Plate 01Long sheetThe long sheet
Timeline of Mental Health Advocacy and Patient Movements
Thirty-four dated milestones, from the York Retreat to the WHO action plan, each tied to a source you can open, with notes on what changed and what critics said.
- Plate
- 01 of 17
- Series
- The long sheet
- Reading
- 11 min
- Sources
- 28 opened and cited
- Updated
- 11 October 2026
On this plate (8 sections)
This is the long specimen sheet of Voice Plates: one running list of dated moments in the history of mental health advocacy, from private madhouse licensing in the eighteenth century to crisis-line policy in 2022. It selects milestones across several countries and leaves out many others, so absence from the list says nothing about importance. Every entry names the source it rests on, and dates are given as that source gives them. Where a source describes a law or a movement as contested, the entry says so, and for the longer story you can follow the links to the essays on this site.
Before 1800
- 1774
England regulates private madhouses
The Act for Regulating Private Madhouses limited patient numbers, created licenses and regular inspections for proprietors, and required medical certification for confinement. Its practical impact was limited: the source reports that historian Roy Porter called it "toothless," and pauper patients did not need certification.
- 1796
The Retreat opens at York
Founded in 1792 by Yorkshire Quaker William Tuke, The Retreat opened in 1796. The source says it used no chains or manacles, banned physical punishment, and relied on personalized attention and benevolence. Its approach was widely derided at first. See asylum reform and its critics for the wider argument.
1800s
- 1843
Dorothea Dix addresses the Massachusetts legislature
In her 1843 Memorial, Dorothea Dix described people with mental illness held in jails and almshouses near Boston, alongside criminals and paupers. She wrote that she came "as the advocate" of those people and argued that only vigorous legislation could end the abuses. It is an early case of reform argued from firsthand visits.
- 1845
England sets up the Commissioners in Lunacy
A run of laws replaced the 1774 Act, among them an Act of 1845. They kept licenses and visitors but created a central authority, titled the Commissioners in Lunacy under the 1845 Act, and ordered that no one enter a licensed house without an order and a medical certificate. Visitors were to call at least four times a year.
Source: The National Archives: Private Asylums (Surrey History Centre record QS5/5/)
1900 to 1945
- 1908
Clifford Beers publishes A Mind That Found Itself
Clifford Beers left an institution in January 1905 and completed a book about his experiences, published in 1908. The source says the book made an immediate impact and helped launch the mental health reform movement in the United States.
- 1909
The National Committee for Mental Hygiene begins
In 1909 Beers launched the National Committee for Mental Hygiene. According to the source, it spearheaded legal reforms in several states, gave grants for research into the causes of psychiatric disorders, and funded training for medical students. The vocabulary of the period differs from today's.
1946 to 1969
- 1946
The US National Mental Health Act is signed
President Harry S. Truman signed the National Mental Health Act in 1946. The National Institute of Mental Health describes its broad purpose as improving "the mental health of the people of the United States," and says it enabled the founding of NIMH three years later.
- 1948
The WHO Constitution enters into force
The WHO Constitution was adopted on 22 July 1946 and entered into force on 7 April 1948. Its principles define health as a state of "complete physical, mental and social well-being," which places mental well-being inside the definition of health itself.
Source: World Health Organization: Constitution of the World Health Organization
- 1952
Chlorpromazine enters psychiatric practice
Chlorpromazine entered psychiatric practice in 1952, after Paris psychiatrists reported on its use with inpatients. The source says antipsychotics gave clinicians and managers confidence to discharge patients and set up community services, in a period when asylums were overcrowded and understaffed. Inpatient numbers fell in most but not all countries. See deinstitutionalization and community care.
- 1961
Goffman publishes Asylums
Sociologist Erving Goffman based Asylums on a year of field research at St. Elizabeths Hospital in Washington, DC. A journal summary says he described the mental hospital as a "total institution," where regimentation dominated every aspect of daily life and patients were denied basic means of self-expression.
- 1961
Action for Mental Health reports to the US public
The Joint Commission on Mental Illness and Health issued its final report, Action for Mental Health; a journal review of it is dated November 1961. A later history says it detailed inadequacies in national services and called for better state hospitals and community care. Congress passed the Community Mental Health Act in 1963.
