I N 1897 Mark Twain told a reporter: “The report of my death has been grossly exaggerated.” The state mental hospital might well send the same message. In the past decade there have been repeated announcements and declarations that the mental hospital is outmoded and ineffective and will no longer have a place among mental health services. The arguments rest on assumptions that may prove true for a few mental hospitals, but certainly not for most. It is becoming clear that most hospitals are rising to the challenge of community service and are taking advantage of increasing possibilities for change to meet the needs for such service. To illustrate, I should like to report on recent developments in the two state mental hospitals in Cobrado. Some have argued that the large size of the mental hospital makes it unmanageable and therefore ineffective in responding to the needs of the people it should serve. In 1958 Colorado State Hospital, located in Pueblo, had about 6000 patients. In 1962 the hospital was divided into sections serving specific parts of the state’s population. That change, among other program developments, helped reduce the hospital’s population to its present 2300. The reorganization enabled the semi-autonomous units to respond to the needs of their catchment populations almost as if they were located in their midst. Traveling teams visit their catchment areas at frequent intervals, and the hospital has assigned permanent staff to live and work in the more distant areas. Another reason given in predicting the failure of the mental hospital is that it is so overcrowded and understaffed that it is beyond hope. Our experience in Colorado belies this. If a hospital is expected to operate on a per diem of $3, of course it will fail. But if the body politic is willing to support adequate staffs and facilities, overcrowding and understaffing do not occur. In 1958 some felt that Colorado State Hospital was beyond hope. But no one thinks so now. The support of the citizenry through its legislative and executive branches of government was the most important single element in beginning the changes that took place in Colorado. Any state willing to support its state hospital system can have effective hospitals. In 1961, while changes were taking place at Colorado State Hospital, the state opened its second hospital, the Fort Logan Mental Health Center in Denver. This center, unlike Colorado State Hospital, is in a large urban setting. It serves the one million people of metropolitan Denver, while Colorado State Hospital serves a largely rural and small-city population of one million. The challenge of a state hospital in a large urban setting is to find ways to integrate its services with the wide variety of existing and newly developing mental health facilities. Different and creative patterns of integration are emerging all over the country. Fort Logan presents just one example. There four patterns are developing: