The state mental hospital: a local health department's role

The publicizing of the abysmal conditions in state mental institutions and the problems precipitated by their deinstitutionalization programs, have challenged local health authorities to develop effective roles in ameliorating these difficulties. Long-view State Hospital is a state mental hospital in Cincinnati, Ohio. The Cincinnati Health Department acted as a change agent to deal with the hospital's many chronic problems and the new difficulties precipitated by moving patients into the community for care. The city conducted its own evaluation of the hospital and its deinstitutionalization program and strongly advocated needed improvements. Problems were encountered in implementing this advocacy role, particularly in relation to the local health department's authority regarding this state-funded and operated institution. However, the many city recommendations that were implemented, the increased funding given the hospital and the community mental health centers, the continuing communication between city and state officials, as well as a follow-up evaluation indicated that the Cincinnati Health Department had played a positive role in the change process. (Am. J. Public Health 69:64-67, 1979.)