From 1963 until 1981, community mental health centers (CMHCs) received categorical federal grant funding which enabled them to serve all members of their respective communities, regardless of their ability to pay, effectively creating a safety net for basic mental health services. The Omnibus Budget Reconciliation Act of 1981 redirected federal mental health funding away from the CMHCs and toward state mental health agencies. Under this arrangement, many CMHCs were expected to focus services on the needs of people with serious mental illness, often to the exclusion of other community members.

This project will study selected CMHCs serving rural communities. Our selections will be made on the basis of the presence or absence of county government in mental health financing and the presence or absence of managed behavioral healthcare contracts with the CMHC. Our research questions are as follows:

• 1) To what extent do CMHCs act as a mental health safety net? Where do uninsured community residents not covered by targeted funds receive mental health services?
• 2) Do CMHCs include in their missions a commitment to provide mental health services to all in the community who cannot afford to obtain them from private practitioners? and
• 3) How great is the variation among CMHCs in terms of the services they provide and the mission? To what extent is this variation explained by the role of county-level governance and/or managed care?

Publications

• The Role of Community Mental Health Centers as Rural Safety Net Providers
  Maine Rural Health Research Center
  Date: 05/2002
  This paper investigates the extent to which those organizations formerly designated as community mental health centers currently act as a rural mental health safety net, e.g., provide mental health services for free or at reduced charges to rural populations not covered by public or private insurance or grants.