Overview of the Community Mental Health Centers Program from an evaluation perspective

The 18-year Community Mental Health Center (CMHC) Program of the National Institute of Mental Health (NIMH) was a complex and ambitious social experiment. This review identifies nine of the major goals of the program and examines available evaluative information on how well each was achieved. The most significant achievements of the program include increasing the quantity and range of public mental health services. Equality of access to services was also improved but all inequities were not removed. Problems continue to exist in funding services on the basis of need, in providing services to chronic clients, and in coordinating services. Prevention efforts suffered from uncertainties and perhaps overly optimistic expectations. The achievements of the program are currently threatened by third-party reimbursement mechanisms, the loss of federal leadership and oversight, and the loss of a community orientation in public mental health services. A great deal can be learned from the achievements and the shortfalls of the CMHC program that may be useful in state and federal mental health planning.