Because mental health institutions wield both cultural influence and physically coercive authority, debates about when behavior is mentally ill (as opposed to criminal, acceptable, or some other category) [Page 2820]is inherently a subject of political interest; and throughout the history of mental health, both governments and professional associations have been petitioned or pressured to reform. From the beginning, reforms have focused on improving conditions for those who are mentally ill, but the philosophical underpinnings and implementations have varied tremendously from one era to the next.