The changing role of the state psychiatric hospital

UMMS Affiliation

Department of Psychiatry



Document Type


Medical Subject Headings

Commitment of Mentally Ill; Cooperative Behavior; Cost Control; Cross-Sectional Studies; Dangerous Behavior; Forecasting; Health Care Reform; Health Facility Closure; Health Policy; Health Services Needs and Demand; Hospitals, Psychiatric; Hospitals, State; Humans; Length of Stay; Mental Disorders; United States


Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology


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.

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Citation: Health Aff (Millwood). 2009 May-Jun;28(3):676-84. Link to article on publisher's site

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Link to Article in PubMed

PubMed ID