Community care for chronic mental patients: the need for a reassessment

The release of chronic mental patients from the hospital to the community has been prompted more by political and economic considerations than by any planned treatment strategy. Large numbers of former patients have gone to live in privately operated boarding houses and nursing homes, where staff have had little experience with mental illness, and where conditions are not much different from the back wards of state hospitals of past decades. New models for caring for chronic, dependent patients should be developed; they should incorporate the precepts of an open social system and should be built around the needs of such patients as they themselves perceive them. To date, few state mental hospitals, have had the funding, staff, or support to adequately explore the possibilities of an optimal environment.