ABSTRACT
This chapter focuses on the men and women principally responsible for running the chronic wards in the state hospital. To move about the state hospital and to achieve some understanding of its structure and procedures, one requires two sorts of map: geographic and sociological. An initial allocation begins with the arrival of the patient from a referring agent, a medical or legal office located outside the hospital. Contemporary medical and psychiatric categorization for ward distribution is fairly gross even at the most advanced psychiatric hospitals. The major problems of employees at the state hospital center around providing, with minimum resources, a modicum of decent care for 150 masses of patients. The downward escalator is a brutal fact, and all effort to intervene or slow it down is both the chronic service's answer to "treatment" and its own attempt to integrate patients into continuing institutional life.
