Institutional and Frame Characterizations of the Community Mental Health Beneficiary, 1960- 2023

Mauri Amanda, The University of Michigan

In the past decade, Congress revitalized the federal community mental health program of the mid-twentieth century after nearly thirty years of devolving regulatory authority to state and local communities. In this paper, I compare the contemporary model to its predecessor program to examine changes in institutional definitions and frames of the community mental health policy beneficiary between 1960-2023. Put another way, my objective is to answer the following: does the institution of the community mental health beneficiary align or diverge from its presentation? To capture institutional definitions, I analyze how laws, regulations, and other formal federal policies define who community mental health centers serve regardless of the actual beneficiaries of clinics. To examine frames, I conduct a content analysis of the congressional record from 1960-2023 and senatorial and presidential press releases from 2010-2023 to investigate shifts in the topics used to describe the community mental health beneficiary. I find that federal institutions consistently describe the community mental health policy target as vague and encompassing of persons with and without mental disorders. Despite this consistency, the issue characterizations of the community mental health beneficiary have evolved, privileging specific sub-groups of the broad institutional targets in discussions at one time while minimizing their beneficiary status at others. These findings suggest that inclusive institutional definitions of a policy beneficiary may provide opportunities for politicians to spotlight selected sub-frames. Future research will explore how these beneficiary characterizations influence the distribution of policy benefits.

No extended abstract or paper available

 Presented in Session 126. Public Health and the American Welfare State