November 9, 1984
It is with great pleasure that I sign into law H.R. 6224, the Saint Elizabeths Hospital and District
of Columbia Mental Health Services Act. This legislation, which has been developed with the
participation of the administration and the District of Columbia government and was passed by
unanimous vote in both Houses of the Congress, will make Saint Elizabeths Hospital an integral
part of the District's mental health delivery system.
Since its establishment by the Congress in 1855, Saint Elizabeths Hospital has provided care to
military personnel and to District of Columbia residents. The hospital has played an historic role in
American psychiatry and continues to provide care, treatment, and rehabilitation services to
approximately 1,700 inpatients. Located on more than 300 acres, it includes programs for adults,
child and adolescent services, a forensic unit, an Hispanic unit, and an array of support programs
necessary to ensure quality care.
The patient population of Saint Elizabeths has undergone significant shifts. For almost 100 years,
most patients were Federal beneficiaries. Today, however, almost 90 percent of the inpatients and
virtually all of the 2,800 outpatients are residents of the District of Columbia.
The hospital has maintained accreditation in all of its programs since 1978, receiving full
accreditation by the Joint Commission on the Accreditation of Hospitals in 1980 as well as
commendation by that body for the quality of care provided.
Enactment of the District of Columbia Self-Government and Governmental Reorganization Act
provided impetus to the growing concern over the appropriateness of the Federal Government's
operating Saint Elizabeths primarily for the benefit of the District of Columbia.
The transfer that H.R. 6224 makes possible means that the hospital will be controlled and
supported at the local level. This will provide the people of the District of Columbia with an
effective mental health services delivery system and will be in keeping with the modern practice of
comprehensive programs for mental health care.
As provided by this legislation, the District of Columbia's plan for structuring and operating the
new system will be developed in close consultation with officials of Saint Elizabeths Hospital,
labor-management advisory groups, and professional and community groups in the District. In
addition, public hearings will be held and plans submitted to the Congress for review. Thus, there
are guarantees that the new unified system will provide a continuum of care with the full range of
services that do not currently exist in the District. The groundwork for a comprehensive
community-based system of mental health services is now in place.
Note: As enacted, H.R. 6224 is Public Law 98 - 621, approved November 8.