Dimensions of State Mental Health Policy

By Christopher G. Hudson; Arthur J. Cox | Go to book overview

6
Organization of State Mental Health Systems

Jessica Wolf

Public mental health systems have evolved in each state in response to political, demographic, and social forces. Responsibility for oversight and management of these mental health systems may be located primarily at the state level or vested in a combination of state, county, regional, local, or municipal levels. State-funded services for people with mental illness may be provided through a freestanding state department; mental health services may be one of a number of services under the authority of an umbrella human services agency; or a variety of combinations of services for people with mental illness, mental retardation, or substance abuse may be authorized through a single state agency. In addition, in some states, services are organized according to the age of recipients; children's mental health services may or may not be administered by the same bureau, division, or agency that is responsible for adult services.

From the perspective of both scholars and administrators, it is important to understand the consequences of different state mental health structural arrangements. Organization theory suggests some possible outcomes of particular structures. However, information that pinpoints the relationship between state administrative structure and the quality and effectiveness of service delivery is limited.

This chapter identifies theoretical issues relevant to the structure and organization of state mental health systems, describes some of the existing variety of state mental health structural arrangements, and briefly examines the organization and evolution of the mental health delivery system in Connecticut.

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