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The Mental Retardation Facilities and Community Health Centers Construction Act, also known as CMHC Act 1963, led to a high number of community health centers across the United States. In particular, persons with mental illnesses who were receiving treatment in hospitals and institutions were required to move back into their communities. Community health centers ensured that mental illness admissions into state hospital systems could be controlled.
Social policy description
According to Hartley and Lambert (2002), one of the arguments for the CMHC Act relates to the introduction of community-based care viewed as the most appropriate psychotherapy for persons with mental illnesses. The policy assumes that persons with mental illnesses receive better treatment through cost-effective systems.
Besides, a cost-effective system in a community setting would ensure that persons with mental illnesses receive quality care. Traditional psychiatric hospitals could not provide the ideal setting for providing community-based care. The CMHC Act eliminates the institutionalization of health care. In particular, there is a need to guarantee access to quality healthcare as well as costs about the ability of the taxpayer and the private payer. As a result, community-based mental health became necessary through the CMHC Act.
Arguments against the CMHC Act relates to the inability to define priority service populations. Several CMHCs failed to take responsibility for the mental health care of patients discharged from state hospitals. The policy could not provide conditions for follow-up care after a patient has been discharged into the community. The most vulnerable persons, majorly the poor, cannot receive quality care through the CMHC Act. As a result, mental illness has been linked to poverty. Policies and practices, therefore, fail to consider the most vulnerable persons in society (Hartley and Lambert, 2002).
Policy Impact and Implications
Jung & Aguilar (2015) assert that the CMHC Act led to the construction of community health centers that could provide community-based mental illness intervention measures. However, the CMHC Act did not support staffing. Several community mental health centers lacked professionals who could take care of patients with mental illness. Furthermore, operating funds became a major issue in the policy. Several community health centers constructed under the CMHC Act witnessed severe financial challenges in the short-term.
Financial challenges made several CMHCs market health care services to patients covered by health insurance while neglecting the poor who cannot afford health insurance. As a result, the CMHC Act failed to meet the need of the needy populations. The CMHC Act also failed to serve low-income persons as well as people with serious and persistent mental illness. Due to resource limitations, CMHCs were overwhelmed by large numbers of patients who could not afford care.
In the long-term, “behavioral healthcare” was added to the range of programs provided under the CMHC Act. Treatment of addiction disorders ensured that services rendered at CMHCs became effective and comprehensive. In the modern health care system, the goal of CMHCs is to provide comprehensive mental health services combined with addiction services (Morris, 1995). Furthermore, CMHCs eliminated the need for institutionalization of mentally ill patients.
American citizens achieved access to quality healthcare despite their ability to afford health insurance. Furthermore, organizations providing community-based mental health and addiction care have evolved to cover other populations beyond the initial community mental health centers. Government and county-operated CMHCs can offer services. Other institutions in the private nonprofit, as well as for-profit organizations, can provide services such as Medicare, Medicaid, state, county, self-pay, private insurance, and federal program services.
The CMHC Act has an impact on both the future of social welfare plans as well as social work. One of the implications relates to targeting economically disadvantaged. Any social welfare policy should ensure that persons who cannot afford healthcare are assisted. A wide range of mental health services should be provided to persons who are economically challenged. A social welfare policy fails to meet its objectives when the economically disadvantaged are not considered (Jung and Aguilar, 2015).
The coordination as well as the integration of services for people with mental illness so that they could return to communities implies that social work as a profession has a critical role to play in the process. Social workers must be trained and employed for them to work in CMHCs. The performance of a social welfare policy depends on the ability to consider the most vulnerable groups as well as the need to employ qualified social workers to work in CMHCs.
Any social welfare policy should guarantee adequate funding so that resources and staff such as social workers are availed to provide care to patients. Furthermore, state priorities should not be allowed to affect social welfare policies aimed at providing affordable care to the most vulnerable groups.
The CMHC Act has introduced optimism in the treatment of mental illnesses. The establishment of community mental health centers is critical in the process of introducing community-based care. Patients with mental illnesses are no longer required to be institutionalized in hospitals and other facilities. Social policies should consider persons financially disadvantaged so that policies meet specified objectives. Cost-effective social policies are necessary so that community-based care becomes effective in treating mental illnesses.
Hartley, D., and Lambert, D. (2002). The Role of Community Mental Health Centers as Rural Safety Net Providers. University of Southern Maine.
Jung, H., and Aguilar, J. P. (2015). Everyone’s responsibility: Community partnerships and shared commitment for mental health promotion. Social Work in Mental Health, 1–23.
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Morris, Jr., J. A. (1995). A Leadership Role for Social Work in the Mental Health Transition to Local Care. Journal of Community Practice, 2(3), 65–95.