Originally published in 1985, this book provides a comprehensive analysis of mental health policy and practice in the USA during the latter part of the 20th Century by focussing on 3 main themes: political-economic structures, the pitfalls of professionalism and institutional obstacles to adequate care. 'This book is the single best and most comprehensive description of these developments for social scientists. There is wealth of data? clearly presented and intelligently discussed.' Michael S. Goldstein, Contemporary Sociology 'Highlights problems, difficulties and needs in a way that will interest professional readers, policy makers and the general public.' Journal of the Institute of Health and Education 'Phil Brown has made the first full-length attempt to analyze the mass exodus of chronic mental patients from state mental hospitals to 'community settings'?As a resource book on deinstitutionalization, this is the best we have.' E. Fuller Torrey, author of The Death of Psychiatry 'Should be read by every individual providing a service to psychiatric patients, and particularly by the planners.' Psychological Medicine