Charge to the Community: Some Early Effects of a State Hospital System's Change of Policy

The current thrust toward community care in New York State has had a dramatic positive effect as local facilities have actively presented alternatives to long-term hospitalization. But there have also been negative effects, some anticipated and some unanticipated, as local facilities have found it difficult to meet the needs of many patients, particularly those unable to make the transition from custodial care to living on their own. The authors discuss these developments in the light of New York City's recent experiences with community psychiatry and offer some recommendations for similar transitions in other communities.