National Commissions on mental health in the United States: how many tries to get it right?
| Published date | 30 November 2012 |
| Date | 30 November 2012 |
| Pages | 260-266 |
| DOI | https://doi.org/10.1108/13619321211289335 |
| Author | Kenneth S. Thompson |
| Subject Matter | Health & social care |
National Commissions on mental health in
the United States: how many tries to get it
right?
Kenneth S. Thompson
Abstract
Purpose – This paper aims to review the background, history and results of the three Federal
Commissions addressing mental illness and health in the United States of America.
Design/methodology/approach – This is a historical review of key articles and commentary.
Findings – Despitesignificanthandicaps, imposedby the structureof governmentin the United States,the
limits of knowledgeand conflicts of between stakeholders, the evidenceappears to suggest that Federal
Commissionshave been productive,even when there is little powerto enact their recommendations,to the
degree thatthey concentrate knowledgeand effort in an advancing but generally quite disjointedfield.
Research limitations/implications – The Commissions touch on a vast number of subjects and actions
and do so in the context of the moving target of time. Historical review can only capture so much and the
likelihood of errors of omission are significant, as is the possibility of errors of commission due to the
requirement of interpreting historical evidence.
Social implications – The social implication of this study is that the political effort to create and
implement Federal Commissions has been worthwhile. The question now is what kind of entity and
political effort will be necessary in the future?
Originality/value – Federal Commissions have had a practical utility in the USA of periodically bringing
the field together with a shared agenda. The question is, as behavioral health care increasingly melds
into general health, what force will help the field focus on behavioral health initiatives. Will we even need
such a force?
Keywords Mental health services, Mental illness, Commission, New freedom, Policy,
United States of America
Paper type Case study
Introduction
Over the course of the last 60 years, the Federal Government of the USA has organized three
national Commissions to address the mental health needs of the nation. The work of the Joint
Commission on Mental Illness and Health (1955-1960), the President’sCommission on Mental
Health (1977-1978) and the New Freedom Commission on Mental Health (2002-2003) trace
the evolution of mental health care through the arcof deinstitutionalization, community mental
health, biological psychiatry and the emerging recovery movement. On a broader canvas,
they also trace the rise and fall of post-war modernity with its focus on technical expertise and
science and its partial eclipse by, for lack of a better term, a ‘‘post-modern’’ sensibility,with a
much greater focus on diversity of voice and a more pluralistic understanding of knowledge
and expertise. These changes, in turn, are etched into the ongoing evolution of the role and
function of American Government. In themselves, the Commissions represent both the
galvanizing capacity of national leadership and governmental action in the USA and their
significant limitations.
This paper will consider a number of themes in attempting to describe what the significance
of the Commissions has been. These include the issues of leadership within the mental
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MENTAL HEALTHREVIEW JOURNAL
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VOL. 17 NO. 4 2012, pp. 260-266, QEmerald Group Publishing Limited, ISSN 1361-9322 DOI 10.1108/13619321211289335
Kenneth S. Thompson is
based at Recovery
Innovations, Phoenix,
Arizona, USA.
The author wishes to
acknowledge the continuous
support and mentorship of Alan
Rosen, who has personally
fostered psychiatric
involvement and international
collaboration on the subject of
public mental health policy.
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