Build a Better State Hospital: Deinstitutionalization Has Failed
Alexander Gralnick M.D.1
1 High Point Hospital, Upper King Street, Port Chester, New York 10573
The author cites increasing numbers of chronic, homeless, and neglected mentally ill people as evidence of the failure of deinstitutionalization and community care to live up to their promise to reduce chronicity, the need for long-term hospitalization, and even mental illness itself. He believes the state hospital system, despite having been maligned and nearly destroyed, has great therapeutic potential. It could provide extended care to acutely ill patients before they become chronically ill; restore the ability to pinpoint responsibility for patient care, which has been lost under community care; and provide a stimulating academic environment conducive to research into treatment of the mentally ill.
Note:
The tragedy of large numbers of homeless mentally ill in America's cities has stimulated renewed debate about whether deinstitutionalization has failed and should be abandoned as a social policy. We asked Alexander Gralnick, M.D., and Robert L. Okin, M.D., to present their views on this controversial issue. Dr. Okin's commentary begins on page 742.
