Title
Second-generation deinstitutionalization, I: The impact of Brewster v. Dukakis on state hospital case mix
UMMS Affiliation
Department of Psychiatry
Publication Date
1990-08-01
Document Type
Article
Subjects
Adolescent; Adult; Aged; Community Mental Health Services; distribution; Costs and Cost Analysis; Deinstitutionalization; Diagnosis-Related Groups; Hospitals, Psychiatric; Hospitals, Public; Hospitals, State; Humans; Length of Stay; Massachusetts; Mental Disorders; Middle Aged; Patient Advocacy
Disciplines
Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology
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.
Source
Am J Psychiatry. 1990 Aug;147(8):982-7.
Journal/Book/Conference Title
The American journal of psychiatry
Related Resources
PubMed ID
2115750
Repository Citation
Geller, Jeffrey L.; Fisher, William H.; Wirth-Cauchon, J. L.; and Simon, Lorna J., "Second-generation deinstitutionalization, I: The impact of Brewster v. Dukakis on state hospital case mix" (1990). Systems and Psychosocial Advances Research Center Publications and Presentations. 261.
https://escholarship.umassmed.edu/psych_cmhsr/261
