title: U.S. mental health policy. Doomed to fail.
abstract: Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, U.S. health policy in the 20th century has been inherently flawed. The short-term general hospital--the "doctors' workshop"--emphasizing acute care and surgery, has been the cornerstone of U.S. health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure.
authors.affiliation: Vanderbilt University, Nashville, TN 37240.
authors.forename: C A
authors.initials: CA
authors.lastname: Kiesler
mesh_terms: D003155:Community Mental Health Centers / Q000331:legislation & jurisprudence; D003688:Deinstitutionalization / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D017063:Outcome Assessment, Health Care / Q000331:legislation & jurisprudence; D014481:United States