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The politics of closing state mental hospitals: A case of increasing policy gridlock

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Abstract

There are political and administrative barriers to closure of the remaining state mental hospitals. Some of these barriers owe their existence to the current lack of community-based alternatives for the care and treatment of the severely mentally ill. In addition, uncertainty of the future funding and regulatory commitment of state governments to community programs contributes to an unwillingness by influential groups to recommend or implement closure. Finally, other barriers include rigid budgetary processes, the self-interest of public employees., and the lack of consensus in the decision making process.

The result is that even when the case for closure of a state mental hospital is convincing, these political and administrative factors can cause “policy gridlock.”. This article describes how such policy gridlock occurs and offers several suggestions as to how it can be prevented.

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References

  • Anthony, W.A., Cohen, M., Farkas, M., & Cohen, B.F. (1988). Clinical care update: The chronically mentally ill.Community Mental Health Journal, 24, 219–228.

    Google Scholar 

  • Becker, F.W. (1992). Contracting for the involuntary treatment of the mentally ill: Legislative attitudes.Administration and Policy in Mental Health, 19(4): 321–333.

    Google Scholar 

  • Bond, G., Miller, L.D., Krumwied, R.D., & Ward, R.S. (1988). Assertive case management in three CMHCs: A controlled study.Hospital and Community Psychiatry., 39, 411–418.

    Google Scholar 

  • Cutler, D.L. (1986). Community care options for the chronically mentally ill.Community Mental Health Journal, 22, 61–73.

    Google Scholar 

  • Dickey, B. & Goldman, H.H. (1986). Public health care for the chronically mentally ill: Financing operating costs.Administration in Mental Health, 2, 63–71.

    Google Scholar 

  • Dorwart, R.A., Epstein, S., & Davidson, H. (1988). The shifting balance of public and private inpatient services: Implications for administrators.Administration and Policy in Mental Health, 16, 4–13.

    Google Scholar 

  • Feis, C.L., Mowbray, C.T., & Chamberlain, P.J. (1990). Serving the chronic mentally ill in state and community hospitals.Community Mental Health Journal, 26, 221–232.

    Google Scholar 

  • Florida Council for Community Mental Health (FCCMH). (1991).Right-sizing state institutions. Tallahassee, FL: FCCMH. Mimeographed.

    Google Scholar 

  • Florida Department of Health and Rehabilitative Services (HRS). (1989).A study of mentally ill persons residing in adult congregate living facilities. Tallahassee, FL: HRS. Mimeographed.

    Google Scholar 

  • —. (1991). South Florida State Hospital briefing package. Tallahassee, FL: HRS. Mimeographed.

    Google Scholar 

  • Franklin, J.L., Solovitz, B., Mason, M., Clemons, J.R., & Miller, G. (1987). An evaluation of case management.A merican Journal of Public Health, 77, 674–678.

    Google Scholar 

  • Glazer, S. (1987). Unfulfilled promises to the mentally ill.Congressional Quarterly's Editorial Research Reports, 1(6), 66–75.

    Google Scholar 

  • Goering, P.N., Wasylenki, D.A., Farkas, M., Lancee, W.J., & Ballantyne, R. (1987). What difference does case management make.Hospital and Community Psychiatry, 39, 272–276.

    Google Scholar 

  • Kiesler, C.A. & Sibulkin, A.A. (1987).Mental hospitalization: Myths and facts about a national crisis Newbury Park, CA: Sage.

    Google Scholar 

  • Langer, M., & Marshall, P.E. (1988). New direction for treating the chronically mentally ill in New York State.Administration and Policy in Mental Health, 16, 107–110.

    Google Scholar 

  • Lyall, S. (1992). Psychiatric hospitals facing big cuts.New York Times, January 30.

  • Peters, R., Miller, K.S., Schmidt, W. & Meeters, D. (1987). The effects of statutory change on the civil commitment of the mentally ill.Law and Human Behavior, 2, 73–99.

    Google Scholar 

  • Rogers, P. (1992). Life less bleak at state hospital, but, care still called poor.Miami Herald, March 8, p. 6B.

  • Santiago, J.M. (1987). Reforming a system of care: The Arizona experiment.Hospital and Community Psychiatry, 38, 270–273.

    Google Scholar 

  • Shulberg, H.C. & Manderscheid, R.W. (1989). The changing network of mental health service delivery. In, C.A. Taube, D. Mechanic, & A.A. Hohmann (Ed.),The future of mental health services research, (pp. 11–22). Washington, DC: U.S. Government Printing, Office.

    Google Scholar 

  • Smith, S. (1990a). Hopes high for psychiatric bed additions.Miami Herald, May 20, p. 1BR.

    Google Scholar 

  • Smith, S. (1990b). State hears debate on quest for more mental ward beds.Miami Herald, June 1, p. 6BR.

  • Taube, C.A., & Goldman, H.H. (1989). State strategies to restructure psychiatric hospitals: A selective review.Inquiry, 26, 146–156.

    Google Scholar 

  • Test, M.A., & Stein, L. (1980). Alternatives to mental hospital treatment.Archives of General Psychiatry, 37, 409–412.

    Google Scholar 

  • Torrey, E.F., Wolfe, S.M., & L.M. Flynn. (1990).Care of the seriously mentally ill: A rating of state programs. Third edition. Washington., DC: Health Research Group.

    Google Scholar 

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Becker, F.W. The politics of closing state mental hospitals: A case of increasing policy gridlock. Community Ment Health J 29, 103–114 (1993). https://doi.org/10.1007/BF00756336

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