The author describes the effect that severe budget cuts accompanied by
guidelines stipulating that direct services be given priority over primary
preventive services had on a community mental health center in New York
City. He focuses his discussion on the effect these guidelines had on the
mental health care services provided the minority populations served by the
center. Before the budget cuts, 1 out of every 4 staff members was a
nonprofessional indigenous worker. After the cutback, 2 out of every 3 of
the people laid off were nonprofessionals. The author provides a number of
recommendations to help government agencies plan budget reductions without
sacrificing primary prevention efforts.
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