The answer to the question: 'by whom and by which factors is the future of the mental hospitals determined' is that the 'mental hospitals themselves are largely responsible for determining their future. The Government Authorities do not aim at discontinuing the mental hospitals, but they aim at reducing the size of those hospitals which are considered to be too large. The extent to which each hospital is able to satisfy the standerds which have currently been laid clown with regard to the admission and treatment of mental patients determines the future of these hospitals.
By means of quotations from scientific publications it is shown how psychiatrists attached to mental hospitals have for many years severely criticized their work and the position of their institutions in the whole system of mental health care, without sufficiently resulting in an adequate solution to the problems concerned. The necessity of providing intramural care for all mental patients in need of it has not yet been met.
Some of the factors which are conductive to determining the future of the mental hospitals are a reduction of the number of chronic patients in the hospita! by establishing half-way hostels, a clear delimitation of the duties assigned to the psychiatrist both inside and outside the institution, a multi-disciplinary team approach and co-operation with other services in the field of mental health care. On account of the way in which the question was formulated the author had to confine himself to the functioning of mental hospitals.