Community mental health: who is being served? What is being offered?

Policy changes in the 1980s have altered the financial status of community mental health centers. Directors have operated, in most cases, with fewer resources than in past decades. How have these reduced resources changed the service delivery system and the characteristics of clients being served? To address these questions, a research project including 69 mental health centers from 27 states was conducted in 1987. While most of the originally mandated community mental health services are still provided, consultation, education and prevention services have been cut back substantially or terminated. Revenue-producing programs and time efficient treatment methods are used more frequently. Despite a higher priority given to the chronic mentally ill, community mental health centers are not serving those without the ability to pay in the same numbers as they have in the past. Some thoughts regarding a modification of the community mental health model are offered.