Salzer Mark S, Kaplan Katy, Atay Joanne
Department of Psychiatry, University of Pennsylvania School of Medicine, 3535 Market Street, 3rd Floor, Center for Mental Health Policy and Services Research, Philadelphia, PA 19104, USA.
Psychiatr Serv. 2006 Oct;57(10):1501-4. doi: 10.1176/ps.2006.57.10.1501.
The Supreme Court ruled in the 1999 Olmstead decision that "unjustified isolation" of individuals with disabilities in institutions is a violation of the Americans With Disabilities Act. This study examined the extent to which state psychiatric hospital census across the United States has changed significantly post-Olmstead.
Twenty years of national state hospital census data (1984-2003) were used to assess trends in the rate of declines from pre- to post-Olmstead periods. Data were organized into five four-year periods.
Steady declines in the hospital census nationally were found over all periods, with especially large decreases in the 1990s. However, when the percent change in hospital census in the two periods immediately before the Olmstead decision (between 1992-1995 and 1996-1999) were compared with the percent change in the periods immediately before and immediately after the Olmstead decision (between 1996-1999 and 2000-2003), an 8 percent decrease in the magnitude of decline was seen.
State hospital census continues to decline but has slowed significantly during the post-Olmstead period. More study of the factors associated with this decline is needed.
美国最高法院在1999年的奥姆斯特德裁决中判定，在机构中对残疾人进行“不合理隔离”违反了《美国残疾人法案》。本研究调查了奥姆斯特德裁决后美国各州精神病院普查人数发生显著变化的程度。
利用20年的全国州立医院普查数据（1984 - 2003年）来评估奥姆斯特德裁决前后期间下降率的趋势。数据被整理成五个四年期。
在所有时期全国医院普查人数都呈稳步下降，20世纪90年代下降幅度尤其大。然而，将奥姆斯特德裁决前紧挨着的两个时期（1992 - 1995年和1996 - 1999年）的医院普查人数百分比变化与奥姆斯特德裁决前和裁决后紧挨着的时期（1996 - 1999年和2000 - 2003年）的百分比变化进行比较时，下降幅度减少了8%。
州立医院普查人数持续下降，但在奥姆斯特德裁决后时期下降速度显著放缓。需要对与这种下降相关的因素进行更多研究。
