Beyond State Hospital Unitization: The Development of an Integrated Mental Health Management System
Robert L. Okin M.D.1 and
Janice Dolnick M.S.P.
1 The Greater Lynn Community Mental Health Center in Lynn, Massachusetts, The Massachusetts General Hospital in Boston
Bedford Road, Lincoln, Massachusetts 01773
As commissioner of the Massachusetts Department of Mental Health, the senior author in 1975 initiated a reorganization of the department designed to provide greater continuity of care for deinstitutionalized patients by integrating management of hospital and community services at a local level. The new system continued the practice of dividing hospitals into units corresponding to geographical catchment areas (unitization), but it abolished the hospital superintendent's position and greatly broadened the role of the area directors ofcommunity services to include clinical administration of the hospital unit serving patients in catchment areas. The authors believe the new system played a role in reorienting the department's services toward community care of the seriously disabled patient and led to a more effective distribution of departmental resources.
Note:
The authors express their appreciation to Robert Kaplan, M.D., for the leadership he provided in the design of the system described in this paper.
