State strategies to restructure psychiatric hospitals: a selective review.

All state mental health authorities are restructuring the role of their state psychiatric systems as part of the overall system of specialty psychiatric services. These efforts include shifting funds to community programs, changing the hospital from both a short- and long-term facility to one or the other, and giving community programs more administrative and budgetary authority over the hospitals. This paper presents case studies of five such efforts, selected to illustrate the range of change and the mechanisms for achieving it. Inferences are drawn from these studies and directions for research are suggested.