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December 21, 1984

Madness and Government: Who Cares for the Mentally III?

Author Affiliations

Uniformed Services University of the Health Sciences Bethesda, Md

JAMA. 1984;252(23):3306-3307. doi:10.1001/jama.1984.03350230064047

Although the authors give a brief overview of care for the mentally ill from colonial times to 1946, the book is really about the Community Mental Health Centers (CMHC) program with which the authors have been intimately involved. The origins of the CMHC movement can be traced back to an extraordinary time in American history: the 1956 to 1965 (or so) era of peace and prosperity. Federal support for medical research during this decade grew at a mind-boggling rate. The Fogarty-Hill— Shannon-Felix legislative cabal operations are reverently detailed. The excitement of the times, which culminated in President Kennedy's February 1963 special message to Congress on mental health, is obvious.

As a history of the CMHC movement, the book is also a history of the parent organization, the National Institute of Mental Health (NIMH). This part of the story is given less attention than this reviewer believes it warrants. That is,