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Eras of Mental Health
1930 to 1955 - Mental Hygiene Era, services in mental hospitals and psychiatric clinics with focus on prevention.
1955 to 1980 - Community Mental Health Era, services in community mental health centers with focus on deinstitualization to community.
1980 to 1995 - Community Support Era, services in community with focus on social problems such as housing, entitlements, and employment.
1995 to present - Recovery Era, services in community by community mental health centers and by consumer-run organizations focusing on developing a satisfying, hopeful and meaningful life in spite of mental illness.
Timeline of Mental Health Services
1930s
1930 Mental Health Treatment Act (England) Introduced concept of voluntary admission and the notion of rehabilitation. It changed "lunatics" to "persons of unsound mind" and "asylums" to "mental hospitals".
1940s
1946 - National Institute of Mental Health was formed under the National Institute of Health
1950s
1950 - National Committee for Mental Hygiene modernized to National Association for Mental Health.
1950s - Use of now-discredited treatments such as insulin shock therapy and lobotomies
1950s - Widespread use of psychotropic medications began.
1952 - Theraputic trials of LSD
1954 - Thorazine (Chlorpromazine) first introduced.
1955 - Mental Health Study Act - National Institute of Mental Health appointed Joint Commission on Mental Illness and Health to "…evaluate the needs of the mentally ill and to make recommendations to Congress…"
1959 - Haldol (Haloperidol) introduced
1960s
Early 1960s - Rise of the Civil Rights Movement to fight against inequality and social injustice.
1961 - Report of Joint Commission on Mental Illness and Health recommended upgrading of hospitals and establishing community-based treatment centers.
1962 - Aid to the Permanently and Totally Disabled (APTD), an early form of SSI.
1963 - JFK signed legislation for the creation of Community Mental Health Centers.
1965 - Introduction of Medicaid and Medicare to provide benefits to patients NOT in state hospitals.
1969 - NIMH started funding psychiatric training with federal funds. Since there were no provisions to prevent doctors from going directly into private practice (and more consumers were in the community) doctors began doing only private practice.
1970s
1970 - Lithium releases as a treatment for BiPolar Illness.
1970 to 1975 - The number of psychiatrists willing to work in the public sector dropped by 50%. They were replaced by social workers and psychologists.
1970s - Emergence of women's movement, gay rights movements, and disabilities rights movement.
1975 to 1977 - At the same time that hospitals were being "deinstitutionalized" the proportion of patients treated for serious mental illness was declining in community mental health centers. Those receiving treatment were treated for "predictable problems of living". This phenomenon was known as treating the "worried well".
1977 - Task Force on Deinstitutionalization of the Mentally Disabled was created because it became obvious that community mental health system was not working and was being used to treat the worried well.
1979 - Based on the report of the Task Force on Deinstitutionalization of the Mentally Disabled, NIMH created the Community Support Programs. It was for adult psychiatric patients whose disabilities are severe and persistent. The goal was to allow individuals with mental illnesses to remain in their home communities with minimal hospitalization.
1980s
1982 - Strengths Model of case management with person's suffering from severe and persistent mental illness used.
1987 - Stewart B. McKinney Homeless Assistance Act providing federal funds for the homeless population, many of whom experience mental illness.
1987 - Prozac released for depression, followed by other SSRI's
1990s
1990s - Atypical antipsychotic medications are released showing better clinical response with fewer side effects (Clozaril, Risperdal, Zyprexa, Seroquel, etc.)
1996 - Mental Health Parity Act barred insurance companies and large self-insured employers from placing annual or lifetime dollar limits on mental health coverage.
1996 - Ongoing changes in mental health system shaped by consumer and recovery emphasis: assertive community treatment, vocational rehabilitation, and interventions for "illness management" and "self-managed care".
1997 - Wellness Recovery Action Plan written by Mary Ellen Copeland to assist consumers in developing a personalized plan to stay well.
1999 - First White House Conference on Mental Health
1999 - Mental Health: A Report of the Surgeon General
2000s
2000 - Community Mental Health Centers begin embracing Recovery ideas and empowering consumers to build meaningful lives above and beyond symptom control and stability.
2001 - Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General