In an era of scarce resources, public mental health systems have been
struggling to develop comprehensive community-based treatment and
rehabilitation systems for persons with mental illnesses. In New York State
the Community Mental Health Reinvestment Act, signed into law in December
1993, establishing the state government's commitment over a five-year
period to provide substantial new resources to fund the development of
community services. The basic principle behind the legislation, the most
significant reform in the state's mental health care financing in decades,
is that funds saved from downsizing the state hospital system through
closures and census reductions must be "reinvested" to create more
community-based services. The authors describe the political processes
leading to the act's passage, the obstacles overcome by legislative
negotiators, the act's provisions, and some implementation issues. Although
the act has received some criticism, it appears to be favorably regarded by
mental health advocates, recipients, providers, and administrators.
Abstract Teaser