Abstract
The status of 28 children, who had been transferred from a city hospital's acute psychiatric care unit to long-term care in state hospitals, was reviewd eighteen months later. Unexpectedly, only 25% of these youths remained in the state hospital to which they had been transferred and some of those had complicating medical problems. In order to learn what strategies they used to discharge the children to their homes (50%) or to group residences (254, the state hospitals' staff were interviewed. Time, engagement with the family, and a day hospital support system, not diagnosis or severity of the children's psychopathology, were the major contributors to discharge from state hospitals. The adjustments demanded of child services that work with urban poor families are discussed.
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