On Oct. 31, 1963, President John F. Kennedy signed a bill meant to free many thousands of Americans with mental illnesses from life in institutions. It envisioned building 1,500 outpatient mental health centers to offer them community-based care instead. The bill would be the last piece of legislation Kennedy would ever sign; he was assassinated three weeks later.
To mark the law’s 50th anniversary, former Congressman Patrick Kennedy and others are convening at the Kennedy Library today to discuss how to improve mental health care now. Here, Vic DiGravio, president of the Association for Behavioral Healthcare, which represents Massachusetts community mental health clinics, comments on the law’s effects — and what remains to be done.
By Vic DiGravio
Fifty years ago, when President John F. Kennedy signed the Community Mental Health Act into law, the quality of life for hundreds of thousands of men, women and children in Massachusetts and across America was stunted and grim. For the most part, daily life was a gray tableau behind locked institutional doors, marked by inadequate treatment, primitive medications and isolation from family, friends and the community.
Patients in locked facilities were subject to retaliation if they complained about conditions. Family members were frequently discouraged from inquiring about care. Massachusetts and other states operated a patchwork of in-patient state hospitals that served as little more than systemic quarantine facilities.
In the final bill he signed into law before his death, President Kennedy called for society to embrace a new vision for people with mental health disorders and developmental disabilities, one in which the “cold mercy of custodial care would be replaced by the open warmth of community.”
Since then, perhaps no other field of health has changed as much and affected as many people as positively as the treatment of people with mental illness. The shift from in-patient to community-based care has created a more humane, effective and dignified network of support and treatment for men, women and children.
In Massachusetts, we created a network of private community-based agencies to serve people where they work and live. Many of these organizations are members of the Association for Behavioral Healthcare. These organizations serve over 750,000 men, women and children each year.
On Wednesday, October 23, hundreds of behavioral health-care advocates, providers, researchers and policy makers will gather at the Kennedy Library in Boston, led by JFK’s nephew and former Rhode Island Congressman Patrick Kennedy, to commemorate the signing and discuss the need for a renewed commitment to support the millions of Americans and their families affected by mental illness, intellectual disabilities and addiction disorders.
The Community Mental Health Act reflected a bold new vision for the treatment of mental illness, but much remains to be done to fulfill that promise.
WHile the legislation did usher in positive and hopeful changes for millions of people with serious illnesses such as schizophrenia, progress stalled because of funding challenges and continuing stigma. Continue reading