Kennedy’s Vision Fifty Years Ago was Never Fully Realized.

Fifty years ago this month, President John F. Kennedy signed the last piece of legislation of his administration:  The Community Mental Health Act, had as its goal to transform how people with mental illness were treated,  but also to transform the care they receive in the United States.



The bill was signed on October 31, 1963, just weeks before Kennedy was assassinated in Dallas, Texas.  In a special address to Congress that same year, the President said then that the idea was to treat patients successfully and quickly in their own communities.

 The legislation´s center piece was the construction of mental health centers accessible to all Americans who needed treatment or care.  The thought was that individuals with mental health issues should be treated while working and living at home instead of keeping these individuals in large state institutions, often for the remaining life of the patient.  Often patients in these large mental institutions succumbed to neglect and poor care. Unfortunately, Kennedy’s vision fifty years ago was never fully realized.

If there is anything that we have learned from the recent incidents involving mass shootings, is that we are not treating the mentally ill well enough to protect them as well as the communities in which they live. Whether we are talking about the horrifying massacre of school children in Connecticut, or the Washington Naval Yard, or a movie theater in Colorado, or the Gabby Gifford´s political stop where so many died and she was permanently injured, it is time for the public attention to focus once again on how we deal with the mentally ill in our Nation.

 And so today, when we look back at this important contribution made by President Kennedy with regard to treatment and care for the mentally ill, we must accept that we as a country have failed to provide for this segment of our society. According to Paul Appelbaum, a Columbia University psychiatry professor and expert in how the law affects the practice of medicine, about 90 percent of beds have been cut in hospitals, without providing for alternative treatment sites for these individuals.

Several mental health experts have said, that the elimination of these beds has left nowhere for the sickest people to turn, so they end up homeless, abusing substances in order to self medicate.  The fact is that with reduction in treatment facilities for the mentally ill, these individuals with no place to go are living with families, if they are lucky, or in the streets as we all see driving through any big city intersections.

Alternatively, they end up in our prisons. We know that the three largest mental health providers in the nation today are jails: Cook County in Illinois, Los Angeles County and Rikers Island in New York, a topic we discussed last week in our of our Blogs.

I understand completely that the issues of mental illnesses are difficult to comprehend, with far too many ramifications for the lay person to comprehend.  But one thing is clear, unless we change how we treat mentally ill members of our society, we can expect the problems to continue to escalate as the population continues to grow.

I had the opportunity this morning to listen to former U.S. Representative Patrick Kennedy address with eloquence and compassion this very topic.  He said: “The goals of deinstitutionalization were perverted. People who did need institutional care got thrown out, and there weren’t the programs in place to keep them supported.”

This week, Kennedy is gathering advocates in Boston for the Kennedy Forum, to mark the 50th anniversary of his uncle’s legislation as well as discussions on what needs to be done to improve mental health care in America.  Rep. Kennedy stated that, “We don’t have an alternate policy to address the needs of the severely mentally ill.”

Let us hope then that good things come about from this meeting and those involved in the treatment and care of our mentally ill brothers and sisters find the answers needed, but most of all, that the appropriate government entities take an active role in chartering a plan of action that makes the necessary corrections to our public health policies.


I am Attorney Martin E. Regan, Jr. and these are my personal thoughts.