The number of children in state mental institutions is inevitably increasing. At the same time it is increasingly difficult to generate enough staff adequate for caretaking, training, and supervision. There are no instant solutions to this problem; no hidden panaceas that might make it right soon. Hoping for some partial help, it makes sense to review the place of the pediatrician in the state mental hospital and the hospital's traditional sources for program design as well as staff training and supervision.
Such hospitals were designed for adults. In addition, they both benefit and suffer from a massive tradition and inertia.