PMID: 2115750Aug 1, 1990Paper

Second-generation deinstitutionalization, I: The impact of Brewster v. Dukakis on state hospital case mix

The American Journal of Psychiatry
J L GellerL J Simon

Abstract

A 1978 consent decree affecting one region of Massachusetts mandated a drastic reduction of census at its state hospital, where considerable deinstitutionalization had already occurred over the prior two decades. The transfer of patients from hospital to community was to be accomplished through the unprecedented expansion of community resources. This second-generation deinstitutionalization effort achieved substantial census reduction but less than was envisioned. It was most effective in discharging geriatric and mentally retarded patients but far less effective with longterm and new chronic patients, many of whom continue to require repeated hospitalizations despite the availability of a comprehensive array of community-based services.

Citations

Jan 1, 1992·The Psychiatric Quarterly·J L GellerK Moynihan
May 12, 2005·The Psychiatric Quarterly·Jeffrey L GellerPaul S Appelbaum
Jun 23, 2006·Administration and Policy in Mental Health·William H FisherNancy Wolff
Jan 1, 1996·New Directions for Mental Health Services·M F Hogan
Jan 1, 1994·European Archives of Psychiatry and Clinical Neuroscience·F J NienhuisD Wiersma

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