Mental health policy in the United States has involved varying approaches, often reflecting the social and economic conditions of the times. The compelling needs of individuals, however, have consistently demanded attention and some form of public policy response has been necessary, even since the early days. Societal reaction has moved in many differing directions--from institutionalization and deinstitutionalization to the care and costs borne at public expense to the current emphasis on increasing privatization.

Dorwart and Epstein stress that the mental health system must be seen as...