Reducing Mass Incarceration: Lessons from the Deinstitutionalization of Mental Hospitals in the 1960s

In a message to Congress in 1963, President John F. Kennedy outlined a federal program designed to reduce by half the number of persons in custody. The institutions at issue were state hospitals and asylums for the mentally ill, and the number of such persons in custody was staggeringly large, in fact comparable to contemporary levels of mass incarceration in prisons and jails. President Kennedy\u27s message to Congress – the first and perhaps only presidential message to Congress that dealt exclusively with the issue of institutionalization in this country – proposed replacing state mental hospitals with community mental health centers, a program ultimately enacted by Congress in 1963 under the Community Mental Health Centers Act. President Kennedy\u27s message to Congress was straightforward: If we launch a broad new mental health program now, it will be possible within a decade or two to reduce the number of patients now under custodial care by 50 percent or more. Many more mentally ill can be helped to remain in their homes without hardship to themselves or their families. Those who are hospitalized can be helped to return to their own communities … Central to a new mental health program is comprehensive community care. Merely pouring Federal funds into a continuation of the outmoded type of institutional care which now prevails would make little difference. President Kennedy\u27s aspiration of a 50% drop, it turns out, underestimated the extent of deinstitutionalization that would take place. The passage of the Community Mental Health Centers Act in 1963 would be followed by the largest institutional migration that has ever occurred in this country. During the period 1965 to 1975, the inpatient population in state and county mental hospitals would plummet a stunning 59.3%. The mean decrease per year over that period would reach almost 9%. During the next five years, from 1975 to 1980, the drop in inpatient populations would continue, down another 28.9%. All in all, from 1955 to 1980, the number of persons institutionalized in mental health facilities declined by 75%