Who pays: ■ A lot of services in the community were paid for by Medicaid ■ Medicare - old ppl ■ Supplemental security income ■ For people who were insufficient at a certain level, were supplemented ■ Public assistance ● What makes a group home unique? ● What is a club house service?
Terms for Review for Exam #3 Deinstitutionalization: the process of closing state hospitals and transferring inpatients to community-based mental health services, began in the 1950s. ○ Also stopped allowing new patients from entering into institutions ● under parens patriae the state has the obligation to serve the best interests of individuals, which means it must protect those with mental illness from potential harm. ● Deinstitutionalization was very controversial: people did not want mental patients living in in their communities (there was a lot of crime and homelessness) ● Had positive impact on worried well (those with less severe forms of mental illness such as anxiety) 4 contributors to Deinstitutionalization: ● 1. Drug technology advancement ○ medications used for seizures were also affecting mood ■ allowed healthcare workers to care for/ control patients outside of hospitals ○ Thorazine and Lithium were 2 major advancements ■ They did not cure in the big hospitals, these 2 drugs were for control and immediate success when patient was acting out ■ Easy to administer ○ Gave new hope and optimism that these 2 drugs could allow people to live in communities ● 2. Legal changes ○ Robert Kennedy checked up on institutions around the country and saw the living conditions and began to pass the CMHC act ○ Community Mental Health Centers (CMHC) Act of 1963: directed each state to develop a statewide plan designating catchment areas that would serve 75,000 to 200,000 people, with a community mental health center serving each catchment area ■ it taught tolerance, respect, and helpfulness towards patient ○ funded by federal government but state taxpayers paid for it ○ social model ■ The CMHC had 3 main functions: ● To provide focused, individual competency-building programs ● To coordinate agencies that serve the mentally ill (i.e., transportation, housing, income maintenance, vocational rehabilitation, crisis intervention, and emergency hospitalization)
● to promote social support networks for those with mental illnesses at all levels ■ CMHC’s did not directly reduce the size of hospital populations nor served the needs of those with severe mental illness; instead they served new patient populations; those with less acute disorders and segments of the middle class ○ Civil rights movement: legal model for who you could commit into institutions changed ■ mental illness was no longer enough to lock someone up ○ Decided that people have the right to live in the least restrictive environments (had the right to live in the same environment as everyone else) ○ People had the right to trial by jury (not just state should decide who goes into hospitals) ○