Social workers have played an integral role in the treatment of psychiatric patients in hospitals since the earliest days of the 20th century. At first totally dependent on the support and approval of the medical profession, psychiatric social work later became professionalized and began to take responsibility for a wide variety of duties in the institution. Through a study of private and voluntary hospitals, the authors found that despite decades of acceptance by medical staff, the social worker today functions in an environment where final administrative authority on hiring staff and deciding the need for social work services often falls outside the social work department. The survey also identifies the relative importance of various professional duties and the impact of social work on institution decision-making. Involvement by social workers in patient discharge planning could well ensure the future of social work in hospitals in a time of tight budgets, they conclude.