Abstract
Although unified public mental health care systems are optimal, most treatment is offered in non-systems, where the community and state have discrete responsibilities. This paper describes the implementation of a single system model of care for chronic and severely disturbed psychiatric patients in a large urban area. It involves a collaboration between a university's community mental health center and a state psychiatric hospital. Data about the impact of the project are presented, including admission and recidivism rates, census in hospital and alternatives, and linkage with community-based services. Discussion focuses on the implications for empirically-based capitation models, future clinical and research goals, and the administrative mandate required to achieve them.
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