Management and programmatic constraints on community mental health services

While the special needs of the mentally ill are discussed in detail by society in general and by federal and state governments in particular, it is the local mental health services that must develop, integrate, and manage resources from federal and state levels and must deal with the constraints and strings attached to those resources. The author divides the constraints into several categories--clinical, administrative, fiscal, and legal--and offers suggestions for dealing with them, drawing in several cases on examples from the state of California. He feels that the control of mental health services must be kept in the hands of those who are knowledgeable about and have an investment in the delivery of those services.