title: Against the grain? A reasoned argument for not closing a state hospital.
abstract: In the face of the Massachusetts Governor's attempts to close one of the state's four remaining state hospitals, Massachusetts legislators overrode the Governor's veto of funding for the hospital, but required the state's Mental Health Authority to author a study of the implications of further loss of public sector inpatient beds. The Center for Mental Health Services Research of the University of Massachusetts Medical School conducted its own study concluding that maintaining a longer-term inpatient capacity in the public sector in central Massachusetts was both necessary and accrued a significant number of benefits. This article can serve as a model for the reasoned position that a state hospital in 21st century psychiatry can be looked at as a multiservice center that fulfills a key role in a public sector, integrated system of treatment, care, training and research.
authors.affiliation: Center for Mental Health Services Research, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA. jeffrey.geller@umassmed.edu
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Geller
authors.forename: Helen
authors.initials: H
authors.lastname: Shore
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Grudzinskas
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
mesh_terms: D001509:Bed Occupancy / Q000191:economics / Q000331:legislation & jurisprudence; D003362:Cost-Benefit Analysis / Q000639:trends; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000331:legislation & jurisprudence; D005380:Financing, Government / Q000191:economics / Q000331:legislation & jurisprudence; D005544:Forecasting; D006271:Health Facility Closure / Q000191:economics / Q000331:legislation & jurisprudence*; D006742:Hospital Bed Capacity / Q000191:economics; D006778:Hospitals, Psychiatric / Q000191:economics / Q000331:legislation & jurisprudence*; D006783:Hospitals, State / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000331:legislation & jurisprudence; D008404:Massachusetts; D008484:Medicaid / Q000191:economics / Q000331:legislation & jurisprudence; D017150:Public Sector / Q000191:economics / Q000331:legislation & jurisprudence; D012051:Reimbursement Mechanisms / Q000191:economics / Q000331:legislation & jurisprudence