Block granting disburses mental health funds largely at the discretion of state mental health authorities, and state priorities typically focus on the most severely ill persons. Rural centers may suffer because multipurpose programs responding to a wide range of community needs are excluded from the mental health service delivery concept. (JHZ)

The rural community mental health center tends to serve a large geographic area, have decentralized service delivery, require its professionals to function as generalists, and coordinate closely with other agencies. The last decade has seen an increasing strain placed on this pattern. As block grant and fee-for-service shifts resulting from the…