The history, economics, and financing of mental health care. Part 2: The 20th century.
1. To understand how mental health nursing practice was affected by the financing and policy changes occurring rapidly in the second part of the 20th century, sources can only be found in the literature in psychiatry, the social sciences, and economics. There was no psychiatric nursing journal until the 1950s, and no article by a nurse in the general nursing literature about finances. 2. Deinstitutionalization was really transinstitutionalization. Changes in regulations in Medicaid allowed the shifting of mentally ill people who were older than age 65 to nursing homes. 3. Community mental health centers never developed programs to serve people who were seriously mentally ill. Rather than serving clients who were psychotic, the community mental health centers marketed their treatment programs to people with anxieties, who were undergoing divorce, or who had mildly troubled children.
Smoyak
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Bloustein School of Planning and Public Policy, Institute of Health, Health Care Policy, & Aging Research, Rutgers, State University of New Jersey, New Brunswick, USA. smoyak@email.rci.rutgers.edu
D015276:Health Care Rationing / Q000191:economics / Q000266:history; D049673:History, 20th Century; D006760:Hospitalization / Q000191:economics; D006778:Hospitals, Psychiatric / Q000191:economics / Q000266:history; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000266:history* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics / Q000266:history* / Q000331:legislation & jurisprudence; D014481:United States