Introduction Bruce Lubotsky Levin, Dr.P.H. Organizational downsizing, institutional closures, cost contain- ment, and fiscal crises have all become well-known issues to health and mental health professionals, often associated with "health care reform" initiatives or the result of renewed efforts at "managing" health care. Despite continuing efforts to restruc- ture treatment pathways to more ambulatory, community-based systems of care, health and mental health care delivery systems continue to struggle to become more efficient, coordinated, acces- sible, effective, and accountable to their consumers, providers, and funding sources. This special issue of Psychiatric Quarterly examines the con- tinuing efforts of downsizing and closing government funded psy- chiatric hospitals, as well as presents implementation issues related to the growing complexities involved in transitioning in- dividuals with mental disorders into community-based services and programs. The five articles included in this special issue al- low readers of Psychiatric Quarterly to become more familiar with the continuing metamorphasis in the structure and financing of health and mental health service delivery, which extends well beyond the confines of the continental United States. Addition- ally, these articles underscore the importance of planning for Bruce Lubotsky Levin, Dr.P.H., is Associate Professor, Department of Child and Family Studies, Florida Mental Health Psychiatric Quarterly Springer Journals


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Kluwer Academic Publishers-Plenum Publishers
Copyright © 1997 by Human Sciences Press, Inc.
Medicine & Public Health; Psychiatry; Public Health; Sociology, general
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