Muddling through mental health policies.

This study reports the process and outcome of a mental health policy change designed to relieve overcrowding in the 10 municipal adult psychiatric inpatient units in New York City. The authors describe the strategies used to achieve a limited change in admission policies and analyze the effect of this change on the municipal hospitals. Comparison of conditions before and after the policy change suggests its positive impact. Results are discussed in reference to the model of incrementalism in policy making, emphasizing the need for comprehensive rational planning, the training of mental health professionals in policy making, and further research on this important area of psychiatry.