Abstract

ABSTRACT:Periodic outcries have focused attention on gross deficiencies in our large state hospitals. Shortages of psychiatrists, commonly attributed to insufficient funding, also may be due in part to tack of prestige and power, disadvantages of public practice and unrewarding relation-ships with involuntary patients: In spite of discouraging experiences for more than three decades, we continue to ask what can be done to improve large state hospitals and persist in thinking that a workable formula will be found. Logically this is most unlikely; and a better approach might be to raise a different question. I have suggested that we ask, “What can replace large state hospitals?” and to this question I have offered an answer.