In the introductory chapter, Rosemary Stevens highlights an important message that emerges from several essays when she writes, “The politics of deflection have become policies of convenience” (p. 3). In other words, the current state of our health care system is shaped by political inaction as well as the enactment of specific policies. The essay by David Mechanic and Gerald Grob illustrates how this particular issue applies to the mental health care system through the story of deinstitutionalization. During this process, individuals with severe and persistent mental illness were discharged from institutions to an inadequate community-based system that did not have sufficient resources to care for their complex needs. As a result, there was an increase in homelessness, substance abuse/dependence, and “criminalization” of the mentally ill. These problems persist today as a result of political inaction in developing comprehensive systems of care for this population.