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The goal of modern state mental hospitals has become one of stabilizing illness, helping a patient return to some level of functioning and returning him to the community as soon as possible. The notion seems to be that real treatment can only be done outside hospitals, that hospitals promote their own illness. A dichotomous patient population results from this philosophy—some staying one to three months or a little longer, others remaining in residence for many years.
A question which came to mind three years ago, upon being appointed director of one of nine small hospitals which comprise Creedmoor State Hospital,* was how to enable a staff of about 150 to function in more positive ways so that rather than settling for symptom stabilization, some therapeutic gain for patients might be realized within the hospital setting itself.
This large staff services various arms of the hospital. Inpatients number about 150 to 200. In addition, there are some 70 day-center patients, about 600 former patients housed in two residential homes, plus a clinic outpatient population of around