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Hospitals in Trouble

Sheila M. Rothman
JAMA. 1987;257(7):984-985. doi:10.1001/jama.1987.03390070104037.
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J. P. Martin's study of British responses to a series of exposés on substandard care and incidents of staff brutality in 15 of their long-term—care hospitals for the mentally ill and mentally disabled contains important information for American mental health administrators and advocates for the mentally disabled. Professor Martin's detailed and perceptive accounts of staff-initiated abuse, lengthy and expensive governmental investigations, and consistent blue-ribbon—committee recommendations for administrative changes all indicate that the British mental health system has experienced as much turmoil as our own.

In fact, until the 1970s, Great Britain and the United States faced similar predicaments. With the advent of psychotropic drugs in the 1950s and a growing body of social science research that questioned the rehabilitative functions of large custodial institutions, both countries began to reduce their hospital populations. They placed, or often "dumped," many former patients into the community, but a reduction in institutional numbers did


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