THE COMMUNITY MENTAL health movement achieved some of its broad and idealistic goals. More people, including low-income Americans, had access to mental health services. A number of problems were identified earlier than they had been in the past. Legislation reinforced the rights of mental patients. Yet some problems persisted, and new ones resulted from the massive release of patients from state mental institutions.

Dissenting voices

From the start, a number of people had voiced reservations about the community mental health approach. In 1954, Kenneth R. Appel, the president of the American Psychiatric Association, had stressed the need for nationwide, long-term planning. Appel and others thought such planning was needed in order to determine which mental health problems needed solutions, what resources were needed throughout the nation, and how priorities were to be set.

Other experts, usually medical doctors, objected to the...