Family-focused mental health care policy

Mental health care is undergoing many changes that affect families, which continue to provide much of the day-to-day care for mentally ill persons. This article reviews the history of mental health care in the United States from 1940 to the present as it has changed from a system of programs providing institutional care to a system of programs providing community and family care. Mental health policy has shifted in response to widely held values and assumptions about mental illness and caregiving roles. The pertinent literature that addresses the effects of family-focused research on the formation and evaluation of treatment programs is reviewed. Recommendations are made for policy initiatives that consider family caregiving. The emergent roles of nurses in the policy arena are also discussed.