Mental Health Service Delivery Systems in the United States

The U.S. mental health service delivery system consists of a broad array of inpatient and ambulatory services operated under governmental, corporate, nonprofit, and entrepreneurial auspices. Granted this complex mixture of control patterns, a primary question to be addressed by this paper is the degree to which this set of services can be conceptualized as a system at any level of social organization beyond a single control point for a subset of services. This paper will also explore the utility of systems formulations, including cybernetic processes, for addressing the question of whether mental health services can be controlled and directed to such a degree that they act in concert across different control points. Reference will be made to exogenous systems, such as public and private reimbursement programs, that may influence control processes. Some directions for future research will also be explored.