State hospitals in the new millennium: rehabilitating the "not ready for rehab players".
Over the past ten years, FSH has seen the initial implementation of the SLP grow from a single ward in the maximum-security forensic unit to include three additional wards within that unit, two wards on the medium-security forensic unit, and two wards within the general adult psychiatric service. There are now four FSH group homes, which admit clients from the hospital's forensic as well as nonforensic populations. Six to eight clients live in each home and function in a relatively self-sufficient manner, and many more (including forensic clients) have been discharged from the group homes and now live independently in the community. They work in supported employment or competitive job settings and manage their own households. Several of our discharged clients even return to visit us from time to time. The FSH administration remains solidly committed to being a rehabilitation-ready facility. We have had a number of positive outcomes over the years (Baldwin and others, 1992; Beck and others, 1991; Beck and others, 1997; Finnell, Card, and Menditto, 1997; Menditto, Baldwin, O'Neal, and Beck, 1991; Menditto, Valdes, and Beck, 1994; Menditto and others, 1996; Menditto, Beck, and Stuve, in press; Pestle, Card, and Menditto, 1998), and we regularly host visitors from other state hospitals seeking consultation on how to make their own facilities rehabilitation-ready. Recently, we were featured on a segment of the nationally broadcast medical education program psychLINK (Glazer, 1998), where it was suggested that rehabilitation programming models such as ours represent the future of state hospitals. The "Not Ready for Rehab Players" think so too.
Stuve
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Department of Psychiatry and Neurology, School of Medicine, University of Missouri, USA.
Menditto
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AA
D000328:Adult; D003688:Deinstitutionalization; D005544:Forecasting; D005555:Forensic Psychiatry / Q000458:organization & administration; D006751:Hospital Information Systems / Q000458:organization & administration; D006778:Hospitals, Psychiatric / Q000639:trends*; D006783:Hospitals, State / Q000639:trends*; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D008923:Missouri; D020380:Needs Assessment / Q000458:organization & administration; D009937:Organizational Objectives; D016730:Program Development