Reform in a system of mental health services is the result of a variety
of forces that operate synergistically to bring about observed events. This
evolutionary process is most likely to yield substantial results through
multiple interventions over time rather than a single attempt at reform. A
process of change in the mental health service system in Arizona has been
evolving in response to the interaction of several key variables: a social
movement dedicated to reform, a planned design for change, and the use of
litigation. The author reviews each of these factors and assesses the
overall process of change within the state.
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