Am J Psychiatry 1978; 135:1363-1365
Copyright © 1978 by American Psychiatric Association
Will community mental health survive in the 1980s?
SS Sharfstein
There are now 675 funded community mental health centers (CMHCs), covering
almost half the country. Many of these programs were funded in the social
optimism of the 1960s and now face a crisis of purpose and funding.
Additional requirements imposed by the 1975 amendments to the CMHC act are
not matched by additional fiscal resources. Programs are graduating from
the federal grant to find that other sources of funds, especially
third-party insurance funds, are not replacing the lost federal dollars.
There is evidence that CMHCs are changing from clinical/medical programs to
social programs; the numbers of persons seeking care who have diagnosable
mental illness and of psychiatrists and nurses relative to other staff are
decreasing. The issue is whether CMHCs as a national program are headed for
extinction or whether there will be new vitality for this program into the
1980s.
