The changing role of the state psychiatric hospital.
State hospitals were once the most prominent components of U.S. public mental health systems. But a major focus of mental health policy over the past fifty years has been to close these facilities. These efforts led to a 95 percent reduction in the country's state hospital population. However, more than 200 state hospitals remain open, serving a declining but challenging patient population. Using national and state-level data, this paper discusses the contemporary public mental hospital, the forces shaping its use, the challenges it faces, and its possible future role in the larger mental health system.
Fisher
William H
WH
Center for Mental Health Services Research, University of Massachusetts Medical School, in Worcester, USA. Bill.Fisher@Umassmed.edu
Geller
Jeffrey L
JL
Pandiani
John A
JA
D003134:Commitment of Persons with Psychiatric Disorders / Q000191:economics; D003299:Cooperative Behavior; D003363:Cost Control / Q000639:trends; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D005544:Forecasting; D018166:Health Care Reform / Q000191:economics / Q000639:trends*; D006271:Health Facility Closure / Q000191:economics / Q000639:trends; D006291:Health Policy / Q000191:economics / Q000639:trends*; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends; D006778:Hospitals, Psychiatric / Q000191:economics / Q000639:trends*; D006783:Hospitals, State / Q000191:economics / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology* / Q000534:rehabilitation*; D014481:United States