The History of Mental Health Care Reform

Written by matt knouff
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Mental health care reform has improved the quality of life of the mentally ill by providing additional treatment services and discouraging discrimination against the mentally ill.


Prior to the 19th century, the mentally ill were subjected to harsh treatment, including excessive use of physical restraints and other abuse. In the 19th century, Dorthea Dix and others advocated for more humane treatment of the mentally ill which resulted in the beginning of reform.


Deinstitutionalisation refers to a movement in the early-to-mid 20th century that focused on the importance of providing better outpatient services, such as psychiatric medication management and therapy, so that the mentally ill would not be forced to rely upon long psychiatric hospital stays.

Community Mental Health Centers

The Mental Health Systems Act of 1980 provided grants to states for the construction and operation of community mental health centres (CMHCs). CMHCs provide a wide range of mental health services that allow the seriously mentally ill to remain in the community.


The Americans with Disabilities Act was passed in 1990. Under this act, discrimination of the mentally ill in housing, employment, public services and transportation was outlawed.

Insurance Coverage

The Mental Health Parity Act of 1996 and the Mental Health Parity and Addiction Equity Act of 2008 restricted insurance providers from setting costs and limits on mental health coverage that vary significantly from medical coverage. The 2008 Act requires that insurance companies provide reasons for denying benefits for mental health services.

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