In 1955, a five-year inquiry by the U.S.  Joint Commission on Mental Illness and Health recommended replacing institutions with Community Mental Health Centers (CMHCs). According to Henry A. Foley, Ph.D., and Steven S. Sharfstein, M.D., authors of  Madness in Government, �Psychiatrists gave the impression to elected officials that cures were the rule, not the exception� and �inflated expectations went unchallenged.� Cost estimates recommended doubling the mental health budget within five years, and tripling it in ten.

Europe followed suit about a decade later, with Holland, Belgium and England adopting community mental health in the hope of greater efficiency and reduced costs. �On the contrary,� later wrote Dr. Dorine Baudin of the Netherlands Institute of Mental Health and Addiction, �it appears to be more expensive.� Furthermore, it created homelessness, drug addiction, crime, disturbance to public peace and order, unemployment and intolerance of deviance.

In truth, the CMHCs became legalized drug dealerships that not only supplied drugs to former mental hospital patients, but also supplied psychiatric prescriptions to individuals not suffering from �serious mental problems.�

As a result, as author Peter Schrag wrote in Mind Control , by the mid-seventies, enough neurolepetic (nerve seizing) drugs and antidepressants �were being prescribed outside hospitals to keep some three to four million people medicated fulltime�roughly ten times the number who, according to the [psychiatrists�] own arguments, are so crazy that they would have to be locked up in hospitals if there were no drugs.� 

After a decade of the Community Mental Health program, consumer advocate Ralph Nader called it a �highly touted but failing social innovation.� It �already bears the familiar pattern of past mental health promises that were initiated amid great moral fervor, raised false hopes of imminent solutions and wound up only recapitulating the problems they were to solve.�

Other countries experienced similar outcomes. In Australia in 1993, federal Human Rights Commissioner Brian Burdekin announced that de-institutionalization was a �fraud� and a failure. In 1999, British officials also acknowledged the failure of community mental health care.

As for the funding of CMHCs and psychiatric outpatient clinics, the fact is that psychiatry�s budget in the United States soared from $143 million in 1969 to over $9 billion in 1997�a more than 6,000% increase in funding, while increasing by only 10 times the number of people receiving services. The estimated costs today are around $11 billion. 

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