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Use of community surveys in mental health planning.

IN 1963 the Federal Congress, taking "a bold now approach," enacted the Community Mental Health Centers Act, which was intended to pave the way for 2,000 new mental health center facilities by 1980. This act was followed in 1965 by Public Law 89-105 which, in turn, provided federal support for staffing such centers, as a stimulant to state investment. The underlying philosophy that justified this vast allocation was to "enable the patient to maintain himself in the community in a normal manner," and to model and modify mental health programs on the basis of research data so that they would develop and perfect both humane and effective services. It was expected that many patients who had previously been sent to remote, overcrowded hospitals could be treated on an outpatient basis directly in the community. It was also expected that many more persons should be able to seek and receive treatment, and that treatment would be sought at an earlier point in life. This paper investigates the extent to which these three objectives-reaching more people, reaching them earlier in life, and treating a larger proportion in the community rather than in the hospital-has been achieved in the course of establishing a community mental health center in an urban disadvantaged community. The data will also be studied for their possible value in anticipating future patterns of service utilization, particularly as these patterns may develop in connection with the imminent decentralization of the mental health centers into functional satellites. In a sense we are contending, then, that if we view our recent experience carefully through the eyes in back of our heads we should be better able to focus our forward vision and plan for more effective future community service. The center under examination is the Temple University Community Mental Health Center, active in North Philadelphia since 1966. This agency, an arm of the Department of Psychiatry of the Temple School of Medicine, first admitted patients during May, 1967. The data to be reviewed here have been collected from the 1960 federal census and from a series of surveys designed by one of the authors of this paper (EAG), including a center-engineered census of the catchment area and a study of mental health utilization patterns by community residents before the center was