chapter  13
16 Pages

Management of Forensic Hospitals

ByCharles C. Dike

Th e current concept of a forensic psychiatric hospital in the U.S. began taking shape in the late 1960s and early 1970s. Before then, forensic psychiatric patients (forensic patients) were housed in large state hospitals, most of which were built in the late nineteenth century. Forensic patients were admitted into designated or specialized units in state hospitals and shared space with civil patients. Th e massive depopulation of state hospitals in favor of community mental health agencies and treatment led to dramatic shrinkage in state psychiatric beds. For example, in 1955 there were 558,239 public (state and county) psychiatric beds available for a U.S. population of 164.3 million, compared to 52,539 public (state and county) psychiatric beds for a U.S. population of 269.4 million in 2005 (Torrey et al. 2008)

Th is exodus of psychiatric patients from public psychiatric facilities was associated with both an increase in homelessness and in arrests and incarceration of individuals with mental illness. Th is gradually but predictably led to a need for psychiatric facilities specialized in managing a unique group of psychiatric patients involved with the legal system and/or with the Department of Correction (DOC).