1848 — Dorothea Dix, a Massachusetts-bred mental health care reformer, tells Congress, “Humanity requires that every insane person should receive the care appropriate to his condition.” Her pioneering work spurs most states to build psychiatric asylums.
1963 — President Kennedy announces a “great national effort” to replace mental institutions with a system of community-based care.
1967 — The documentary film “Titicut Follies” exposes horrific treatment including force feeding and solitary confinement inside Bridgewater State Hospital. A series of legal disputes related to patient privacy prevented the film from being viewed by the general public until 1991.
1973 — A wave of psychiatric hospital closures in Massachusetts begins under Governor Francis Sargent with the shutdown of Grafton State Hospital. All but two state hospitals eventually close.
1978 — A decision by the state Supreme Judicial Court makes it harder to commit people with mental illness to hospitals involuntarily. Also a federal judge approves a consent decree compelling Massachusetts to establish community treatment alternatives to Northampton State Hospital.
1981 — President Reagan takes power and dismantles Kennedy’s ambitious program to build federally funded community mental health centers.
1990 — William Weld is elected governor of Massachusetts and ushers in a new era of privatization, diminishing state oversight by handing responsibility for mental health services over to an array of private vendors.
1999 — A US Supreme Court decision requires states to treat people with disabilities in the most integrated settings possible.
2003 — Governor Mitt Romney eliminates Medfield State Hospital and a so-called Difficult to Manage Unit at Taunton State Hospital for mentally ill men with a history of violence.
2010 — The state shutters Westborough State Hospital two years early as Governor Deval Patrick targets mental health spending to close a budget gap made worse by the financial crisis.
2011 — Three people working with those suffering from severe mental illness are killed on the job. Soon after, the leaders of a state panel scrutinizing the system warn, “If we care about safety, we cannot pretend that all is well.”
2016 — After one of the assailants, Pericles Clergeau, pleads guilty to second-degree murder, his lawyer, Keith Halpern stands up in court to call for change. “There are thousands of people like this who need to be helped,” he says. “And we’re not giving them the help.”Scott Allen can be reached at firstname.lastname@example.org.