The economic and political forces of the 1980s will have a profound effect on state hospitals. The total number of these facilities is likely to decline, although their utilization will probably remain high. Their staffing will most likely remain low and their total budgets relatively stable. The extent of judicial advocacy that characterized the role of the courts in the last decade will be somewhat diminished in the 1980s. Most state hospitals will be forced by the insufficiency of community alternatives to provide primary and secondaty care as well as tertiaty care to the catchment areas they serve.