Fountain House and Community Psychiatry

  • Alan Doyle


Prior to the 1960s, most people suffering from severe mental illness were housed in state mental hospitals. Although asylums for the insane evolved from a caring, therapeutic approach of the moral treatment, a century later these institutions had become overcrowded, underfunded, and hardly reflective of the humane values upon which they were originally based. With the passage of the Community Mental Health Centers Act of 1963, a new chapter was announced in the care and treatment of people suffering from mental illness; they should be able to live in society like everyone else. Deinstitutionalization was one of the largest social experiments in American history in which close to one-half million people moved out of these institutions and back into their communities (Grob 1994). This occurred, however, without sufficient social supports in place, and with even less understanding of the impact that the resulting homelessness, unemployment, and drug addiction would have in the lives of people struggling with mental illness. Furthermore, former patients were expected to live in communities where the stigma associated with mental illness caused them to be viewed with both fear and suspicion. Torrey (1997) has described the result as a psychiatric “Titanic.” Others commenting on the current challenges facing community mental health (Rosenberg and Rosenberg 2006) found the current shape of mental health practice as a “fragmented system of care” (p. 3). More pointedly, the President’s New Freedom Commission on Mental Health (2003) characterized it as “in disarray” (Executive Summary, p. 4). There are no consistent theories of treatment and the funding system is ill-suited to the demands of those in need. In effect, the goal of deinstitutionalization—namely, that people suffering from mental illness can live and function in society—is a book whose final chapter has yet to be written.


Mental Health Mental Illness Severe Mental Illness Mental Hospital Community Mental Health Center 
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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Fountain House, Inc.New YorkUSA

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