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America’s Mental Health
The Effects of the Deinstitutionalization of Mental Patients
in the 1960s on my Life and Society
Jennifer Kitchen
4/1/2011

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The history of psychology is long and the trek to understanding and helping the
World’s mentally ill has been a lengthy and challenging journey through scientific
history. Over half a million years ago, ancient healers used trephining, chipping away at
the skull to release the evil spirits within, to “cure” the mentally ill. By 430 BC, the great
father of modern medicine, Hippocrates, argued for the four temperaments of
personality, which he associated with the four humors of the body which he felt, affected
the personality. In the early 1800s, phrenology, the study of the bumps on one’s head,
is used by physicians as a means to discern intelligence, moral character, and other
personality characteristics of an individual. By the early 1900s,psychology gained the
psychodynamic perspective of Sigmund Freud and then the fundamental principles of
learning from Ivan Pavlov. Due to the misunderstanding of mental illness throughout
this history many people were institutionalized in asylums.
Today there are five major perspectives used in psychology to help explain and
understand human behavior and the causes of mental illness. These are the biological,
psychodynamic, cognitive, behavioral, and humanistic perspectives of psychology
(Feldman, 2002). Each of these psychological perspectives focuses on different
aspects of behavior and mental processes. Using these perspectives, psychologists and
social scientists have learned much of how individuals learn, how the personality is
developed, and why they react the ways they do and many psychotropic medications
have been developed to assist in managing the symptoms of mental illness.With this
understanding a cure to mental illness seems more a possibility than ever before and in
the 1960s mental institutions began releasing or deinstitutionalizing mental health
patients. This single event, which happened over four decades ago, has had an effect

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on society, on my personal life, and on my course of study and future career.
Mental illness must first be defined to be able to understand the impact that
deinstitutionalization has had in the World and in my life. Mental illness can be defined
as any of the various disorders in which a person's thoughts, emotions, or behaviors are
abnormal and may cause suffering to himself, herself, or other people.
Therefore,mental health is psychological well-being and satisfactory adjustment,
emotionally and behaviorally, to society and to the ordinary demands of life.The
National Institute of Mental Health (NIMH) a branch of the National Institute of Health
(NIH) defines Serious Mental Illness (SMI) as:
“A mental, behavioral, or emotional disorder (excluding developmental and
substance use disorders), diagnosable currently or within the past year, of
sufficient duration to meet diagnostic criteria specified within the 4th edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and resulting in
serious functional impairment, which substantially interferes with or limits one or
more major life activities” (2010).
How prevalent is mental illness in the United States? A quarter of American adults can
be diagnosed with one or more disorders in any given year. Although mental disorders
seem commonplace only about 6% of the population (that is 1 in 17 people) suffers from
debilitating serious mental illness (NIHM, 2010). This seems such a small number but
when we look at the affect that mental illness has on not only those suffering but the
family of these people it affects more than just that 1 out of 17 people. Living with a
mental disorder can be hard but there are methods of treatment and information that is

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available to assist all persons involved.
In the late 1960s, a majority of mentally ill patients were moved from institutions
and into the community. It all started with the new psychotropic medications that were
available and the Community Mental Health Center Act in 1963.Psychoactive drugs
developed in the preceding decades enabled the discharge of large numbers of patients
into the community. In1935 Amphetamines were used for depression and in1949
Lithium was used being used to treat manic states. By the 1960s drugs, such as
Thorazine (the first antipsychotic) and a variety of antidepressants and antianxiety
medications, were being used regularly in the psychiatric practice (Department of Health
Services, n.d.). Initially these drugs were only used for managing patients within the
institutions, and then became a part of outpatient treatment.This outpatient treatment
was the basis for the Community Mental Health Centers Act. This act put each state in
charge of providing community based mental health careand the development of
facilities to provide the services of prevention, diagnosis, care, treatment, and the
rehabilitation of the mentally ill and if a patient was unable to pay for the services
provided the state was obligated to pay for the services (NIH,1963). With the
implementation of these community mental health care centers and the use of out-
patient psychotropic drug therapy, many of the mental institutions and asylums were
able to release patients that were considered not a danger to themselves, others, or
society. The mentally ill were deinstitutionalized and given prescription medication to
assist them in managing the symptoms of their illness.The deinstitutionalization of
mental patients has affected American society in many ways.

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There are many agencies that have been developed to study the effects of
mental illness on persons and society and the outcome of this deinstitutionalization is
still in the process of being determined. NIMH informs us that about two-thirds of the
inmates in America prisons suffer with mental illness (2010) and according to Harrison
and Dye one-fourth to one-third of America’s homeless population suffer from mental
illness (2008). Why is this? The Substance Abuse and Mental Health Services
Administration (SAMHSA) reported that in 2008, 13.4% of adults in the United States
received treatment for a mental health issues, this included all adults who used in-
patient or out-patient care or used prescription medication for mental or emotional
issues (NIMH, 2010). This means that even though there is treatment available only
about half everyone who suffers with a mental disorder receives help. Some people just
are not aware that help is out there, some people do not look for help due to the stigma
that still goes along with mental illness, and some people simply do not feel they have
the access or the money to afford mental health care. The Agency for Healthcare
Research and Quality's (AHRQ's) Medical Expenditure Panel Survey (MEPS) in 2006
shows that 36.2 million people paid for mental health services totaling $57.5 billion.
This means $1,591 was spent on average by those who paid (NIMH, 2010). The year
before, a study by SAMHSA found that the U.S. total spending on behavioral health was
$135 billion which is 7.3 percent of the $1.85 trillion spent on health care (SAMHSA,
2010). Community mental health programs are available and the government does pick
up most of the mental health tab here in the U.S. I, personally, have taken part in the
services provided by these community programs and know that they do work when
used properly by patients and care providers.

