Roots of neglect of the long-term mentally ill

A pattern of neglect of the severely mentally ill, then outrage and movements for reform, followed again by a lapse into neglect has been characteristic of the mental health professions and society generally. This article explores the possibility that neglect of the mentally ill may be rooted in professionals' dissatisfaction with meeting chronic dependency needs, a moral disapproval of dependency and passivity, a distaste for the lower social classes, and an inclination, like that in the larger society, to exclude the mentally ill. The discussion then turns to the problem of the overselling of rehabilitation and the observation that despite the powerful dependency needs and limited tolerance for stress of the mentally disabled, when attention is finally turned to them, neglect often gives way to unrealistic expectations of rehabilitation. The paper concludes with recommendations for alleviating these problems.