Am J Psychiatry 1984; 141:786-789
Copyright © 1984 by American Psychiatric Association
Brewster v Dukakis: developing community services through use of a consent decree
RL Okin
Filed against the state of Massachusetts in 1977, Brewster v Dukakis
involved the claim that psychiatric patients living in state hospitals or
at risk of being hospitalized in these facilities have a right to treatment
in community settings. The decree that emanated from the suit resulted over
a 5-year period in a tenfold increase in state expenditures for community
mental health services, a 48% decline in the state hospital census, and a
15% drop in the state hospital admission rate in the region of the state
targeted by the suit. Factors that facilitated this outcome are described,
as well as the dangers and limitations of exclusive reliance on the
judicial process to promote the development of community services.
