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The downsizing of mental health facilities--a process known as "de-institutionalization" -- resulted from at least three factors. Court decisions in the 1970s established the patient's right to refuse treatment, which many exercised. Medical advances in drug therapy allowed many to leave traditional institutions, return to their community, and receive treatment through local centers. Additionally, limited funding forced hospitals to reduce patient population. When Missouri's 1982 mental health budget was cut by $3 million, Fulton was forced to discharge nearly one-half of its patients. Social workers attempted to place patients in nursing homes, group homes, foster care, or with family members. Limited community services meant many patients were cut adrift.
 Fulton State Hospital
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