JFK’s Final Act Heeds 50 Years of Community Mental Health
On October 31, 1963, President John F. Kennedy signed into law the Community Mental Health Act to federally fund community mental health centers and research facilities devoted to the treatment of mental illness. It was the last legislation President Kennedy signed into law.
“The 50th anniversary of the Community Mental Health Act gives us occasion to celebrate a vision for behavioral health that has been 50 years in the making — and to bring it to scale,” said Gail Lapidus, Family & Children’s Services CEO. “JFK encouraged a bold new approach to mental health, one in which the ‘cold mercy’ of custodial care would be replaced by the ‘open warmth’ of community. He established a vision we still strive to fully realize — for a community focused on prevention, treatment, education, and recovery.”
In the past 50 years, new medications, psychotherapies, peer support, and other treatment technologies have dramatically expanded the ability to treat a range of conditions. And today, more people with mental illnesses get treated than at any other time in history — mostly in community settings.
Yet, while science and public policy have taken giant leaps since 1963, as JFK warned, “The problems are not all solved and the battles are not all won.”
“We haven’t realized the full potential of community-based care,” said Lapidus. “Financing arrangements, clinical training, and systems of accountability are often misaligned, and mental illnesses continue to be the largest source of morbidity, just as they were in 1963.” In fact, between 1990 and 2010, the worldwide incidence of mental illness went up by 38%, according to a 2010 Global Burden of Disease Study.
Patrick Kennedy, who has formed The Kennedy Forum to create a national conversation on mental health and addictions, said in a recent National Council for Behavioral Health blog article, “The intent and energy behind the Community Mental Health Act diminished in the years following JFK’s untimely death. The money didn’t follow patients from institutions to the community, as he envisioned. While we’ve provided community and family-based treatment for many, we haven’t been able to make it a reality for all who need it.”
Fifty years ago, President Kennedy said, “The new frontier is here, whether we seek it or not.” He described it as one of “unknown opportunities and perils, a frontier of unfulfilled hopes and threats.” In the new frontier, mental health and addictions treatment has parity with all other healthcare treatments. The Affordable Care Act is expanding mental health and addiction benefits to 62 million Americans. This will accelerate an already growing demand for behavioral health services and for care on request.
“Behavioral health is becoming part of the new frontier of mainstream medicine, which is driven by science,” said Lapidus. “Now, it’s time to advance into the new frontier. We must embrace scientific advances, and advocate for public policies that emphasize prevention and early identification. “
Three bills in front of Congress would move mental health and addictions care into the new frontier.
- The Mental Health First Aid Act offers education and training to teachers, health workers, firefighters, police officers, emergency services personnel, and other community members.
- The Excellence in Mental Health Act creates Certified Community Behavioral Health Centers to better meet the needs of people currently being served, and those who will seek care as a result of coverage expansion and parity.
- The Behavioral Health IT Act provides financial incentives for the adoption and “meaningful use” of health information technology — the bedrock of improved care and coordination among practitioners— for mental health and addiction treatment providers and facilities.
Family & Children’s Services looks forward to working with its legislators to achieve the full promise of the Community Mental Health Act.