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During the past 25 years (1956 to 1981), there has been major growth in mental health services at virtually all levels, with considerable expansion of outpatient services, psychiatric units in general hospitals, private psychiatric hospitals, and community mental health centers. There has also been a shift in the locus of services and in the manner in which they are delivered. The resident population in state hospitals has decreased dramatically, from 550,000 in 1956 to an estimated 138,000 in 1980.1 An improved ability to treat seriously ill patients with neuroleptic medications, antidepressants, and lithium, and a civil rights movement supporting treatment . . .
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