title: Hospital downsizing and patients' assaults on staff.
abstract: Although the downsizing and closing of state mental hospitals is occurring with increasing frequency nationwide, there appears to be only one case study of the clinical impacts of downsizing state hospitals. In this study, Snyder reported a four-fold increase in frequency of assaults on staff as the hospital census decreased. The present paper is a second case study of state hospital downsizing and closing in which the frequency of assaults on staff decreased by 63%. Possible explanations for the two differing outcomes are considered, and some general guidelines for the downsizing and closing of state hospitals are proposed.
authors.affiliation: Department of Psychiatry, Cambridge Hospital, MA 02139, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Flannery
authors.forename: M A
authors.initials: MA
authors.lastname: Hanson
authors.forename: W E
authors.initials: WE
authors.lastname: Penk
authors.forename: G J
authors.initials: GJ
authors.lastname: Pastva
authors.forename: M A
authors.initials: MA
authors.lastname: Navon
authors.forename: G J
authors.initials: GJ
authors.lastname: Flannery
mesh_terms: D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006276:Health Facility Size / Q000639:trends*; D006754:Hospital Restructuring / Q000639:trends*; D006778:Hospitals, Psychiatric / Q000639:trends; D006783:Hospitals, State / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D012308:Risk Management / Q000639:trends*; D012559:Schizophrenia / Q000453:epidemiology; D014754:Violence / Q000639:trends*