Brief history of community mental health services and case management
The care and treatment of individuals with serious mental illness in America has evolved over a period of some 300 years.
The first hospitals serving people with mental illness were opened in the late 18th century. They were largely custodial, and treatments were often harsh. By the 19th century, more hospital institutions were developed.
Treatment focused on creating a calming environment, with long term stays, often far away from family and friends.
Custodial care provided in large institutional settings remained the predominant approach well into the 1940’s.
Treatments such as psychosurgery, electro-convulsive therapy and psychotropic medications emerged in inpatient settings. Little attention was directed to services in the community.