The Robert Wood Johnson Foundation Program on Chronic Mental Illness: an overview

Area of Science:

• Public Health
• Health Services Research
• Mental Healthcare Policy

Background:

• The Robert Wood Johnson Foundation's Program on Chronic Mental Illness (1985) aimed to enhance care for individuals with chronic mental illness.
• A core principle was the establishment of a central mental health authority for improved service systems.

Purpose of the Study:

• To describe the implementation and operation of the Program on Chronic Mental Illness.
• To outline the eligibility criteria and service system requirements for participating cities.
• To present a case study of challenges encountered in establishing a central authority.

Main Methods:

• The study describes the selection process for nine participating cities.
• It details the operational framework of the program and its grant-making process.
• A qualitative case example illustrates the difficulties in establishing a central governing body.

Main Results:

• Nine cities received grants and assistance to improve chronic mental illness services.
• Participating cities were required to develop comprehensive service systems, including a central authority, continuity of care, comprehensive services, housing plans, and new financing.
• One city's experience highlighted significant challenges in the creation of a central mental health authority.

Conclusions:

• Establishing a central mental health authority is crucial for improving chronic mental illness care systems.
• The program's structure, while aiming for comprehensive reform, faced practical implementation hurdles, particularly in governance.
• Successful reform requires addressing systemic issues like financing, service integration, and centralized leadership.