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The 1970s constitute the decade of decisions about state mental hospi tals! These large, monolithic, and seemingly impervious institutions are being phased out in some states and their basic purpose for exis tence is being seriously questioned in almost all others. Since 1970, hospitals have closed in California, Illinois, Kentucky, Massachusetts, Minnesota, New York, Oklahoma, Washington, and Wisconsin. Simi lar closings have occurred in several provinces of Canada, in Great Britain, and in some European countries. The purpose of the book is to examine the multiple issues growing out of the hospital closings: Why are the state hospitals being closed? What is the impact of closings on patients, hospital staff, and the communities where the hospitals are located? What has been the impact on the communities receiving these patients? What are the trends for the future, in terms of numbers of closings and types of hospitals which will remain? Is there a role for the state hospital in the care of the mentally ill or is it an obsolete institution? The impetus for the closings is diverse. The discovery and wide spread use of the tranquilizing drugs in the early 1950s allowed more patients to be returned to the community-under medication.
Sommario
I. Perspectives in the Closing of Mental Hospitals.- 1. Introduction and an Overview of the Closing Scene.- 2. Historical Factors Affecting the Closing of State Hospitals.- 3. The Case for Closing of the Hospitals.- 4. The Case Against Closing of State Hospitals.- 5. The Alternative Care Is Not There.- II. The Impact of the Closing.- 6. The Impact of the Closing of DeWitt State Hospital.- 7. When They Closed the Doors at Modesto.- 8. The Posttransfer Fate of Relocated Patients.- 9. Community-Based Sheltered Care.- III. Issues in Community Care and the Closing of Hospitals.- 10. Some Major Issues in the Closing of the Hospitals.- 11. Moving Patients Out of Hospitals-In Whose Interest?.- 12. Is the Community Ready?.- 13. Whither the State Hospital? Issues and Trends in Mental Health Services Delivery.
