What level of government? Balancing the interests of the state and the local community

  • Howard H. Goldman
  • Richard G. Frank
  • Martin S. Gaynor


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.


Mental Health Health Service Local Government Mental Health Service Local Community 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Human Sciences Press, Inc. 1995

Authors and Affiliations

  • Howard H. Goldman
    • 1
  • Richard G. Frank
    • 2
  • Martin S. Gaynor
    • 3
  1. 1.Department of PsychiatryUniversity of Maryland School of MedicineBaltimore
  2. 2.Health Economics at Harvard Medical SchoolUSA
  3. 3.Heinz School of Public PolicyCarnegie-Mellon UniversityUSA

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