National Commissions on mental health in the United States: how many tries to get it right?

This paper aims to review the background, history and results of the three Federal Commissions addressing mental illness and health in the United States of America.

This is a historical review of key articles and commentary.

Despite significant handicaps, imposed by the structure of government in the United States, the limits of knowledge and conflicts of between stakeholders, the evidence appears to suggest that Federal Commissions have been productive, even when there is little power to enact their recommendations, to the degree that they concentrate knowledge and effort in an advancing but generally quite disjointed field.

The Commissions touch on a vast number of subjects and actions and do so in the context of the moving target of time. Historical review can only capture so much and the likelihood of errors of omission are significant, as is the possibility of errors of commission due to the requirement of interpreting historical evidence.

The social implication of this study is that the political effort to create and implement Federal Commissions has been worthwhile. The question now is what kind of entity and political effort will be necessary in the future?

Federal Commissions have had a practical utility in the USA of periodically bringing the field together with a shared agenda. The question is, as behavioral health care increasingly melds into general health, what force will help the field focus on behavioral health initiatives. Will we even need such a force?