Box 5.1 A Brief History of Research and Services Programs for Mental Health and Substance Abuse

The purpose of the following chronology is to describe the chain of events that eventually led to the October 1, 1992 reorganization of ADAMHA. It is based on information from of the IOM Report—Research and Service Programs in the PHS: Challenges in Organization (IOM, 1991b), from a chronology prepared by the SAMHSA Legislative Office, from the Lewin and Associates (1988) study, and from the 1991 hearings on ADAMHA Reauthorization.


Congress authorized a Narcotics Division within the PHS to administer two ''narcotics farms."


The division was renamed the Division of Mental Hygiene and its objectives were expanded to include medical and psychiatric care in federal correctional institutions.


The National Mental Health Act led to the establishment of the National Institute of Mental Health (NIMH), which had three separate missions based on the premise that research, training, and services were inherently interrelated. Following considerable debate, NIMH ultimately became an institute of NIH. It was a unique institute not only because of its explicit commitment to services, but because it was the only NIH institute to strongly support behavioral and social science research.


As the service mission of NIMH grew, the NIH director began to oppose the inclusion of services within any part of the NIH program.


As part of a general PHS reorganization there was an unsuccessful proposal to move the services programs of NIMH (which made up 9 percent of the budget) to other PHS bureaus. This move was defeated by the director of NIMH with congressional support.


The Community Mental Health Center (CMHC) Act led to a major shift in NIMH budgetary priorities—establishing community-based psychiatric treatment and developing separate community-based treatment centers for alcohol and drug abuse.


The National Center for Prevention and Control of Alcoholism (which included research, training, and services programs) and the Center for Studies of Narcotic Addiction and Drug Abuse were both established as part of NIMH. Funding for the services programs had increased to 24 percent.

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