For almost a century, the responsibility of providing care and treatment for our nation’s mentally ill has fallen to the state. The programs followed in the state hospitals and clinics of New York are here described by DR. PAUL H. HOCH, commissioner of mental hygiene for the state of New York since 1955. Dr. Hoch, who is professor of clinical psychiatry at Columbia, was born in Hungary and came to the United States in 1933 after serving as physician in charge of brain research at the University of Goettingen in Germany. In this country he has continued his research and practiced psychiatry.