Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Earth and Planetary Sciences, 1980. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND LINDGREN. / 3 maps and 2 ill. inserted in pocket inside back cover. / Bibliography: leaves 182-189. / by Peter Lorentz Guth. / Ph.D.

During the past several years, service delivery for mental health in Clark County has changed dramatically. The increase in funding from the federal government in the 1960's, the trend toward de-institutionalization, the emphasis on local control and administration, the proliferation of service agencies and types of programs, and the increase in demand for mental health services, has created the complex, multi-dimensional, multi-funded "system" called the mental health system. This increased complexity in the service delivery system has resulted in confusion among decision makers, consumers, providers of service, and the community at large. This confusion has manifested itself in a call for accountability. For local agencies receiving federal funds, accountability has been primarily an audit function. With respect to private agencies receiving private donations, accountability has been limited to budget presentations and rudimentary data collection, i.e., numbers served, client/staff ratios, program utilization by clients and the like. In general, no systematic, continous effort has been made to develop a full range of program evaluation accessible to decision makers, consumers, providers of service, and the community at large. In addition to the influence on the mental health system due to the increasing demands for accountability, elected officials are often becoming administrators of mental health funds. This increase in the span of control of elected officials has created greater visibility for their positions, thus bringing pressure from consumers as well as the community at large, to the mental health system. Recognizing the above trends in mental health care, the Clark County Commissioners contracted with the Health and Welfare Planning Council (HWPC) to investigate and provide information describing the nature of the mental health service delivery system in Clark County, and to report this information to the Commissioners and the community at large. In addition, the study attempts to evaluate the effectiveness of that system in the delivery of service.

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