When President John F. Kennedy signed the Community Mental Health Act of 1963, the landmark legislation fundamentally shifted our country’s mental health and wellness system by prioritizing grassroots, community-centric care over long-term hospital stays that Kennedy recognized as ineffective, inhumane, and unsuccessful in promoting real recovery.
In the years since the Act’s passage, hundreds of thousands of people left institutions and returned to their communities. As October ends, Americans can celebrate the 60th anniversary of the Act.
I was lucky enough to kick off October at the JFK Library and Museum, alongside other mental health advocates, to hear from Patrick J. Kennedy and make a commitment to fulfilling the promises of his uncle’s ground-breaking work through a new set of 90-90-90 goals. This 90-90-90 vision states that by 2033, 90% of all individuals will be screened for mental health and substance use disorders, 90% of those screened will be able to receive evidence-based treatment, and 90% of those receiving treatment will be able to manage their symptoms in recovery.
The collaborative, global effort to achieve this vision marks significant progress toward the original objectives of the 1963 Act.
Today, a new era of community mental health care employs a comprehensive approach that aims to provide accessible, person-centered mental health services within the community. It focuses on prevention, early intervention, and treatment, prioritizing individuals’ needs and preferences.
Our city and state understand the investments needed around mental health care. Under Gov. J.B. Pritzker’s leadership, the Illinois Department of Human Services’ Division of Mental Health, in coordination with federal agencies, facilitated the rollout of 988, a nationwide, confidential, free suicide prevention crisis line. In addition, Illinois’ “living rooms” — places where people experiencing a crisis can have a safe, home-like environment to process the event and receive services and support — and the General Assembly’s work to expand more accessible insurance coverage of annual mental health visits, have helped position the state as a leader in mental health care, where people can access the services they need.
Illinois also provides leadership and funding for evidence-based supports that help people with even the most serious mental illnesses live independently (Permanent Supportive Housing); succeed in employment (Individual Placement and Support); and integrate fully into their communities (Assertive Community Treatment). We also applaud Mayor Brandon Johnson and the City of Chicago for their vision to take a “Treatment Not Trauma” approach to handling mental health crises.
The future of health care
While we have made a lot of progress in 60 years, it is important to focus on the parts of the Act that still need to be achieved and the gaps in mental health care that remain.
The pandemic created an opportunity for a more public dialogue around mental health and wellness for everyone, with a focus on those who are often overlooked, particularly people dealing with long-term or disabling mental health conditions. During my time leading Thresholds, I have seen first-hand the importance of connecting with individuals in their own spaces and neighborhood settings, outside the traditional clinic experience.
The future of health care must prioritize mental health. At all stages of life, it is crucial to be proactive in addressing your mental wellness. To create access to comprehensive services in communities across the country, the federal Substance Abuse and Mental Health Services Administration has funded over 500 Certified Community Behavioral Health Clinics (CCBHC’s) where people of all ages can access comprehensive, community-based mental health and substance use treatment, when and where they need it. As more CCBHC’s are created, people will have more access to services and supports right in their own communities.
Yet, mental health disparities persist, and many individuals continue to face barriers in accessing appropriate care and permanent, affordable housing. If we want to fulfill the promises of the Community Mental Health Act and achieve the 90-90-90 goals, it is essential that we continue to advocate for increased funding, improved policies, and enhanced community support to build a more equitable system and create a society that prioritizes mental health care.
Let’s celebrate the achievements of the past 60 years and honor the resilience of individuals and communities affected by mental illness. Together, we can strive for a future where mental health is truly a priority, and everyone gets the care they need and deserve.
Mark Ishaug is the chief executive officer of Thresholds, which provides mental health and substance use disorder treatment.
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