AbstractThe Mental Health Institute at Independence, Iowa, as part of a progressive State mental health program, made substantial gains in treatment of the mentally ill, with a marked reduction in the average daily census even though the admission rate had increased. Because of limited funds, however, the treatment of geriatric patients did not approach the progress made in other areas of the hospital. In 1966, with the aid of a grant from the National Institute of Mental Health, the intensive treatment of geriatric patients became a reality. The staff was strengthened in all disciplines and a fully equipped physiotherapy department was added to the geriatric unit. Whereas previously all patients over 65 were admitted to psychiatric units, under the new plan these patients were admitted directly to the geriatric unit. There they received a complete medical and psychiatric review before being assigned to one of two areas within the unit. In one area were the patients who had potential for making substantial gains with intensive psychiatric treatment (group and individual therapy, ward government, remotivation techniques, occupational therapy and other activity therapies such as music, recreation, adult education and homemaking services, as well as intensive case work by experienced social workers). In the second area were the patients who were markedly regressed and organically deteriorated; even some of these showed enough improvement to be transferred to the more intensive unit. Patients unable to benefit from intensive treatment were transferred to nursing homes. Under the new regimen, the discharge rate for geriatric patients increased from 36 per cent to 59 per cent, and the discharge rate to their homes from 28 per cent to 47 per cent. The average length of stay in the hospital was markedly reduced from 112 days to 65 days.