How community mental health centers deal with cutbacks and competition

The results of a survey of 71 directors of community mental health centers in 15 states in 1982 and 1983 indicate that CMHCs made major changes in their services, staffing, sources of revenue, administration, and organization to cope with shrinking budgets, increased state regulation, impending prospective payment systems, and accelerating competition from private for-profit health care providers. Services offered by the CMHCs became less comprehensive and more oriented toward chronic and severely ill patients in 1982 and 1983, and entrepreneurial principles were employed to increase efficiency and attract new sources of revenue. These strategies have been successful, but the authors believe more long-range planning is necessary if CMHCs are to retain their distinctive place in the health care system.