Beyond state hospital unitization: the development of an integrated mental health management system

Abstract

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 of community 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.