Weathering the cuts: a Delphi survey on surviving cutbacks in community mental health

Funding reductions and changes in the priorities of funding agencies have deeply affected community mental health programs. The burden of handling resource scarcity and shifting service priorities falls primarily on the community boards and staff of local agencies. We report a Delphi study in which an expert panel of 106 community mental health center executive directors and government officials generated a list of key strategies that local agencies could take to survive cutbacks. From an initial list suggested by the panel, a consensus was developed on the 15 most important and most feasible strategies. Discussion focuses on the implications and use of these strategies to promote the survival, even growth, of community-based mental health services during times of scarcity.