State Mental Health Policy: Shifting Resources to the Community: Closing the Illinois State Psychiatric Hospital for Adolescents in Chicago

ince deinstitutionalization, thereapportionment of mental healthservices from large state-operated fa-cilities into community-based pro-grams has evolved unsteadily. In thepast decade, the census of state hos-pitals has shrunk to the point thatclosing these facilities has become aviable option (1). A number of clo-sures have occurred in recent years,and the majority have involved hospi-tals that served adults with severeand persistent mental illness (2,3).No closures of state-operated facili-ties for children have been discussedin the mental health services litera-ture. This paper details a three-yearprocess of ending the involvement ofthe Illinois state government in thedirect provision of inpatient care tochildren and adolescents in theChicago area.Several challenges have been iden-tified as barriers to the successful clo-sure of state facilities (4–6). Clinicalconsiderations include whether suffi-cient community treatment alterna-tives exist to address the needs ofpersons who were formerly treated atthe state hospital (4). Decisionsabout employment and human re-source allocation must address po-tentially broad implications for laborwhen a facility is closed (5). Finally,the transition of the physical plantfrom a hospital to its next use must beconsidered (6). Each of these con-cerns must be addressed in a coordi-nated fashion.