few received care in the new community mental health centers, as mental health professionals turned their attention to acutely ill patients with mild to moderate psychiatric conditions and limited treatment histories. In the context of the civil rights movement and the social change sweeping the nation in the 1960s, the community mental health movement embraced civil libertarian reform, focusing not just on psychiatric disorder, but on larger social issues like “poverty, racism, civil unrest, violence, and criminality” (Goldman & Morrissey, 1985). Although patients continued to suffer from chronic mental illness, access to the services they needed to live successfully in community settings grew increasingly limited (Cutler et al., 2003). By the end of the 1970s, only about half of planned community mental health centers were ever built, none were fully funded, and the legislation did not provide for long-term funding. In the early months of the Reagan administration, funds remaining from the Community Mental Health Centers Act were diverted into block grants to the states.