The chapter first considers the contexts in which release decisions occur and the tensions experienced by mental health professionals who participate in such decisions. In the section on policy development, the author considers administrative issues in the development of hospital policies to guide release decision making. The next section deals with substantive matters related to such policies, including staffing, assessment, decision rules, and documentation. The final section considers issues in the implementation of release decisions. The chapter advises that public perceptions about the "criminally insane" have given rise to legal safeguards and procedures that limit mental health professionals' discretion in making discharge decisions. Both clinical considerations (the clients' mental health needs) and social and legal influences (protecting the public, avoiding malpractice claims) affect clinicians in discharging their duties. This chapter advises that these duties can best be fulfilled through the development and implementation of a well-conceived, structured plan that is subjected to both clinical and administrative review. 2 notes and 51 references