Rochefort updates his classic comprehensive review of mental health policy issues in American society, beginning with early practices that predate the formal mental health system and ending with current debates about parity insurance coverage for mental illnesses, managed care, and Medicaid reform.

Foreword by David Mechanic Preface to the Second Edition Preface to the First Edition Introduction Approaching Mental Health Policy Analysis Historical Evolution of Mental Health Policy U.S. Mental Health Care: The First Three Centuries The Community Mental Health Revolution Federal Retrenchment, Block Grants, and State Control Theoretical and Political Perspectives Mental Health Policymaking Cycles and Their Causes Political Factors in Mental Health Policymaking and Service Delivery Contemporary Policy Trends and Issues The Challenge of Coordination Mayor Koch, Joyce Brown, and New York City's Homeless Mentally Ill: A Case Study Canadian Mental Health Services: The View from Nova Scotia Mental Health Care and National Health Policy Reform Deinstitutionalization: Practice and Promise Conclusion A System in Flux Bibliography Author Index Subject Index