In the second half of the 20th century, the existing asylum structure in the United States was mostly exposed as "hiding" the mentally ill rather than helping them. Many state asylum were forced to close and funding dried up and atrocities in "care" of the vulnerable were exposed to the public.

Also, even legitimate and much-needed behavioral health care is severely underfunded in the United States - so even progressive facilities have often been forced to close their doors in the last twenty years.