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The Open DoorHomelessness and Severe Mental Illness in the Era of Community Treatment$
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Carol L. M. Caton

Print publication date: 2017

Print ISBN-13: 9780190463380

Published to Oxford Scholarship Online: April 2017

DOI: 10.1093/acprof:oso/9780190463380.001.0001

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The Open Door

The Open Door

The Mental Health System Transformed

(p.1) Chapter 1 The Open Door
The Open Door

Carol L. M. Caton

Oxford University Press

The post–World War II transformation of mental health care in the United States is marked by the shift in the locus of care for episodes of mental illness from the state mental asylum to the community. Community services specific to the needs of people with severe mental illness have been slow to develop, creating gaps in care that have exposed multiple generations to the ravages of homelessness. This chapter details the web of influences that not only led to the decline of the state mental asylum, but also determined the nature of usual care for people with severe mental illness in the era of community treatment. Facilitators of change included advances in psychiatric treatment, greater involvement of the federal government in mental health policy, federal support for health insurance and income support for the disabled poor, and the action of courts in expanding the civil liberties for the mentally ill.

Keywords:   decline of mental asylum, community-based care, treatment advances, federal policy, federal health insurance, disability income support, expanded civil liberties

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