In 1955, Congress passed the Mental Health Study Act, which directed the Joint Commission on Mental Illness and Health to determine the mental health needs of America and make concrete recommendations for a national program that would “approach adequacy.” Its final report, published in 1962 under the title “Action for Mental Health,” has become a call to arms for an all-out attack on the nation’s number one health problem. Here are the highlights of the report:It is an accepted fact that one out of ten people suffer from emotional or mental disturbance, and more than one out of one hundred (about 2 million persons) are incapacitated by their illness. These seriously ill people are the core of the mental health problem today. In spite of some advance toward humane and effective care, 80 per cent of the country’s 277 state hospitals can still be classified as custodial institutions. Typically, they are located far from population centers, and the patients (often the doctors as well) feel like exiles from society. Moreover, these hospitals spend only $4.44 per day on each patient, as compared with $31.16 in community general hospitals—and the proportion of state expenditures for mental patients is actually declining.The irony in the situation lies in the fact that highly effective treatments for the mentally ill have been developed— and when they are used, between 60 and 80 per cent of schizophrenic and other serious cases improve sufficiently to lead a useful life in the community. Why, then, do we not apply these treatments more widely? The principal obstacle lies in attitudes of indifference and even rejection toward the mentally ill. They are “singularly lacking in appeal” because their strange behavior tends to disturb and offend people instead of arousing sympathy. In fact, the general public tends to think of them not as sick people, but as nuisances to be avoided. Many members of the medical profession share these attitudes, and until they are changed, progress will be slow.One of our greatest needs, therefore, is a massive campaign of education and enlightenment, designed to disseminate authoritative information about mental illness, and show that it is possible to work with the mentally ill, to treat them as human beings, and to help them recover. Such a campaign would not only produce more friendly and accepting attitudes toward these sick people, it would also bring more workers, more volunteers, and eventually more funds into this neglected field —and at the same time overcome the defeatism that stands in the way of effective treatment.A second major need is to develop a comprehensive and diversified research program. It is especially necessary to invest a large proportion of funds in basic, long-term research, since this is the only way to achieve major breakthroughs comparable with those in other fields of medicine. To make this possible, the Federal Government should establish mental health research centers and institutes to be operated independently or in collaboration with educational institutions.Finally, the entire patient-care program in this country needs to be radically revised, and new patterns of treatment must be introduced. All mental health professions should launch a national recruitment and training program, not only for highly professional personnel, but for nonmedical workers as well. Counseling must be made available in the community at the first signs of disturbance; and emergency psychiatric care should be provided at the onset of acute disturbance. Provision must be made for treatment of all major mental illnesses through (a) community mental health clinics operated on an outpatient basis, in order to reduce the need for prolonged and repeated hospitalization; (b) short-term hospitalization in every community general hospital; (c) conversion of small, suitably located state hospitals (1000 beds or less) into intensive treatment centers as rapidly as possible, with gradual conversion of all large state hospitals into centers for long-term care and improvement of persons with chronic diseases, including mental illness; and (d) inclusion of after-care and rehabilitation as essential components of all service to mental patients, since the objective of modern treatment is to save the patient from the debilitating effects of institutionalization, and return him to home and community life as soon as possible.To implement this entire program of research, training and patient care, federal, state, and local expenditures should be doubled within the next five years and tripled within the next ten. The federal government should also develop a subsidiary program that will not only bear a share of the cost of services, but also encourage state and local governments to take increasing responsibility. All matching grants to states should be awarded according to criteria of merit and incentive formulated by an expert advisory committee appointed by the National Institute of Mental Health.