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The Decline of Mental Hospitals, 1950s

The movement of mental health care from mental hospitals to treatment in outpatient settings and nursing homes  began in the 1950s.  Here is how it happened.

The field of medicine where the ‘rediscovery of community’ found an immediately welcome reception was mental health services.  A movement away from mental hospitals had already begun in the mid-1950s.  The national census of mental hospitals declined from a peak of 634,000 in 1954 to 579,000 by 1963.  The predominant, though contested, explanation for the drop is that the discover and introduction of major tranquilizers (e.g., Thorazine) was the decisive event.  Patients who were previously hospitalized could now be safely treated, or at least more safely ignored, on an outpatient basis.  Another interpretation points to the adoption by Congress in 1956 of amendments to Social Security that provided greater aid to states to support the aged in nursing homes. Mental hospitals had been filled with unwanted older people suffering only from a harmless senility.  By transferring such patients from mental hospitals to nursing homes, the states could transfer part of the cost of upkeep to the federal government.  Probably both drugs and nursing homes had some effect on the decline of mental hospitalization.

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