Sources: American Journal of Psychiatry: Action for Mental Health. The Final Report of the Joint Commission on Mental Illness and Health; American Journal of Psychiatry Residents' Journal: Deinstitutionalization Through Optimism: The Community Mental Health Act of 1963
- 1961
Powell's Water Tower speech in England
On 9 March 1961 Health Minister Enoch Powell told a mental health conference that in 15 years there might need to be no more than half as many places in hospitals for mental illness, a redundancy of 75,000 beds. He urged a change in "whole mentality" about mental hospitals. The speech is remembered as the Water Tower speech.
- 1962
England's Hospital Plan
A historical review says the 1959 Mental Health Act and the 1962 Hospital Plan presaged the rundown of the asylums and the assimilation of psychiatric care into the wider hospital system. It adds that powers of compulsion codified in 1959 were later mitigated substantially by the 1983 Act.
- 1963
The US Community Mental Health Act
Congress passed and President Kennedy signed the act in 1963. It funded three years of federal grants, totaling $150 million, to build and start staffing 1,500 planned community mental health centers. A later review says it did not fulfill its promise: states built about half, and many centers lacked basics that people with serious illness needed. See community care.
1970 to 1989
- 1970
The Insane Liberation Front forms in Oregon
An account published in 1990 lists the Insane Liberation Front in Portland, Oregon (1970) among the earliest patients' liberation groups in the United States. Groups followed in Boston in 1971 and San Francisco in 1972. Their story continues on the page about the consumer/survivor movement.
Source: National Empowerment Center: The Ex-Patients' Movement: Where We've Been and Where We're Going
- 1970s
Service user movements appear in England
A medical history journal notes that the earliest service user movements in England appeared in the early 1970s, demanding civil and economic rights for patients in the community. In parallel, pressure groups such as Mind began to press for changes to the 1959 Act.
- 1973
First conference on psychiatric oppression
The first Conference on Human Rights and Psychiatric Oppression met in 1973 at the University of Detroit, with about fifty people from across the United States and Canadian representatives. Ex-patients' leadership was acknowledged, and a proposed title, "The Rights of the Mentally Disabled," was rejected as stigmatizing.
Source: National Empowerment Center: The Ex-Patients' Movement: Where We've Been and Where We're Going
- 1975
O'Connor v. Donaldson
Decided on June 26, 1975, the US Supreme Court case held that a state cannot constitutionally confine, without more, a nondangerous person who can survive safely in freedom alone or with willing family or friends. Laws differ by place and change over time, so this describes one ruling, not anyone's own situation.
- 1978
Italy passes Law 180
Law 180 of 1978 stopped new admissions to Italian asylums and new psychiatric hospital construction, and affirmed patients' rights. It is often credited to Franco Basaglia alone, but a 2024 history says it was a compromise among groups and parties. Closing every asylum took years, and historians disagree on whether the law was a breakthrough or an idealistic proposal.
Source: History of Psychiatry: The Basaglia Law. Returning dignity to psychiatric patients
- 1983
England and Wales pass the Mental Health Act 1983
The Act, dated 9 May 1983, was an Act "to consolidate the law relating to mentally disordered persons." A historical review says it substantially mitigated the compulsion powers of 1959, yet notes that detained patients were rarely successful in challenging the system in practice.
Sources: legislation.gov.uk: Mental Health Act 1983; Medical History: The History of Mental Health Services in Modern England
- 1986
US protection and advocacy for mental illness
The Protection and Advocacy for Mentally Ill Individuals Act of 1986 authorizes a grant program that SAMHSA describes as protecting and advocating for the rights of adults with serious mental illness and children with serious emotional disturbance. Its activities include legal advocacy and investigating abuse, neglect and rights violations.
Source: SAMHSA: Protection & Advocacy for Individuals with Mental Illness
1990 to 2009
- 1990
The Americans with Disabilities Act is signed
President George H. W. Bush signed the Americans with Disabilities Act on July 26, 1990. The National Archives calls it the world's first comprehensive civil rights law for people with disabilities. The 1999 Olmstead ruling below applied it to institutional care.
Source: National Archives: Anniversary of the Americans with Disabilities Act
- 1996
The Mental Health Parity Act
The Mental Health Parity Act of 1996 provided that large group health plans cannot impose annual or lifetime dollar limits on mental health benefits that are less favorable than limits on medical and surgical benefits. See parity law in the United States.
