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This paper discussed the changing role of state psychiatric hospitals within the mental health system. Important factors included state demographics, the education and training of psychiatric residents, and the revolutionary changes taking place within the medical care system in America. The author emphasized the importance of viewing specific approaches to system problems from a total mental health system perspective.

Of the 270 patients who had been hospitalized at least 1 year in Maryland public psychiatric facilities in 1976, 15% remained 7 years later. The authors' data provide evidence that a new long-term population is not accumulating in Maryland.

The authors examine the development and characteristics of a "new" long-term population in the public mental health system in Maryland. The findings do not substantiate concern over a large increase in the number of chronic patients in state hospitals in the next several years.