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IMPORTANT
FACTS
1. Community Mental Health
(CMH) has been promoted as the solution to institutional problems. However,
it has been an expensive failure.
2. By the 1970s, enough
neuroleptic drugs and antidepressants were being prescribed outside psychiatric
hospitals to keep some three to four million Americans drugged full-time.
3. The Netherlands Institute
of Mental Health and Addiction reported that the CMH program in Europe created
homelessness, drug addiction, criminal activities, disturbances to public peace
and order and unemployment.
4. In Australia in 1993,
federal Human Rights Commissioner Brian Burdekin announced that deinstitutionalization
was a �fraud� and a failure. In 1999, British officials also acknowledged its
failure.
5. Psychiatry�s CMH care
budget in the U.S. soared by more than 6,000% between 1969 and 1997. Today the
estimated costs are around $11 billion a year.
CHAPTER
ONE Community Mental Health Origins
Community Mental Health (CMH) is a major psychiatric expansion initiative.
It began in the United States in the 1960s and spread to other countries in
the 1980s. It has netted psychiatry many billions of dollars over the last four
decades.
Prior to this, patients had been warehoused in Bedlam-like psychiatric institutions,
pumped full of drugs to make them submissive, and left to wallow in drug-induced
stupors. Throughout the 1950s, pressure grew from all quarters to address the
appalling conditions, the lack of results and the growing cost burden.
CMH was promoted as the solution to all institutional problems. The premise,
based almost entirely on the development and use of neuroleptic drugs, was that
patients could now be successfully released back into society. Ongoing service
would be provided through government-funded units called Community Mental Health
Centers (CMHCs). These centers would tend to the patients from within the community,
dispensing the neuroleptics that would keep them under control. Governments
would save money and individuals would improve faster. The plan was called �deinstitutionalization.�
Psychiatrist Jack Ewalt hinted at a more global intent for deinstitutionalization
at the time: �The program should serve the troubled, the disturbed, the slow,
the ill, and the healthy of all age groups.� [Emphasis added] In other
words psychiatrists were to go beyond the mentally disturbed, obtaining a healthy
clientele to drug.
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