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Truth and Consequences

JOHN ROMANO, MD
Am J Dis Child. 1976;130(2):135-136. doi:10.1001/archpedi.1976.02120030025004.
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Arnhoff1 noted, as have others before him, that reform movements often create more problems than they solve. In his examination of the social consequences of policy toward mental illness, he found that the major public policy decisions of the Community Mental Health Program have been determined by political expediency and the pressures of social reform, while disregarding the knowledge and skills of biological psychiatry and the behavioral sciences.

The basic objectives of the program, as stated in the report of the Joint Commission on Mental Illness and Health (1961), were to treat the mentally ill person at home and in his community rather than in the traditional mental hospital; in short, to enable the patient to maintain himself in his society in a normal manner.2 This was to be achieved not only by avoiding long-term hospitalization, but by providing appropriate and effective continuing care, when needed, through emergency

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