This chapter presents a brief overview of some legislative efforts within the mental health (MH) arena and examined their limitations and application with respect to older adults and people living with mental illness. The chapter also takes us through a journey to examine the current status of MH and older adults, with a particular emphasis on depression, anxiety, and schizophrenia. It discusses and reviews the programs, services and issues still outstanding within the MH arena. The chapter helps the reader to understand specific components of the Community Mental Health Act and other MH-related legislation. Many of the community day hospital programs and community MH programs administered through the Community Mental Health Act are based on the deinstitutionalization paradigm since the goal is to treat people outside the institution and within community settings. It concludes with laying out some challenges for the future in the area of MH and older adults.

This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.

Aging policy is shaped by a variety of demographic, social, and economic factors. However, these factors are not the only influences on the development of public policy or aging/disability policies. Philosophical paradigms and theoretical frameworks also influence the actual development of policy and play a strong implicit role in how public policy is drafted. Values and philosophies guide the development of specific philosophical paradigms and shape how aging and disability policy is developed and implemented. This chapter explores how these realities play a role in the development and implementation of public policy and aging/disability policy. It showcases some of the realities that may prevent the implementation of the policy or program as envisioned. As a safeguard against a subjectively devised policy and program base, objective evidence and empirically driven initiatives can be developed by aging and disability policy advocates.