Impact of state mental health reform on patterns of service delivery.

Legislation enacted in 1988 in Ohio, aimed at redistributing funding from state hospitals to community support services and prioritizing the funding for treatment of individuals with severe mental disabilities (SMD), raises important questions from a service system perspective. To assess the impact of this reform legislation on Ohio's mental health service delivery system, cluster analyses of community mental health service data were conducted for five yearly samples of approximately 4,000 adults with SMD. An analysis of resulting service patterns demonstrated a decrease in service clusters comprised of individuals receiving little more than medication check-ups and an increase in clusters comprised of individuals receiving combinations of two or more services. Increases were found in most community mental health services; however, in each year, approximately 50% of the sample received few services of any kind, while approximately 10% of the sample received voluminous amounts of highly individualized services.