Healing: Our Path from Mental Illness to Mental Health

by Thomas Insel MD

In 1982, the funds from the Community Mental Health Act were shifted to a Mental Health Block Grant routed through state mental health departments. By statute, block grant funding could not be used for hospital costs, a legacy of deinstitutionalization. Between the reduction in funding and the loss of services, people with serious mental illness, already underserved, increasingly were left without care. For anyone living with SMI, there was no longer a humane public mental health program for long-term care. By this time, as advocate Torrey describes it, “all authority and responsibility for the mental illness treatment system had essentially disappeared. Authority that had previously been vested in state legislatures, departments of mental health, and governors had become so diffused that it seemed to evaporate altogether. . . . The mental illness treatment system had been essentially beheaded.”