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The care of persons with severe and persistent mental disorders is full of uncertainty and controversy. There is a crisis in public health and safety today because of the many thousands of such persons who are homeless or incarcerated and in need of treatment and support. To a great extent, we have regressed as a society to an era of 150 years ago, when a moral crusade on behalf of the homeless and incarcerated "insane" led to the asylum movement in the United States.
Sarah Sitton's history, Life at the Texas State Lunatic Asylum, 18571997, recalls that earlier era of
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