Mental Retardation and Community Mental Health Centers Construction Act of 1963
Long title
An Act to provide assistance in combating mental retardation through grants for construction of research centers and grants for facilities for the mentally retarded and assistance in improving mental health through grants for construction of community mental health centers, and for other purposes.
42 U.S.C. ch. 33, subch. IV §§ 2691, 2692, 2693-2697b
42 U.S.C. ch. 33, subch. V §§ 2698-2698b
Legislative history
Introduced in the Senate as S. 1576 by J. Lister Hill (D–AL) on May 21, 1963
Committee consideration by Senate Labor and Public Welfare, House Interstate and foreign Commerce
Passed the Senate on May 27, 1963 (72-1)
Passed the House on September 10, 1963 (335-18)
Reported by the joint conference committee on October 21, 1963; agreed to by the Senate on October 21, 1963 (agreed) and by the House on October 21, 1963 (299-13)
Signed into law by President John F. Kennedy on October 31, 1963
President John F. Kennedy signing the act
The Community Mental Health Act of 1963 (CMHA) (also known as the Community Mental Health Centers Construction Act, Mental Retardation Facilities and Construction Act, Public Law 88-164, or the Mental Retardation and Community Mental Health Centers Construction Act of 1963) was an act to provide federal funding for community mental health centers and research facilities in the United States. This legislation was passed as part of John F. Kennedy's New Frontier.[1] It led to considerable deinstitutionalization.
In 1955, Congress passed the Mental Health Study Act, leading to the establishment of the Joint Commission on Mental Illness and Mental Health.[2] That Commission issued a report in 1961,[3] which would become the basis of the 1963 Act.[2]
The CMHA provided grants to states for the establishment of local mental health centers, under the overview of the National Institute of Mental Health. The NIH also conducted a study involving adequacy in mental health issues. The purpose of the CMHA was to build mental health centers to provide for community-based care, as an alternative to institutionalization. At the centers, patients could be treated while working and living at home.
Only half of the proposed centers were ever built; none was fully funded, and the act didn't provide money to operate them long-term. Some states closed expensive state hospitals, but never spent money to establish community-based care. Deinstitutionalization accelerated after the adoption of Medicaid in 1965. During the Reagan administration, the remaining funding for the act was converted into a mental-health block grants for states. Since the CMHA was enacted, 90 percent of beds have been cut at state hospitals, but they have not been replaced by community resources.[4]
The CMHA proved to be a mixed success. Many patients, formerly warehoused in institutions, were released into the community. However, not all communities have had the facilities or expertise to deal with them.[5] In many cases, patients wound up in adult homes or with their families, or homeless in large cities,[6][7] and without the mental health care they needed.[8] Without community support, mentally ill people have more trouble getting treatment, maintaining medication regimens, and supporting themselves. They make up a large proportion of the homeless and an increasing proportion of people in jail.
^Kennedy, John F. (31 October 1963). Remarks on signing mental retardation facilities and community health centers construction bill (Speech). Signing S. 1576, the Community Mental Health Act of 1963. White House Cabinet Room, Washington, DC: John F. Kennedy Presidential Library and Museum. JFKPOF-047-045.
^ abFriedman, Michael B. (8 April 2004) [2002]. "Think About the Next 25 Years: Advice for the President's Commission on Mental Health". NAMI SCC. National Alliance for the Mentally Ill Santa Cruz County. Archived from the original on 2008-05-09.
^"History of the Organization and the Movement". Mental Health America. Archived from the original on 2008-10-30.
^Smith, Michelle R. (20 October 2013). "50 years later, Kennedy's vision for mental health not realized". The Seattle Times. The Associated Press. Archived from the original on 2013-10-23.
^"History of Public Mental Health in California and the U.S." Center for Mental Health Services Research. The University of California, Berkeley and San Francisco. Archived from the original on 2007-05-25.
^Scanlon, John, "Homelessness: Describing the Symptoms, Prescribing a Cure" Archived 2008-10-02 at the Wayback Machine, The Heritage Foundation, Backgrounder #729, October 2, 1989
^Rubin, Lillian B. (Fall 2007). "Sand Castles and Snake Pits: Homelessness, Public Policy, and the Law of Unintended Consequences". Dissent.
^Friedman, Michael B. "Keeping The Promise of Community Mental Health". Mental Health Association of Westchester. Archived from the original on 2004-06-23. Retrieved 8 August 2003.
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