Indiana Consortium For Mental Health Services Research Indiana University

Abstract

Reprint # 15: The Closing of Central State Hospital: An Alliance of Academic and Government Collaboration

ERIC R. WRIGHT and TERRY F. WHITE,
Indiana Consortium for Mental Health Services Research, Indiana University and
RICHARD N. DELIBERTY, Indiana Division of Mental Health

Over the past four decades, thousands of people with serious mental illness have been discharged from large state psychiatric hospitals to smaller and more diffuse treatment programs in community settings (Grob 1994). This policy of deinstitutionalization occurred gradually during this period but gained the strongest momentum during the late 1960s and 1970s (Gronfein 1985). More recently, this "transfer of care" has gained renewed support as state governments have been forced to reconcile serious budget crises with the large budgets needed to support state mental hospitals (Brown 1985). Political debate has intensified with the recent resurgence in state efforts to downsize and close additional state mental hospitals, and. with claims by many mental health advocates that deinstitutionalization has proven to be a failed policy (Isaac and Armat 1990). While researchers have been instrumental in documenting both the intended and unintended consequences of this policy (see Mechanic 1989 and Brown 1985 for comprehensive reviews), much of this work fails to inform current policy directed at reshaping America's state mental hospital system.

The closing of Central State Hospital (QSH), the oldest state mental hospital in Indiana, offered a significant opportunity for public policy makers and academics to work together to study many critical and still unanswered issues about the policy of deinstitutionalization. This case study provides a brief overview of a collaborative research effort launched between researchers at Indiana University and the Indiana Division of Mental Health shortly after the decision to close CSH. Over the course of the project, the team faced a number of significant challenges that had to be resolved in order to stay on track and ensure the success of the study. Here we recount briefly some of the sociopolitical circumstances surrounding the closure of CSH and the implementation of our research project (known locally as the Central State Hospital Discharge Study). With this background, we highlight two particular challenges that shaped our work and the overall organization of our study. Specifically, we focus on the importance of forging a balanced partnership and the mechanisms to do so; and the strategies we employed for ensuring the scientific integrity of the data. We conclude with a brief discussion of how future public-academic collaborative research projects could be improved.