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A State Mental Health System With No State Hospital: The Vermont Feasibility Study
Paul J. Carling; Sutherland Miller; La Vonne Daniels; Frances L. Randolph
Psychiatric Services 1987; doi:
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This study would not have been possible without the involvement of large numbers of Vermont consumers, family members, service providers, policy-makers, and advocates. The expert consultants included David Goodrick, Ph.D., James Sorensen, Ph.D., H. Stephen Leff, Ph.D., Neil Mickenberg, J.D., Barry Cohen, Ph.D., and Thomas Fox, M.D. Special thanks are due to James Stockdill and Neal Brown of NIMH, to Priscilla Ridgway, M.S.W., and Cherise Rowan for their thoughtful comments, and to Ronald Brothers, who produced the many drafts.

Center for Psychiatric Rehabilitation of Boston University, University of Vermont in Burlington

Albert Einstein College of Medicine in the Bronx

University of Nebraska

Center for Psychiatric Rehabilitation

American Psychiatric Association

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Abstract

A comprehensive study of both the feasibility and the desirability of operating a state mental health system without a state hospital, except for a small forensic facility, was carried out in Vermont. Feasibility was examined in terms of client needs, service system capabilities, financing, human resource requirements, legal and rights protection issues, and political considerations. The study team concluded that developing comprehensive regional community support and rehabilitation services to replace the state hospital for all public mental health clients except forensic patients was both feasible and desirable since it would result in better services at a roughly equivalent cost to the state. The team also developed recommendations for optimizing the success of regionalization.

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