ABSTRACT
The US undertook a massive reform in the delivery of mental health services under the banner of ‘community mental health.’ The concept of ‘community mental health’ implied a dual promise: treatment and rehabilitation of the severely mentally ill within the community and the promotion of mental health generally. The deinstitutionalization statistics are illusory. It is important to see just where deinstitutionalization has encountered difficulties, and that requires some understanding of the dynamics of the program: the complex interaction of financial, professional, political and administrative factors that operate almost independently of the intentions or the legislation that initiated it. The centers’ deviation from traditional methods of psychotherapy and their frequent preoccupation with nonclinical issues involving public health, social problems and economics have made many academic professionals reluctant to become engaged in community mental health programs. The problem of conflicting governmental jurisdictions in mental health has been exacerbated in recent years by increased judicial involvement.
