Between 1960 and 1990, the population of Jamaica's single mental hospitalwas reducedby 58 percent, from more than 3,000 to less than 1,300. Services were reoriented from mental-hospitalbased custodial care to rebabilitative, community-based care with no appreciable increase in the mental health budget. Despite several changes in government over the past 30 years, continuity of public policy and fiscal suport has allowed ongoing development of the island's community mental health services. The national community mental health service, which bad a case load of about 14,000 patients in 1990, relies on specially trained psychiatric nurse practitioners who provide crisis management, medication management, and suppertivepsychotherapy; make home visits; and cary out treatment plans developed by the community psychiatrist. Community acceptance of mentally illpersons has been enbanced by public education programs and media coverage of advances in treatment.