Abstract
As part of the rebellion of the 1960s, various movements throughout the world tried to reassess the status of the insane and others who might need assistance. The point was for these persons to have the right to a fulfilling life, untrammeled by unresponsive political institutions and other imperious organizations. In the USA, for example, President Kennedy signed into law the Mental Retardation Facilities and Community Mental Health Centers Construction Act in 1963. As a result, the nature of health planning was supposed to be transformed dramatically by this “bold new approach” to dealing with human services (Sharfstein, Psychiatric services 51(5): 616–620, 2000). In time, this sort of re-orientation took place in various countries throughout the world. This outlook built on and supported additional modalities of action research that called for local involvement in conducting studies and creating interventions, along with a critique of mainstream institutions. As a result, the community was elevated in importance, in addition to the revolutionary element of participation. To many persons, this change was shocking but consistent with a trend in many areas to open the society to novel ideas and encourage change. Prior to the inauguration of this statute, services were provided mostly by professionals in large institutions. The insane, for example, were treated in asylums removed from the mainstream society. As Erving Goffman documented in his book Asylums(1962), these organizations were bureaucratic and generally inhumane. But other, more private facilities were not much better. The problem with this general approach is that patients were rarely discharged from these institutions. Critics began to refer to this method of care as “warehousing” (Paulson, Closing the asylums, 2012, p. 10).
