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Letters   |    
Closing a State Hospital
Peter Nierman, M.D.; John Lyons, Ph.D.
Psychiatric Services 2002; doi: 10.1176/appi.ps.53.9.1180
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In Reply: The State of Illinois remains steadfast in its desire to address the needs of mentally ill children. The funding for the state-operated hospital was transferred in whole to community mental health providers and to private hospital partners. The total amount transferred would now be greater than $50 million over the past five years, and the number of children served would tally in the thousands.

Ms. Holcomb, on behalf of the Mental Health Association of Illinois, makes a good point that private hospitals were rarely integrated into a coordinated system of care. One of the significant benefits of the experience in the Chicago area has been to greatly increase the participation of private-sector hospitals in a coordinated system of care. These hospitals, through increased collaboration with community mental health partners, have gained clinical experience and system management skills that greatly enhance their crafting of appropriate aftercare plans.

A cascading effect has been the improvement in private-sector hospital services to children who are wards of the state, forensic clients, and Medicaid clients not covered under the contract with the office of mental health of the Illinois Department of Human Services (DHS). The role of the office of the inspector general of the Illinois DHS has been expanded, and these private hospitals are now required to follow the same procedures as state-operated hospitals with respect to incidents of potential abuse and neglect and violations of patients' rights.

The office of mental health of the Illinois DHS has provided ample evidence that Metropolitan Child and Adolescent Services has implemented a model that is efficient, consistent with the principles of the Child and Adolescent Service System Program, and fully within the tenets of the Olmstead decision. With the help of consumer organizations and advocacy groups like the Mental Health Association of Illinois, we will continue to be held to the highest standards.

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