The delivery system of health care to Americans is in crisis. As costs continue to escalate, and as access to services deteriorates, an increasing number of individuals in need of physical and mental health care are experiencing difficulty accessing the necessary services. Changes in economic resources have resulted in quantitative shifts in mental health service delivery. A greater number of individuals seek mental health services as a result of the stress and anxiety created from a threatened or actual loss of financial stability. This increase in demand for service comes at a time when mental health programs are experiencing a decrease in resources which has resulted in reduced access to services. The emergency mental health service utilization patterns and client characteristics have changed during the same period of time that the overall mental health care delivery system has undergone transformation. However, the changes in mental health care have not necessarily evolved out of careful rational planning, but rather as a response to chaotic shifts in the mental health system at large. The purpose of this study was to gather data about access to these mental health outpatient services as they related to client diagnostic characteristics, system ability to provide the service needed, and ability of the service to meet the client's perceived need. The implications of the findings are clear. Access to services during a crisis was dependent upon system response, degree of psychopathology and a supportive environment. Any reform effort must include adequate crisis intervention and social services to meet the need of the changing population. Education for the general population and the professional would enhance understanding of the needs of the mentally ill and service availability.