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A Historical Review of the Madison Model of Community Care
Kenneth S. Thompson; Ezra E. H. Griffith; Philip J. Leaf
Psychiatric Services 1990; doi:
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The writing of this paper was supported in part by National Institute of Mental Health grant MH-15783 and by the State of Connecticut Center for Mental Health and Policy Research. The authors wish to acknowledge comments made on an earlier version of this paper by Boris Astrachan, M.D., Mary Ann Test, Ph.D., and Leonard Stein, M.D. They also thank Patricia Krieger and Christina Shedlin for editorial assistance.

Yale University in New Haven, Connecticut

1990 by the American Psychiatric Association

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Abstract

The community-based mental health care programs developed by Stein, Test, and their colleagues in Madison, Wisconsin, have bad a profound impact on the delivery of mental health services to the severely mentally ill. The authors trace the development of the model from its late-1960s emphasis on improving Mendota State Hospital and providing intensive post-discharge care through the phases of releasing patients early to the community, preventing hospitalization, providing continuous community care for young schizophremics, maintaining difficult patients in the community, and organizing a system of care. Throughout its evolution the model has changed significantly in response to changing circumstances, reflecting the assertive adaptability of the approach. Program planners attempting to incorporate elements of the Madison model in their own settings must be aware of current pressures that are likely to force further adaptations.

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