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I suffer from compound mental disorders; this means I have more than one
disorder. I was diagnosed with bi-polar disorder when I was 13 and then borderline
personality disorder and anti-social disorder when I was 28. I have used the community
mental health care centers to receive counseling and I have been prescribed a variety
of psychotropic medications in my life. I have also been admitted to the psychiatric
ward in hospitals on two separate occasions. The first time I was ordered by the state
of Arizona to be treated as an in-patient and the second time I chose to enter an
institution in Illinois of my free will because I knew I needed special care. I have only
had to pay for the services and medications provides when I was working and able.
The 1960s event of deinstitutionalization means that even if I do enter a mental health
institution I am not going to have to live the remainder of my life in such an institution. I
have the rights and freedoms that other citizens enjoy. I am not restricted from living a
normal and healthy life and am actually given every opportunity to do so. I even have
the choice of refusing treatment, which was not the case beforedeinstitutionalization. I
exercise this right by not taking medications to treat my mental illness because I do not
believe in the efficacy of some these drugs due to my personal experiences.
This has influenced my course of study and my career path. In my opinion
psychotropic drugs are over-prescribed. I am not saying that none of these drugs work
but that they are not always used properly by providers or patients. Today psychotropic
medications are one of the most commonly prescribed classes of drugs and widespread
usage has increased concerns about if these drugs are being used appropriately (Mark,
2010). I have had medications pushed on me by psychiatrists and have had some
severe adverse reactions that I was told was not the medication. This has caused me

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much stress and I have changed my lifestyle in order to live healthy with fewer side
effects from the symptoms of my disorders. I have also seen other mentally ill patients
misuse the drugs they were given. Hippocrates once made the comment “Keep watch
also on the faults of the patients, which often make them lie about the taking of things
prescribed.”I have seen a problem with the over-use and misuse of these medications
and have decided that I can help make a change by going into research. I am in
university to gain my Bachelors in Science for Health and Wellness to learn about how
all people can live healthy lives. After I graduate I would like to do research on
Complementary and Alternative Medicine (CAM). Why? Well, I have seen firsthand that
nutrition and traditional therapies, like yoga and meditation, can make living with mental
disorders easier. I am not naïve enough to say that my methods can work for everyone
who suffers from the same disorders I do but it may be better for certain individuals
suffering with certain mental disorders. I want to find out what works best and pass this
knowledge on to those who need it. Alternative therapies are not always used alone
either. They can be used in a complimentary or integrative manner, which makes use
of conventional and traditional therapies. This may be the best way to go about treating
mental illness.
Deinstitutionalization has had a major effect on society, my personal life, and my
plans for the future. The U.S. has seen more opportunity for the people suffering with
mental illness. We have also seen the effects of not all of these people taking
advantage of mental health care available. Deinstitutionalization has allowed me to live
like any other American, without the fear that I could lose all my freedoms and rights. I
can strive to be a meaningful member of society, to receive an education and to vote.It

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has allowed me to decide what I need and do not need and given me the opportunity to
help change the World. The study of how our minds work is still in progress, the mind is
a complicated thing, and it may be a very long time before we fully understand human
behavior and personality.We came a long way in the past few centuries and even
further in the past few decades.

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References
Department of Health Services, (n.d.). History of psychotropic medication use for
consumers with developmental disabilities. Retrieved from
http://www.dhs.state.mn.us/main/groups/licensing/documents/pub/dhs16_15767
4.pdf
Feldman, R., (2002). Understanding Psychology. New York; McGraw-Hill.
Harrison, B. and Dye, D., (2008). Powerand Society. Ohio: Cengage Learning.
Mark, T., (2010). For what diagnoses are psychotropic medications being prescribed?
[Electronic version].Retrieved
fromhttp://www.samhsa.gov/Financing/file.axd?file=2011%2F1%2FMark+CNS+
Drugs+2010+24(4)+319-326+508.pdf
National Institute of Health. (1963). Community Mental Health Centers Act [electronic
archive]. Retrieved from http://history.nih.gov/research/downloads/PL88-164.pdf
National Institute of Mental Health, (2010). Statistics. Retrieved from
http://www.nimh.nih.gov/statistics/SMI_AASR.shtml
Substance Abuse and Mental Health Services Administration. (2011). National
expenditures for mental health services & substance abuse treatment, 1986-
2005 [electronic version]. Retrieved from
http://www.samhsa.gov/Financing/post/National-Expenditures-for-Mental-Health-
Services-Substance-Abuse-Treatment-1986-2005.aspx