Abstract

The treatment of schizophrenia in the United States during the twentieth century has been a national embarrassment. The (approximately) 2 million schizophrenics in the United States have received short shrift from the government, mental health professionals, and the public at large. In contrast to citizens with severe physical illnesses or mental retardation, schizophrenics have generally been segregated and either mistreated or ignored. This situation first attracted significant public and governmental attention in the late 1950s and early 1960s as a function of the community mental health (CMH) movement. Referred to as the “third mental health revolution” (Hobbs, 1964), the CMH movement had as one of its primary goals the development of new and more effective treatment programs and the improvement of the quality of life for schizophrenics and for the chronic mentally ill in general. The culmination of CMH efforts was the 1963 Community Mental Health Centers Act, which funded the development of local facilities to provide a range of needed services in the community. To be sure, the CMH movement has led to dramatic changes in the pattern of mental health care and the structure of the mental health system. But, like most revolutions, it has not worked out precisely as planned. To the contrary, it has been argued that in many respects the chronic mentally ill are as victimized and ignored by society today as they were before the erstwhile revolution (Gralnick, 1985).

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