The Central New York Psychiatric Center is fully accredited for treating adult psychiatric patients and staffed by a full complement of mental health professionals including psychiatrists, psychologists, a social worker, nurses, and activity therapists, with specially trained correctional officers assigned to the Center's satellite clinics at each of seven major maximum security facilities. Since it was established in 1977 the Center has had no suicides, escapes, or escape attempts. The rate of readmission for patients after a median stay of 12 weeks or less has been 27% in 26 months. The theoretical underpinnings for the treatment program at the Center include clearly defined methods for dealing with violence (e.g., chemotherapy, camisole, a high staff-patient ratio); a fusion of security and treatment objectives; an elaborate security design; and checks and balances in the involuntary commitment process. The factors which presumably contributed to the initial success of the organization in meeting its stated objectives are identified with special reference to the staffing and organization structure of the center (illustrated by a chart included in the text). The numerous problems involved in the institutional treatment of violent offenders are described, along with the solutions devised by the Center's management, with special emphasis on maintaining the concept of an open system within a closed facility. The right of patients to refuse treatment is clouded with ambiguities, but patient/staff conflicts in this area seldom occur. Five references and a general bibliography with 8 entries are appended.