The Unrealized Dream of Community Mental Health Care

In this edition: A look at President Kennedy's transformative, but failed, vision for remaking the mental health care system.

This week marks the 60th anniversary of the Community Mental Health Act of 1963, the last piece of legislation signed by President John F. Kennedy. 

The act aimed to transform how people with mental illnesses and disabilities were being treated in the United States by ending the reliance on state psychiatric hospitals or asylums that were stigmatized for their deplorable, isolating condition. Instead, community care would deliver the support and treatment that people with mental illness deserved. Its legacy is one of failure that endures today. 

At the time, Kennedy laid out a broad vision for rethinking mental health in the United States. “When carried out, reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability,” Kennedy wrote months before signing the legislation in a message to Congress. 

Kennedy had a personal connection to mental illness — his sister, Rosemary, had undergone a lobotomy with deleterious results, and…