Abstract
Major policy and funding shifts have stimulated a series of changes in local mental health agencies. Policy and operations responsibilities have shifted to state mental health authorities; funding has moved from categorical programs to block grants; and different client groups are increasingly using community services. Local mental health agencies are expanding in certain services in response to high-priority needs targeted by states. Decreases are occurring in other services. Changes and reductions in staff and funding have resulted in a net decrease in volume of service provided. Further, most centers have narrowed the scope of services to a more limited program. The majority of agencies have chosen to remain aligned with state and local funding sources and priorities.
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