MAD, HOMELESS, AND UNWANTED - A HISTORY OF THE CARE OF THE CHRONIC MENTALLY-ILL IN AMERICA

The history of the care and treatment of the chronic mentally ill in America offers a sobering example of a cyclic pattern that alternated between enthusiastic optimism and fatalistic pessimism between institutional confinement and community responsibility. In the early nineteenth century, the mental hospital was perceived as a harbinger of progress; after World War II, it was defined as the problem as psychiatric activists argued that community care and treatment were far superior alternatives. This article traces the history of public policy toward the severely and persistently mentally ill from the early nineteenth century to the present, and emphasizes the changes and shifts in public policy.