What Level of Government? Balancing the Interests of the State and the Local Community

The authors describe the cycles of reform that have characterized the evolution of the mental health services system. State and local governments predominated until the 1960s when the community mental health movement introduced the federal government into mental health care financing. The past decade has seen a return shift toward increased state and local control. The authors contend that local interests and innovations are supported best by local government, but central government is needed to maintain equity, protect the larger interests of society, and assure that the most disabled are served. (Summer 1995)