Has the conference made a difference? As the state mental hospital population dropped from 550,000 in 1995 to less than 170,000 in the 1970s, changes have occurred, but problems remain, such as homelessness and jails as an alternative to hospitals. Talbott has continued to push for improved services. His leadership in linking academia and state hospitals resulted in a fruitful experiment. He has continued to draw attention to the continuing problems by publishing more than 40 papers in journals and as book chapters. The American Textbook of Psychiatry, 3rd Edition (1999), of which Talbott is an editor, mentions in the section on schizophrenia that the focus of treatment has shifted from state hospitals to outpatient clinics and the community to the benefit of patients, families, and society. Patients have more opportunity for independence, but in many places an integrated, coordinated system of care to meet patients' needs is still not available. In a chapter in a 1995 book on schizophrenia, Talbott reviewed recent significant changes, writing "it is probably neither science nor advocacy…that will shape services but economic forces."