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Examines the origins, recent history, and future of state hospitals.
State hospitals still account for the majority of the state dollars spent on mental health care across the nation. Why do state hospitals persist and expand despite public scandal and professional disapproval? What role does the state mental hospital play in the current system of care for the seriously mentally ill? What role should it play, and at what cost? Dowdall explores recent efforts, successful and unsuccessful, to meet the increasingly elaborate standards imposed from without on the contemporary state mental hospital, and the impact of these efforts on the quality of care provided to its patients.
"The use of data to address many of the questions raised is most innovative. I believe this book would make a good contribution to the study of mental health treatment and policy." — Clifford L. Broman, Michigan State University
List of Figures
List of Tables
Acknowledgments
Preface
1. State Mental Hospitals as the Organizaitonal Pivot of Policy
2. The Natural History of an Organizational Form: The State Mental Hospital
3. "A Most Noble Charity": The Birth of a State Asylum
4. Organizational Development: How the State Asylum Became the State Hospital
5. The State Hospital: Reform as Inertia
6. "Trying Times of Transition:" From State Hospital to Psychiatric Center
7. The Contemporary State Psychiatric Center: Up to Standards?
8. Public Policy and the Seriously Mentally Ill: The Future of the State Mental Hospital
Appendix A: Data Sources and Methods
Appendix B: Standards for State Mental Hospitals
Bibliography
Index