The elderly are generally acknowledged to be at high risk for developing mental illness. Yet most elderly individuals do not voluntarily ask for psychiatric services, however great their need. Moreover, they are reluctant to deal with even one member of the health care network, much less an array of social service providers in a number of service settings. Outreach, therefore, has become the most successful method for ensuring that services reach as many needy elderly persons as possible. The author discusses the development of outreach services beginning with the establishment of the community mental health movement in the 1960s. A number of issues important to program planning are discussed, as are some of the barriers to accessibility for aged clients. The author describes in detail the geriatric outreach program of the Massachusetts Mental Health Center and offers a case study of how outreach affected one aged couple.