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

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    Authors
    Geller, Jeffrey L.
    Fisher, William H.
    Wirth-Cauchon, J. L.
    Simon, Lorna J.
    UMass Chan Affiliations
    Department of Psychiatry
    Document Type
    Journal Article
    Publication Date
    1990-08-01
    Keywords
    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
    Health Services Research
    Mental and Social Health
    Psychiatric and Mental Health
    Psychiatry
    Psychiatry and Psychology
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    Link to Full Text
    https://doi.org/10.1176/ajp.147.8.982
    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.

    DOI
    10.1176/ajp.147.8.982
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/45156
    PubMed ID
    2115750
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1176/ajp.147.8.982
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    UMass Chan Faculty and Researcher Publications

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