The state psychiatric center as an academically affiliated tertiary care hospital

Conventional wisdom views state psychiatric hospitals as a problem as much as a solution in the fight against mental illness. The legacy of the historic shortcomings of these hospitals--overcrowding, dreary environment, ineffective treatments, understaffing--frames the discussions of their future. The authors argue that a positive, constructive mission and vision for state hospitals is emerging in New York. This vision calls for fewer, smaller, specialized centers redefined as academically affiliated, community based, consumer oriented, tertiary care centers. To transform these centers, a major reengineering is proposed, including centralized treatment, patient and family participation, continuing education for all staff, outcome research, specialization, multi-service campuses, and technology transfer programs. With this transformation, State Psychiatric Centers become partners in efforts to improve the quality of life for people with mental illness throughout society.