Origins Community mental health services began as an effort to contain those who were "mad" or considered "lunatics". Understanding the
history of mental disorders is crucial in understanding the development of community mental health services. As medical psychology developed as a science and shifted toward the treatment of the mentally ill,
psychiatric institutions began to develop around the world, and laid the groundwork for modern day community mental health services.
Pre-deinstitutionalization On 3 July 1946, President
Harry Truman signed the
National Mental Health Act which, for the first time in the history of the United States, generated a large amount of federal funding for both psychiatric education and research. The passing of this Act eventually led to the founding of the
National Institute of Mental Health (NIMH) in 1949. At the end of the 1940s and moving into the beginning of the 1950s, the governor of Minnesota
Luther Youngdahl initiated the development of numerous community-based mental health services. He also advocated for the humane treatment of people in state institutions. It was at this point in history that modern community mental health services started to grow and become influential. In 1955, following a major period of deinstitutionalization, the Mental Health Study Act was passed. With the passing of this Act, the U.S. Congress called for "an objective, thorough, nationwide analysis and reevaluation of the human and economic problems of mental health." The Community Mental Health Centers Act funded three main initiatives: • Professional training for those working in community mental health centers • Improvement of research in the methodology utilized by community mental health centers • Improving the quality of care of existing programs until newer community mental health centers could be developed. In 1977, the National Institute of Mental Health (NIMH) initiated its
Community Support Program (C.S.P.). The C.S.P.'s goal was to shift the focus from psychiatric institutions and the services they offer to networks of support for individual clients. • Responsible team • Residential care • Emergency care • Medicare care • Halfway house • Supervised (supported) apartments • Outpatient therapy • Vocational training and opportunities • Social and recreational opportunities • Family and network attention This conceptualization of what makes a good community program has come to serve as a theoretical guideline for community mental health service development throughout the modern-day United States psychological community. This nearly four-fold increase shows just how important community mental health centers are becoming to the general population's wellbeing. This drastic rise in the number of patients was not mirrored by a concomitant rise in the number of clinicians serving this population. Networks like
Open Path Collective, established in 2015, offer discounted rates to uninsured and underinsured people who cannot otherwise afford
psychotherapy. As the 2000s continued, the rate of increase of patients receiving mental health treatment in community mental health centers stayed steady.
Purpose and examples Cultural knowledge and attitude is passed from generation to generation. For example, the stigma with therapy may be passed from mother to daughter.
San Diego county has a diverse range of ethnicities. Thus, the population diversity in San Diego include many groups with
historical trauma and
trans-generational trauma within those populations. For example, witnesses of war can pass down certain actions and patterns of survival mechanism to generations. Refugee groups have trans-generational trauma around war and
PTSD. Providing services and therapy to these communities is important because it affects their day-to-day lives, where their experiences lead to trauma or the experiences are traumatic themselves. Knowledge and access to mental health resources are limited in these multicultural communities. Government agencies fund community groups that provide services to these communities. Therefore, this creates a power hierarchy. If their missions do not align with each other, it will be hard to provide benefits for the community, even though the services are imperative to the wellbeing of its residents. The combination of a mental illness as a clinical diagnosis, functional impairment with one or more major life activities, and distress is highest in ages 18–25 years old. Despite the research showing the necessity of therapy for this age group, only one fifth of emerging adults receive treatment. Psychosocial interventions that encourage self-exploration and self-awareness, such as acceptance and mindfulness-based therapies, is useful in preventing and treating mental health concerns. At the Center for Community Counseling and Engagement, 39% of their clients are ages 1–25 years old and 40% are in ages 26–40 years old as well as historically underrepresented people of color. The center serves a wide range of ethnicities and socio-economic statuses in the
City Heights community with counselors who are graduate student therapists getting their Master's in Marriage and Family Therapy or Community Counseling from
San Diego State University, as well as post-graduate interns with their master's degree, who are preparing to be licensed by the state of California. Counseling fees are based on household incomes, which 69% of the client's annual income is $1–$25,000 essentially meeting the community's needs. Taking into account of San Diego's population, the clinic serves as an example of how resources can be helpful for multicultural communities that have a lot of trauma in their populations. ==See also==