Community mental health care in the U.S.: The impact of deinstitutionalization and assertive community treatment

Abstract

The current review was designed to provide a better understanding of the present situation of mental health care in the U.S. Therefore, a review of the history of deinstitutionalization of the mentally ill in the U.S. and an exploration of the role of a prominent current model in mental health care, Assertive Community Treatment (ACT) were undertaken. Deinstitutionalization changed the paradigm of mental health care in the country. This process underwent different stages from religious based care, to large stated hospitals and to community care, where it stands now. Research articles on ACT in urban and in rural areas were selected so that current challenges and demands for services in the care of severely mentally ill people could be investigated and compared in these different settings. These transitions within mental health care practices have been greatly affected by ethical, political, economic, and technological factors. For the most part, the ACT studies show results in expected directions: improved quality of life, improved psychosocial functioning, and reduction in symptoms, in hospitalization rates, and cost. However, the difficulties of implementing mental health programs in rural areas were discussed. It was concluded that ACT programs show great promise, yet to be successful a great deal of resources must be made available along with an enduring commitment.

Date of Award	2005
Original language	American English
Awarding Institution	Eastern Illinois University
Supervisor	Russell Gruber (Supervisor)