Objective: The Objective of this study was to analyse the characteristics and disabilities of patients becoming new longstay in a Mental Health District, to describe their needs and define the implications for service development. Method: All patients entering into the new longstay category between January 1st 1981 and December 31st 1991 were analysed. New longstay patients were defined as those remaining continuously in hospital for one year or longer. An accumulated inpatient group, still resident in the hospital, was examined using the Community Placement Questionnaire (CPQ), a standardised questionnaire useful for estimating needs for care and accommodation. Results: The analysis revealed a globally disabled patient group, largely intractable to treatment, the majority of whom required care and supervision in the longterm. An estimate of new longstay bed requirements, based on a stay of 1-5 years, was 11.3 per 100,000 for those under 65. The assessment team categorised current inpatients into four groups with regard to placement recommendations. An analysis of the CPQ results supported these recommendations which were: Specialist Unit for chronically disturbed Geriatrics, Geriatric Unit, High Support Staffed Hostel and Medium Support Staffed Hostel. Conclusions: Despite current service practice and community provision new longstay patients continue to accumulate. Given further specialist alternative community structures, it is suggested that these patient's requirements can be met without the need for continued longstay mental hospital beds.