Planning the phasedown of mental hospitals

Abstract

With impending fiscal shortages limiting the growth of new community mental health services and the ability of mental hospitals to perform contemporary tasks remaining dubious, increased attention is being directed throughout the country to the role of state hospitals. Citizens and professionals in Massachusetts concluded that the needs of individuals now treated in mental hospitals are better met via community-based services as they become available than by services now provided in state hospitals. Consequently, public mental hospitals should be phased down over a 5-year period of time and their funds redeployed to community services. Among the factors affecting the success of this program shift are continuity of care for discharged patients, community acceptance of the mentally ill, and redeployment of personnel to community facilities.

Community mental health unraveling: The folly of cost containment.

“…One of the main goals of the community mental health movement, as defined in the Community Mental Health Systems Acts of 1963 and 1965, has been to treat patients close to home, avoiding unnecessary and lengthy state hospitalizations. 2 As funding for the psychiatric care of disturbed children declined, it became possible to see clearly that an effective community mental health system in San Francisco was accomplishing that goal prior to July 1982, but was no longer able to sustain it.…”

The role of psychology and psychiatry in general hospital settings in Alabama.

“…The percentage of inpatient care episodes reported by state and county mental hospitals between 1955 and 1971 dropped from 64% to 42% of the total number of patient care episodes (Ozarin & Taube, 1974;Windle, Bass, & Taube, 1974). Likewise, the resident population of state mental hospitals has dropped steadily since 1955 (Schulberg, Becker, & McGrath, 1976). In 1973, 10 years after President Kennedy had proposed the utilization of community mental health centers, the number of state hospital residents had decreased by 42% (Windle & Scully, 1976).…”