Until relatively recently in its history, psychiatry was a specialty practiced in large institutions. The immigration of psychoanalysts from Europe and the civil rights movement in the 1960s promoted the change of psychiatry from an inpatient practice to one that is largely outpatient. Large state hospitals and forensic hospitals associated with the prison system now only treat a minority of those who can benefit from inpatient treatment-those chronically affected by the most severe mental illnesses. Cultural Implications Community hospitals play an important role in normalizing the existence of mental illness. Such experiences generalize to the community at large through stories, newspaper articles and other means of communication.
Psychiatric hospitals acquire the reputation of being benign.
The loss of community hospitals will result in a reverse of the current trend of decreasing stigma associated with mental illness. Much training of medical students and psychiatric residents occurs at such local facilities. The loss of these facilities would not only reduce sites that provide education but would also likely further decrease the attractiveness of psychiatry to those who might otherwise make it their career. The practice of psychiatry is dynamic. Obviously the nature of treatment is ever-evolving as new medications and somatic interventions are discovered and refined.