The National Reporting Program for Mental Health Statistics: history and findings

The National Reporting Program for Mental Health Statistics had its origins in the decennial U.S. census, with enumeration of the "insane and idiotic" in 1840. A series of special censuses of the insane and feebleminded in public and private hospitals and other institutions began in 1904, and annual censuses of patients in mental institutions were conducted from 1926 to 1946. The National Institute of Mental Health of the Public Health Service took over responsibility for the annual census of patients in mental institutions in 1947. Coverage and content remained the same until the mid-1960s, when only State and county mental hospitals were included in the census. Because the annual census could not provide the data needed, separate programs were begun for inpatient and outpatient service. These were integrated into the National Reporting Program in 1966. Trend data for the last 40 years describe how the specialty mental health sector has developed. Non-Federal general hospitals with separate psychiatric services increased dramatically, from 81 in 1940 to 1,531 in 1982, as did community mental health centers, from 125 in 1965 to 691 in 1980. There was generally less emphasis on inpatient care and more on outpatient care. Full-time equivalent staff in specialty mental health facilities increased from about 325,000 in 1970 to about 432,000 in 1982. Expenditures by facilities also increased dramatically.