Dimensions of State Mental Health Policy

By Christopher G. Hudson; Arthur J. Cox | Go to book overview

1
Introduction: Analysis of State Mental Health Policy

Understanding mental health policy in the United States requires disentangling the disparate undertakings of the federal. state, and local governments, along with those of a myriad of private interests. Most analysts have chosen to face this task either through studying national, typically federal, policies and trends or through an in-depth examination of local service systems. The first of these options has been the most compelling for many commentators because the federal government provided key leadership in the development of community mental health services during the 1960s and 1970s.

In either case, the role of state governments in mental health has been neglected even though state governments have historically been the most prominent regulators, providers, and financers of mental health services in this country. In the 1980s the federal government retreated from its leadership role to decentralize and deregulate decision making, targeting state governments as a chief beneficiary. This change has been most dramatically epitomized by the block grant programs. For these reasons, interest in state mental health policy has grown during the last half of the 1980s. This interest has paralleled the recent formulation of explicit policies by many states to target services to the seriously mentally ill. In addition, there has been a continuing struggle to define a balanced service system, and to reconcile the new priorities with older commitments to the provision of both institutional and community mental health services to a wide range of constituencies.

The study of state mental health policy is not new, but it has been eclipsed in recent years by the community mental health movement. Before the 1960s most studies of mental health

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