OBJECTIVE: Preliminary studies suggest that during the 1980s, spending
for community mental retardation services in the United States may have
grown much more rapidly than spending for community mental health. The
primary objective of this study was to test empirically the validity of
this thesis on a national basis. An additional objective was to determine
why such a distinction in community spending patterns might have evolved
nationally. METHOD: The study used states as the units of analysis and
employed a five-factor hierarchical regression to predict variance in
mental health and mental retardation spending. Factors were state size,
state wealth, degree of federal assistance, state civil rights activity,
and strength of consumer advocacy groups. Strong roles for the civil rights
and consumer advocacy factors were hypothesized. A collateral opinion
survey in the 10 states exhibiting the greatest within-state difference in
community mental health and mental retardation spending was also completed.
RESULTS: Community mental retardation spending grew nearly four times more
rapidly than community mental health spending in the 1980s. The consumer
advocacy and civil rights factors were strongly associated with spending
for community mental retardation services in the states, but these factors
did not predict spending for community mental health services. CONCLUSIONS:
Study recommendations included strengthening mental health family and
consumer advocacy groups in the states and promoting systematic exchange
between the mental health and mental retardation fields through joint state
planning initiatives, studies, and conferences. The need for Medicaid
reform is a unifying theme in both the mental health and mental retardation
fields.
Abstract Teaser