Source: CMS: The Mental Health Parity and Addiction Equity Act (MHPAEA)
- 1999
Olmstead v. L.C.
The Supreme Court held that unjustified institutional isolation of people with disabilities can constitute discrimination under Title II of the ADA when community placement is appropriate, not opposed by the person, and can be reasonably accommodated. SAMHSA notes the Court weighed professional assessments, the person's wishes, state resources and the needs of others.
- 2005
The Helsinki mental health declaration
In January 2005, member states of the WHO European Region met in Helsinki and adopted the Mental Health Declaration and Action Plan for Europe. WHO's report says they set the course for mental health policy for the next five to ten years, with an Action Plan covering 12 areas of work. See European mental health policy.
- 2006
The UN adopts the disability rights convention
The Convention on the Rights of Persons with Disabilities was adopted on 13 December 2006 and opened for signature on 30 March 2007. The UN describes it as a shift from viewing people with disabilities as objects of charity and medical treatment toward viewing them as subjects with rights. See the Convention explained.
Source: United Nations DESA: Convention on the Rights of Persons with Disabilities (CRPD)
- 2007
England adds independent mental health advocates
The Mental Health Act 2007 gave qualifying patients, including those detained or on a community treatment order, the right to an independent advocate. A 2013 parliamentary review found access varied: in 2012 a regulator found 21% of care plans showed no evidence patients were told of the right. See how to request an advocate.
Sources: UK Parliament: Post-legislative scrutiny of the Mental Health Act 2007; Mind: What is an independent mental health advocate?
- 2007 to 2021
Time to Change runs in England
The charities Mind and Rethink Mental Illness delivered the anti-stigma program between 2007 and 2021; it ended on 31 March 2021. Researchers reported positive change in stigma and discrimination among adults in England from 2008 to 2019, then checked whether it lasted. See anti-stigma campaigns.
- 2008
The disability rights convention enters into force
The Convention entered into force on 3 May 2008. The UN says it clarifies how all categories of rights apply to persons with disabilities and identifies areas where adaptations are needed so those rights can be exercised, and where rights have been violated.
Source: United Nations DESA: Convention on the Rights of Persons with Disabilities (CRPD)
- 2008
The Parity and Addiction Equity Act
The 2008 US law generally prevents group health plans that cover mental health or substance use disorder benefits from setting less favorable limits on them than on medical and surgical benefits. It preserved the 1996 protections and extended parity to substance use. It does not require plans to cover those benefits at all.
Source: CMS: The Mental Health Parity and Addiction Equity Act (MHPAEA)
2010 to now
- 2013
The WHO adopts a mental health action plan
In May 2013 the Sixty-sixth World Health Assembly, with ministers of health of 194 member states, adopted WHO's Comprehensive Mental Health Action Plan 2013 to 2020. The next two entries follow the same plan as it was extended and updated.
Source: World Health Organization: Comprehensive Mental Health Action Plan 2013-2030
- 2019
The action plan is extended to 2030
The Seventy-second World Health Assembly extended the action plan until 2030, so the plan adopted in 2013 now runs well past its first end date of 2020.
Source: World Health Organization: Comprehensive Mental Health Action Plan 2013-2030
- 2021
The action plan is updated
The Seventy-fourth World Health Assembly endorsed updates to the plan's options for implementation and indicators. WHO says the updated plan sets out actions to promote mental health for all, prevent conditions among people at risk, and achieve universal coverage of mental health services.
Source: World Health Organization: Comprehensive Mental Health Action Plan 2013-2030
- 2022
A three-digit US crisis line deadline arrives
On July 16, 2020, the FCC issued a final order designating a three-digit code for the national suicide and crisis line, requiring all US providers to activate it for subscribers by July 16, 2022. Crisis contacts are listed elsewhere on this site, not repeated here.
Source: SAMHSA: The Lifeline's History
How to use this sheet
Read it as a map of selected milestones, not a complete record or a ranking. Laws and services differ by country and change, so open the cited source for the exact wording and date before relying on any entry. For your own care or rights, a clinician or a qualified adviser can say what applies where you live.