1997 to 2015
For the last 60 years state mental health agencies (SMHA) have been building comprehensive community-based systems to care for persons with serious mental illnesses. SMHA have also refocused the use of state psychiatric hospitals on patients in major crisis, patients whose illnesses were not being adequately addressed in community settings, and increasingly forensic and other involuntary patients. Since the 1950s, the number of beds in state psychiatric hospitals has declined by over 91 percent. As a result of this phenomenon, many state psychiatric hospitals that had once served thousands of patients every day are now much smaller and many states that had multiple psychiatric hospitals have consolidated their acute inpatient services by merging facilities.