Gertrude Stein is reported to have commented, "You will never find the right answers if you do not ask the right questions." Her comment seems apropos to the subject of this editorial. Together, physicians must pose the questions and find the answers about these patients since increasing numbers of chronically mentally ill are seeking assistance at a wide variety of community resources. The purpose of this editorial is to briefly review many of the factors that have led to the current situation, where chronically mentally ill persons are being cared for in nonpsychiatric facilities. A variety of organizations, institutions, and national advisory groups have already submitted recommendations, with regard to these citizens, for consideration by local, state, and federal governmental bodies.
Over the past 20 years, the resident population of mental hospitals has been reduced by two thirds. Thus, approximately 400,000 former patients now seek their mental health care in