U.S. shifts on mental health: July 3, 1946

With the signing of landmark legislation, President Harry S. Truman officially moves America in a new direction when it comes to the mental health of its citizens.  The National Mental Health Act commits the country to serious, federally-funded research of mental illness, something that had not been a  priority of the state and local institutions that housed “insane” patients.

Almost a century earlier, Congress had attempted to address mental health issues, passing the Bill for the Benefit of the Indigent Insane, which would have provided funding to build hospitals for poor people who were mentally ill. But President Franklin Pierce had vetoed it, contending that it was not the business of the federal government.

So, for almost 100 years, the matter was left up to the states, where the focus was on separating people with mental illnesses from the general  public.  But changes in the patient population that began in the later 19th century made it more  difficult for state hospitals to handle even that role—more and more people were hospitalized for years instead of months, particularly when elderly people showing signs of senility were sent in growing numbers to mental hospitals.  With so many old patients with chronic health conditions, emphasis shifted even more from therapy to custodial care.  With financial support drained by the Depression and then World War II, conditions in these institutions deteriorated.

Ironically, World War II proved to be a turning point.  Military psychiatrists were surprised to discover how many of the soldiers they treated for what they thought were combat-related issues, actually had serious psychological problems before they went to war.  That led to congressional hearings and powerful personal testimony from people like Capt. Robert Nystrom,  a Marine Corps aviator who had been diagnosed with manic depression, but only after months of what he felt was worthless “loafer’s delight” treatment.  He warned that many veterans would suffer if their serious mental health conditions were treated simply as “battle fatigue.”

The law that resulted provided funding for research into psychological disorders, professional training, and grants to states for mental health centers and clinics. Within a year, every state had designated a state mental health authority,  59 training and 32 research grants had been awarded and 212 students were on their way to becoming clinical mental health professionals thanks to federal  stipends.

The legislation also led to the creation, in 1949, of the National Institute of Mental Health.  Today, it is the largest mental health research organization in the world.

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