Gold Award: Reducing the admissions of high-risk chronic patients to state institutions. Gulf Coast Regional Mental Health-Mental Retardation Center, Galveston, Texas.

A regional mental health-mental retardation center has reduced admissions to state institutions for the citizens of the Gulf Coast in Texas by 74 per cent over the past ten years. The center serves first those most in need, based on risk of institutionalization. Because it focuses on the clients' level of functioning rather than on diagnosis, retardation services are not separated from mental health services. There are outpatient programs, day treatment programs, and residential services. Treatment stress clients' acquisition of practical living skills. The center's innovative measures include the use of law enforcement officers who are trained to recognize and deal with mentally and emotionally disturbed clients and thus divert them from the criminal to the mental health system, a liaison team that assesses programs and support systems needed to bring institutionalized clients back to the community, and a local inpatient unit for clients in crisis that precludes commitment to state hospitals.