Local mental health authorities and service system change: evidence from the Robert Wood Johnson program on chronic mental illness

Milbank Q. 1994;72(1):49-80.


The extent of change in the performance of local mental health authorities (LMHAs) and in the development of community support systems (CSSs) is assessed for nine demonstration cities that participated in the RWJF Program on Chronic Mental Illness and one comparison site. Parallel measures of LMHA and CSS performance were obtained from two data sources (key informant and interorganizational network surveys) conducted at each site at two times during the demonstration: 1989 and 1991. Findings indicate that the LMHAs were successfully implemented at most demonstration sites, but changes in the CSSs lagged behind LMHA performance levels. The amount of system change tended to be greater when estimated from network versus key informant data.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Chronic Disease / economics
  • Community Mental Health Services / economics
  • Community Mental Health Services / organization & administration*
  • Deinstitutionalization / organization & administration
  • Financing, Organized*
  • Foundations
  • Humans
  • Mental Disorders / economics
  • Mental Disorders / therapy
  • Pilot Projects
  • Program Evaluation*
  • United States