Unbundling of State Hospital services i

This paper describes the organizational, financial, and programmatic changes surrounding the closure of Philadelphia State Hospital, and the conceptual model employed for “unbundling” or disaggregating the state hospital’s services into community programs run by private non-profit agencies. The current status of the project is discussed as well as the long-term policy and research questions that remain to be answered. Philadelphia State Hospital (PSH), as is presently equipped, is primarily a custodial institution due to the lack of facilities and staff for patient treatment, and the addition of dormitory space alone would perpetuate a type of institution not in accordance with modern concepts of the function of a mental hospital. This marks Pennsylvania’s first attempt to reform the state hospital system initiated back in 1938, with ensuing reports highlighting the chronic issues with patient overcrowding and insufficient staffing. The paper examines the deterioration of PSH over the following decades and the ongoing efforts to address these issues within the context of community mental health services.